CORRInsights®: What is the Ideal Route of Administration of Tranexamic Acid in TKA? A Randomized Controlled Trial

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In their current study, Lee and colleagues determine the best route for administering tranexamic acid (TXA) for patients undergoing unilateral total knee replacement. The authors found that intraarticular administration (IA) by itself was as effective as combined IA and intravenous administration (IV) in reducing blood loss during the five postoperative days of observation. Although TXA has been shown to be effective in reducing blood loss [2], the ideal route of administration is still debated. The current study provides strong evidence that IA can be relied upon without the need for IV dosing.
The adoption of TXA as a blood-preserving tactic for total knee replacement is widely considered one of the important advances of the last decade. There is no question that TXA is effective in reducing blood loss and the need for transfusion following unilateral TKR. It also is considered safe. To date, there is no evidence that TXA increases the risk of any complications following total knee replacement. Finally, as confirmed in this study, there is strong evidence that IA, at the time of wound closure, is as effective as IV administration regardless of the dosage or timing of IV administration [1, 2].
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