The use of tranexamic acid in joint replacement surgery

Perioperative bleeding is a prevalent risk of elective joint replacement surgery that can lead to allogeneic blood transfusions, delayed discharge, and slowed physical therapy progress. Antifibrinolytics such as tranexamic acid (TXA) have been used in various surgical procedures to reduce bleeding; however, the use of TXA in orthopaedic surgery is not widespread. The purpose of this article is to determine whether the use of TXA in joint replacement surgery reduces total blood loss and lowers the need for allogeneic blood transfusions without adding additional surgical risk and cost. All reviewed meta analyses and systematic reviews analyzed did show a statistically significant reduction in total blood loss and reduction in the need for allogeneic blood transfusions. Therefore, researchers conclude that intravenous TXA use does decrease total blood loss and allogeneic blood transfusion needs. Thus, its use should be included in orthopaedic clinical practice guidelines due to its overall positive effect on outcomes.