Administration of Perioperative Tranexamic Acid and Range of Motion After Total Shoulder Arthroplasty

Tranexamic Acid (TXA) has been associated with improved range of motion (ROM) in knee arthroplasty literature. The primary aim of this study is to assess the association between perioperative TXA in Total Shoulder Arthroplasty (TSA) and ROM up to 12-months postoperatively. The authors hypothesized there would be no difference between groups.

A single-institution retrospective cohort study of patients who underwent TSA between 2012-2022 was performed. Shoulder ROM was recorded pre-operatively, 3-months, 6-months, and 9-12-months postoperatively. Secondary outcomes including blood loss, transfusions, pain scores, and 90-day complications were collected. Statistical analyses were performed using STATA/SE.

A total of 551 TSAs were included. Pre-operative elevation was greater in the TXA group (90.1° vs 74.0°, p < .001). Elevation was significantly greater at 3, 6, and 9-12 months postoperatively in the TXA group (106.7°, 124.7°, 129.4°) compared to controls (95.0°, 109.3°, 117.1°) (p < .006). When propensity match analysis was performed to control for preoperative ROM, elevation was significantly greater at 6 months in the TXA group (p = .001).

Patients who received perioperative TXA had significantly improved elevation at 6-months following TSA compared to controls. The results suggest there may be a link between postoperative ROM and TXA in TSA.Level of Evidence: III.