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Use of intravenous (IV) and topical tranexamic acid (TXA) in patients undergoing total knee arthroplasty (TKA) are both effective in reducing perioperative bleeding, according to a study published in the June 20 issue of Journal of Bone & Joint Surgery. 

Researchers randomized 640 patients who underwent unilateral TKA for osteoarthritis at two large academic centers to receive 1 g of IV TXA before tourniquet application and 1 g at closure, or 3 g of TXA diluted in 45 mL of saline and topically applied following cementation. Researchers found that blood loss and drain output were significantly greater in patients who received topical TXA compared to those who received IV TXA, although they said these differences may not be clinically important. Rates of transfusion and thrombotic events were not significant in either group. Read the article...