2016 AAOS Annual Meeting: Tranexamic Acid in Total Hip Arthroplasty: Do Drug Formulation and Dosage Determine Efficacy and Safety?

19 randomized controlled trials (RCTs) with a total of 1,388 patients were included in this network meta-analysis. The object of this analysis was to determine the effectiveness of various tranexamic acid (TXA) formulations in total hip arthroplasty (THA) patients). Findings indicated more significant reduction in transfusion rate and blood loss with intravenous tranexamic acid, either as a low-dose or high-dose protocol, and topical tranexamic acid versus placebo. Oral tranexamic acid did not demonstrate any significant differences compared to placebo for blood loss or transfusion rate. All formulations of TXA demonstrated comparable risk of transfusion compared to one another. Similar results were found in all patient groups for risk of deep vein thrombosis (DVT) or pulmonary embolism (PE).