2023 AAOS Annual Meeting: Comparing the Effectiveness of Oral versus Intravenous Tranexamic Acid in Primary Total Hip and Knee Arthroplasty: A Randomized Trial

Four hundred patients undergoing total knee arthroplasty (TKA; n=200) or total hip arthroplasty (THA; n=200) were randomized to receive either oral (n=200) versus intravenous (IV) tranexamic acid (TXA) (n=200) preoperatively. Patients were randomized using a 1:1 block size within each surgery group. The primary outcome of this trial was calculated blood loss (CBL) based on the hematocrit levels on the first postoperative day. Secondary outcomes of interest included the incidence of blood transfusions and complications. The results found that IV TXA was non-inferior to oral TXA when considering CBL in both surgery groups. Additionally, there were no differences in complication rates and length of stay between groups.