Tranexamic acid in joint replacement : a randomized trial comparing intravenous oral and topical routes

Abstract

Our purpose is to compare intravenous, oral and topical routes of tranexamic acid in terms of reducing perioperative blood loss and blood transfusion rates in total knee and hip arthroplasty. In this prospective randomized comparative study, 57 patients undergoing primary knee or hip arthroplasty were assigned to receive intravenous, oral or topical tranexamic acid. Primary outcomes were blood loss at day 1 and day 3. The mean blood loss at day 1 was 954 ±356 mL in the intravenous group, 880 ±506 mL in the oral group and 754 ±382 mL in topical group with no statistically significant difference (p=0.15). The mean blood loss at day 3 was 1659 ±637 mL in the intravenous group, 1530 ±686 mL in the oral group and 1296 ±588 mL in topical group. With no statistically significant difference (p=0.22). None of the 3 routes was found to be superior in terms of reducing perioperative blood loss in joint replacement.