2026 AAOS Annual Meeting: Ascorbic Acid reduces the hidden blood loss after Total Hip Arthroplasty: Insights from a Randomized Controlled Trial

Ninety-five patients undergoing elective primary total hip arthroplasty (THA) were randomized to receive either perioperative intravenous ascorbic acid or placebo saline. The primary outcome of interest was total blood loss at 48 hours calculated from perioperative hemoglobin changes. Secondary outcomes of interest included hidden blood loss calculated using the Gross formula, hemoglobin decline, transfusion rate, postoperative anemia, pain measured by the Visual Analogue Scale (VAS), and functional outcomes measured by the Harris Hip Score (HHS). Outcomes related to blood loss were assessed within 48 hours after surgery, while functional outcomes were assessed at 6 months. Overall, the results of the study revealed that patients receiving ascorbic acid had significantly lower total blood loss, reduced hidden blood loss, and a smaller decline in hemoglobin compared with the placebo group, along with a lower transfusion rate. These findings suggest that perioperative intravenous ascorbic acid can reduce blood loss after THA.