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Trial registered on ANZCTR
Registration number
ACTRN12616000606482
Ethics application status
Approved
Date submitted
16/09/2014
Date registered
10/05/2016
Date last updated
21/04/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Tranexamic acid use in Total Hip Replacement - beyond blood loss: a randomised clinical trial of efficacy of tranexamic acid in improving postoperative inpatient functional outcomes following anterior total hip replacement.
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Scientific title
Comparing functional measures and blood loss with the of tranexamic acid in patients undergoing elective anterior total hip arthroplasty. A Randomized controlled trial.
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Secondary ID [1]
285345
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Nil
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Universal Trial Number (UTN)
U1111-1161-7799
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hip Osteoarthrtitis
293069
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Condition category
Condition code
Surgery
293344
293344
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0
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Other surgery
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Musculoskeletal
293439
293439
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will be randomly assigned to the control or experiment arm of the study by the pharmacist who will have a random sequence to dictate arm allocation. Those in the intervention arm will receive one 15mg per Kg intraoperative bolus of tranexamic acid intravenously at the time of induction of anaesthesia. With a further 15mg / kg bolus at 8hrs and 16 hours post procedure. The procedure duration is approximately 1 hour. This is the current protocol being employed by Orthopaedic surgeons and reflects the Australian Medical Handbook guidelines for dosing of tranexamic acid. The brand of tranexamic acid to be used will be Cyklokapron, currently the only product available in the Australian market.
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Intervention code [1]
290260
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Treatment: Drugs
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Comparator / control treatment
Those in the control arm will receive an injection of an equal volume of normal saline at induction of anesthesia. Patients in the control arm will receive a further bolus of normal saline at 8 hours and 16 hours after the initial normal saline bolus.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Primary outcome: Thigh swelling. Thigh swelling is assessed using the frustum method of volumetric measurement.
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Assessment method [1]
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Timepoint [1]
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Measured day 1, day 3 and 2 weeks post operatively.
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Primary outcome [2]
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Functional measure - timed up and go test. Measured by recording the time taken to complete the test.
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Assessment method [2]
293261
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Timepoint [2]
293261
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Measured day 1, day 3 and 2 weeks post operatively.
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Secondary outcome [1]
310509
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Secondary outcome: blood loss. This will be measured using observed blood loss intra-operatively as well as post operative haemoglobin levels.
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Assessment method [1]
310509
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Timepoint [1]
310509
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Measured intra-operatively, day 1, day 3 post op.
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Secondary outcome [2]
323564
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Analgesia will be recorded using a visual analogue pain score.
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Assessment method [2]
323564
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Timepoint [2]
323564
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Measured pre-operatively, day 1, day 3 and 2 weeks post op.
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Eligibility
Key inclusion criteria
Eligible participants will be adults aged 40 or above undergoing a total hip replacement in the private practice of Mr Phong Tran.
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Minimum age
40
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria are:
Contraindication to tranexamic acid use:
- Allergies or previously known drug reaction to tranexamic acid,
- Active intravascular clotting – DVT, PE or cerebral thrombosis
- Predisposition to thrombosis – previous documented DVT or PE
- Subarachnoid hemorrhage
Rheumatoid arthritis
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients will be recruited from the private rooms of Mr Phong Tran. Patients undergoing a primary total hip replacement will be invited to participate in the study. The parameters of the trial will be explained verbally and a consent form will be provided which will document the proposed aims, importance, risks and details of the intervention being studied. It will be re-enforced that the patient’s choice to participate in the trial will in no way affect their ability to receive the medical treatment which they are seeking. Allocation concealment will be carried out by the pharmacist preparing the medication. They will have a random number sequence which will be allocated to the patient's data sheet. They will allocate the patients to the arm of the trial. The randomisation sequence will not be available to the participating surgeon or anaesthetist. The patients will be correlated to the sequence at the time of completion of the trial for data analysis.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A random number sequence with an allocation of 1:1 will be generated using the STATA software package.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/02/2014
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Date of last participant enrolment
Anticipated
31/12/2016
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Actual
31/03/2016
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Date of last data collection
Anticipated
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Actual
30/04/2016
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Sample size
Target
100
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Accrual to date
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Final
105
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
2984
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St Vincents & Mercy Private Hospital - Mercy campus - East Melbourne
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Recruitment postcode(s) [1]
8706
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3002 - East Melbourne
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
289957
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Primary sponsor type
Individual
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Name
Dr Andrew Fraval
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Address
St Vincent's Private Hospital
East Melbourne
159 Grey Street, East Melbourne VIC 3002
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Country
Australia
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Secondary sponsor category [1]
288648
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None
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Name [1]
288648
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Address [1]
288648
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Country [1]
288648
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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St Vincent’s HREC-D
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Ethics committee address [1]
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41 Victoria Parade, Fitzroy VIC 3065
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
291674
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23/08/2013
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Approval date [1]
291674
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11/09/2013
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Ethics approval number [1]
291674
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HRECD - 107/13
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Summary
Brief summary
Does tranexamic acid use in the perioperative period reduce post operative thigh swelling, improve short term functional outcomes and reduce analgesia use following total hip replacement? The secondary question of whether tranexamic acid use decreases blood loss in the anterior approach to total hip replacements will also be addressed.
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Trial website
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Trial related presentations / publications
J Arthroplasty. 2017 May;32(5):1516-1519. doi: 10.1016/j.arth.2016.11.045. Epub 2016 Dec 8. OBTAIN A: Outcome Benefits of Tranexamic Acid in Hip Arthroplasty. A Randomized Double-Blinded Controlled Trial. Fraval A, Effeney P, Fiddelaers L, Smith B, Towell B, Tran P.
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Public notes
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Contacts
Principal investigator
Name
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Dr Andrew Fraval
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Address
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St Vincent's Private Hospital
East Melbourne
159 Grey Street, East Melbourne VIC 3002
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Country
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Australia
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Phone
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+ 61 423 155 386
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Andrew Fraval
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Address
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St Vincent's Private Hospital
East Melbourne
159 Grey Street, East Melbourne VIC 3002
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Country
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Australia
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Phone
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+ 61 423 155 386
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Fax
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Email
51467
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[email protected]
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Contact person for scientific queries
Name
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Andrew Fraval
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Address
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St Vincent's Private Hospital
East Melbourne
159 Grey Street, East Melbourne VIC 3002
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Country
51468
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Australia
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Phone
51468
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+ 61 423 155 386
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
OBTAIN E: outcome benefits of tranexamic acid in hip arthroplasty with enoxaparin: a randomised double-blinded controlled trial.
2019
https://dx.doi.org/10.1177/1120700018780125
N.B. These documents automatically identified may not have been verified by the study sponsor.
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