Venous thromboembolism and mortality associated with tranexamic acid use during total hip and knee arthroplasty

J Arthroplasty. 2015 Feb;30(2):272-6. doi: 10.1016/j.arth.2014.08.022. Epub 2014 Sep 6.


TKA and THA are associated with blood transfusion and risk for postoperative venothromboembolism (VTE). Reports show that tranexamic acid (TA) may be safe to use in high-risk orthopedic patients, but further data are needed to substantiate its use. All patients who underwent primary or revision TKA or THA in a five year period were retrospectively identified. In 13,262 elective TKA or THA procedures, neither the odds of VTE (OR=0.98; 95% CI 0.67-1.45; P=0.939) or adjusted odds of death (OR=0.26; 95% CI 0.04-1.80; P=0.171) were significant with TA administration. The major findings of this large, single center, retrospective cohort study show the odds of postoperative VTE and 30-day mortality were unchanged with TA administration.

Keywords: hip arthroplasty; knee arthroplasty; mortality; tranexamic acid; venothromboembolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antifibrinolytic Agents / therapeutic use*
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tranexamic Acid / therapeutic use*
  • Venous Thromboembolism / drug therapy*
  • Venous Thromboembolism / etiology


  • Antifibrinolytic Agents
  • Tranexamic Acid