Topical versus intravenous tranexamic acid in total knee arthroplasty

J Arthroplasty. 2015 Mar;30(3):384-6. doi: 10.1016/j.arth.2014.10.007. Epub 2014 Oct 12.


The objective of this study is to compare the effectiveness of intravenous versus topical application of tranexamic acid in patients undergoing knee arthroplasty. All patients who underwent primary knee arthroplasty at our total joint center over a 12-month period were included in the study. One surgeon utilized 1 g of IV TXA at time of incision in all patients (n=373) except those with a documented history of venous thromboembolism (VTE). Two surgeons utilized a topical application of TXA for all patients without exception (n=198) in which the joint was injected after capsular closure with 3 g TXA/100 mL saline. The transfusion rate was 0% in the topical group vs. 2.4% in the IV group and this was statistically significant (P<0.05).

Keywords: blood management; complications; total knee arthroplasty; tranexamic acid; transfusion.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Intravenous
  • Administration, Topical
  • Aged
  • Antifibrinolytic Agents / administration & dosage*
  • Arthroplasty, Replacement, Knee*
  • Blood Loss, Surgical / prevention & control*
  • Blood Transfusion
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / prevention & control*
  • Postoperative Hemorrhage / therapy
  • Tranexamic Acid / administration & dosage*


  • Antifibrinolytic Agents
  • Tranexamic Acid