Oral Versus IV TXA

• Status: Enrolling by invitation
• Trial end date: 2022-06-01
• Target enrollment: 0
• Participant gender: All

Summary

Tranexamic acid (TXA) is an antifibrinolytic medication used to reduce bleeding in a variety of medical settings. The use of TXA in total hip arthroplasty (THA) and total knee arthroplasty (TKA) has resulted in dramatic decreases in operative blood loss and transfusion rates, revolutionizing the field of arthroplasty. The use of TXA, now common, has made autologous blood donation programs largely obsolete. Additionally, it has made perioperative blood transfusion uncommon.

While AAOS guidelines suggest that all three available preparations of TXA (oral, IV, topical) are effective, preferred route of dosing varies by provider and institution. These preferences are based on habit, understanding of pharmacodynamics, and logistical issues regarding effective dosing. Oral TXA is the cheapest option, but some surgeons prefer IV dosing due to concerns regarding efficacy and controlled dosing.

In this study, we seek to compare the efficacy of a single pre-op oral dose of TXA to a single pre-op IV dose of TXA.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Hospital for Special Surgery, New York
• Treatments: Tranexamic Acid

Criteria

Inclusion Criteria:

• Patients undergoing total hip arthroplasty (THA) through a posterior approach

• Patients undergoing total knee arthroplasty (TKA)

• Patients between 18-80 years of age

Exclusion Criteria:

• Patients with >80 years of age

• Patients with a BMI over 40

• Patients undergoing general anesthesia

• Patients with a history of major ipsilateral joint surgery

• Patients on pre-operative anticoagulation or anti-platelet drugs (other than aspirin)

• Patients with a history of bleeding disorders

• Patients with platelets less than 100/nl

• Patients with new-onset/active atrial fibrillation

• Patients with a history of myocardial infarction in the past year

• Patients with a history of a stroke in the past year