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.