Supercapsular percutaneously assisted total hip approach combined with local and intravenous tranexamic acid reduces perioperative hidden blood loss in hemiarthroplasty

• SuperPATH approach significantly reduces perioperative total and hidden blood loss compared to posterolateral approach in hip hemiarthroplasty for elderly unstable femoral neck fractures. • Combined local and intravenous tranexamic acid effectively reduces perioperative blood loss in both SuperPATH and posterolateral approaches. • The use of tranexamic acid does not increase the risk of lower extremity venous thrombosis. • SuperPATH approach offers a minimally invasive alternative that may improve postoperative recovery in elderly patients.