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CompletedNCT05357079Updated Apr 1, 2025

Impact of Topical Tranexamic Acid on Pre- and Post-operative Hemoglobin/Hematocrit

An Early Phase 1 interventional study of Tranexamic Acid and Normal saline in Fracture of Posterior Wall of Acetabulum, sponsored by University of Cincinnati. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-04-01.

Sponsored by University of Cincinnati · Early Phase 1, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Aug 2024, 2 years 1 month ago, and no results have been posted to the registry.
  • Registered 3 years 10 months after the study started (first participant enrolled Aug 2017, registered Jul 2021).
Phase
Early Phase 1
Study type
Interventional
Enrollment
94
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This multi-center, prospective study will evaluate the use of topical tranexamic acid (TXA - Cyklokapron; Pfizer, New York, NY) on pre-operative and post-operative hemoglobin (Hb)/hematocrit (Hct) in patients undergoing operative repair of isolated posterior wall (PW) acetabular fractures.

Read the detailed description

In this prospective, randomized, double-blinded, multi-center study comparing topical TXA with placebo, investigators will determine whether topical TXA utilization in isolated PW acetabular surgery has beneficial or detrimental effects.

In order to evaluate the delta between pre-operative and post-operative hemoglobin (blood loss parameters) in patients with isolated PW acetabular fractures that were treated with topical TXA or a placebo, investigators will prospectively enroll all eligible patients with the diagnosis of a closed, isolated, PW acetabular fracture that requires surgical fixation. Isolated PW fractures have been chosen to reduce confounding variables, particularly those associated with more complex fracture patterns including longer surgery duration and blood loss.

Each subject will have a pre-operative Hb and Hct drawn on the morning of surgery to establish a baseline level. Prior to surgery, subjects will be computer-randomized by pharmacy to one of two groups: a topical TXA group and a control group. The topical TXA group will be treated with 2 gm/100 ml of normal saline, while the control group will be treated with a placebo (normal saline) in a similar fashion to the TXA experimental group.

The surgeon and the operative team will be blinded as to whether the patient receives TXA or placebo.

Intraoperative transfusion requirements and estimated blood loss (EBL) will be recorded for every patient.

Hemoglobin and hematocrit values will be obtained on postoperative day one and two with routine morning blood draws (typically 5 am-9 am). Post-operative transfusion requirements prior to discharge will be recorded. All patients will have standard low molecular weight heparin DVT prophylaxis for four weeks post-operatively.

Prospectively demographic data will be collected. Injury and treatment data collected will include date of injury, mechanism of injury, laterality of injury, medical co-morbidities, associated injuries, date of surgery, operative time, estimated operative blood loss (EBL) from both anesthesia and operative surgeon, calculated operative blood loss, as well as hemoglobin/hematocrit as described, and blood transfusions.

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Conditions studied

  • Fracture of Posterior Wall of Acetabulum

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03

In context

Fractures, Bone

2,261 studies on the registry are indexed under Fractures, Bone; 325 are open to participants now.

This study's enrollment of 94 is above the median of 69 across 1,482 interventional studies indexed under Fractures, Bone.

Browse Fractures, Bone studies →

Lead sponsor

University of Cincinnati is the lead sponsor of 314 studies on the registry; 43 are open to participants now.

Of its 22 completed or terminated interventional studies of FDA-regulated products, 15 (68%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Patients with an isolated, closed, posterior wall acetabular fracture managed surgically within 7 days of injury. Upper extremity fractures that are non-operative and have no impact on weight-bearing status will be included.
  2. Patients must be skeletally mature.

Exclusion criteria

Exclusion Criteria:

  1. Patients are not skeletally mature.
  2. Patients with any concomitant lower extremity, pelvis, or spine injuries.
  3. Patient admitted as a polytrauma patient to the trauma service due to injury to an internal organ (head, chest, or abdomen).
  4. Patient has an unidentified source of hemorrhage other than acetabular fracture.
  5. Patient requires surgery for treatment of concomitant injuries.
  6. Patient requires multiple surgeries.
  7. Patient has pre-existing thrombus prior to surgery.
  8. Patient with a history of prior pulmonary embolus or other thromboembolic disease.
  9. Patient with a known bleeding disorder.
  10. Patient with a history of renal insufficiency.
  11. Patient who is unable to give consent or is unconscious.
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Study design

Phase
Early Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Investigator)
Enrollment
94 participants (actual)

Study arms

  • Experimental
    Topical TXA Treatment

    2 gm TXA/100 ml of normal saline

    Drug: Tranexamic Acid

  • Placebo comparator
    No Topical Treatment

    Normal saline

    Drug: Normal saline

Interventions

  • DrugTranexamic Acid

    Topical application

    Also known as: Cyklokapron, Pfizer

  • DrugNormal saline

    Topical application

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What researchers measure

Primary outcomes

  1. Hemoglobin (Hb)

    Hemoglobin (Hb) results

    Time frame: Postoperative Day 2

  2. Hematocrit (Hct)

    Hematocrit (Hct) results

    Time frame: Postoperative Day 2

07

Study locations

1 site
  • University of Cincinnati College of Medicine
    Cincinnati, Ohio 45267, United States
08

References and documents

Publications

  • Magnussen RA, Tressler MA, Obremskey WT, Kregor PJ. Predicting blood loss in isolated pelvic and acetabular high-energy trauma. J Orthop Trauma. 2007 Oct;21(9):603-7. doi: 10.1097/BOT.0b013e3181599c27. PubMed 17921834 ↗
  • Lemaire R. Strategies for blood management in orthopaedic and trauma surgery. J Bone Joint Surg Br. 2008 Sep;90(9):1128-36. doi: 10.1302/0301-620X.90B9.21115. PubMed 18757950 ↗
  • Hiippala ST, Strid LJ, Wennerstrand MI, Arvela JV, Niemela HM, Mantyla SK, Kuisma RP, Ylinen JE. Tranexamic acid radically decreases blood loss and transfusions associated with total knee arthroplasty. Anesth Analg. 1997 Apr;84(4):839-44. doi: 10.1097/00000539-199704000-00026. PubMed 9085968 ↗
  • Yamasaki S, Masuhara K, Fuji T. Tranexamic acid reduces postoperative blood loss in cementless total hip arthroplasty. J Bone Joint Surg Am. 2005 Apr;87(4):766-70. doi: 10.2106/JBJS.D.02046. PubMed 15805205 ↗
  • Ralley FE, Berta D, Binns V, Howard J, Naudie DD. One intraoperative dose of tranexamic Acid for patients having primary hip or knee arthroplasty. Clin Orthop Relat Res. 2010 Jul;468(7):1905-11. doi: 10.1007/s11999-009-1217-8. Epub 2010 Jan 9. PubMed 20063079 ↗
  • Phillips SJ, Chavan R, Porter ML, Kay PR, Hodgkinson JP, Purbach B, Reddick AH, Frayne JM. Does salvage and tranexamic acid reduce the need for blood transfusion in revision hip surgery? J Bone Joint Surg Br. 2006 Sep;88(9):1141-2. doi: 10.1302/0301-620X.88B9.17605. PubMed 16943461 ↗
  • Johansson T, Pettersson LG, Lisander B. Tranexamic acid in total hip arthroplasty saves blood and money: a randomized, double-blind study in 100 patients. Acta Orthop. 2005 Jun;76(3):314-9. PubMed 16156456 ↗
  • Kelley TC, Tucker KK, Adams MJ, Dalury DF. Use of tranexamic acid results in decreased blood loss and decreased transfusions in patients undergoing staged bilateral total knee arthroplasty. Transfusion. 2014 Jan;54(1):26-30. doi: 10.1111/trf.12167. Epub 2013 Mar 22. PubMed 23521109 ↗
  • Piggott RP, Leonard M. Is there a role for antifibrinolytics in pelvic and acetabular fracture surgery? Ir J Med Sci. 2016 Feb;185(1):29-34. doi: 10.1007/s11845-015-1375-5. Epub 2015 Nov 11. PubMed 26560109 ↗
  • Ho KM, Ismail H. Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty: a meta-analysis. Anaesth Intensive Care. 2003 Oct;31(5):529-37. doi: 10.1177/0310057X0303100507. PubMed 14601276 ↗
  • CRASH-2 trial collaborators; Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejia-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. doi: 10.1016/S0140-6736(10)60835-5. Epub 2010 Jun 14. PubMed 20554319 ↗
  • Zufferey PJ, Miquet M, Quenet S, Martin P, Adam P, Albaladejo P, Mismetti P, Molliex S; tranexamic acid in hip-fracture surgery (THIF) study. Tranexamic acid in hip fracture surgery: a randomized controlled trial. Br J Anaesth. 2010 Jan;104(1):23-30. doi: 10.1093/bja/aep314. PubMed 19926634 ↗
  • Wei W, Wei B. Comparison of topical and intravenous tranexamic acid on blood loss and transfusion rates in total hip arthroplasty. J Arthroplasty. 2014 Nov;29(11):2113-6. doi: 10.1016/j.arth.2014.07.019. Epub 2014 Jul 30. PubMed 25155138 ↗
  • Patel JN, Spanyer JM, Smith LS, Huang J, Yakkanti MR, Malkani AL. Comparison of intravenous versus topical tranexamic acid in total knee arthroplasty: a prospective randomized study. J Arthroplasty. 2014 Aug;29(8):1528-31. doi: 10.1016/j.arth.2014.03.011. Epub 2014 Mar 21. PubMed 24768543 ↗
  • Dailey SK, Archdeacon MT. Open reduction and internal fixation of acetabulum fractures: does timing of surgery affect blood loss and OR time? J Orthop Trauma. 2014 Sep;28(9):497-501. doi: 10.1097/BOT.0000000000000153. PubMed 24824098 ↗
  • Furey AJ, Karp J, O'Toole RV. Does early fixation of posterior wall acetabular fractures lead to increased blood loss? J Orthop Trauma. 2013 Jan;27(1):2-5. doi: 10.1097/BOT.0b013e31824d96de. PubMed 22495528 ↗
  • Lisander B, Ivarsson I, Jacobsson SA. Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery. Acta Anaesthesiol Scand. 1998 Jul;42(6):707-12. doi: 10.1111/j.1399-6576.1998.tb05305.x. PubMed 9689278 ↗
  • Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults. Surgery. 1962 Feb;51(2):224-32. No abstract available. PubMed 21936146 ↗
  • Tornetta P 3rd. Non-operative management of acetabular fractures. The use of dynamic stress views. J Bone Joint Surg Br. 1999 Jan;81(1):67-70. doi: 10.1302/0301-620x.81b1.8805. PubMed 10068006 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 1, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05357079
Lead sponsor
University of Cincinnati
Collaborators
Foundation for Orthopedic Trauma
Responsible party
Michael Archdeacon (Professor & Chair, University of Cincinnati) — Principal investigator
First posted
May 2, 2022
Start date
Aug 25, 2017
Primary completion
Aug 30, 2024
Completion
Dec 2, 2024
Last update
Apr 1, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Dec 2024. You cannot join it, but the record below documents what was studied.

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