2026 AAOS Annual Meeting: What is the Best Method of Tranexamic Acid Administration in Extracapsular Hip Fractures? A Meta-analysis of Randomized Controlled Trials

Fifteen randomized controlled trials including 1619 patients with extracapsular hip fractures were included comparing tranexamic acid (TXA) administration versus control. Pooled outcomes included thromboembolic events, hematoma formation, transfusion rates, intraoperative blood loss, hidden blood loss, total blood loss, and hemoglobin drop. Overall, TXA significantly reduced transfusion rates, intraoperative blood loss, hidden blood loss, total blood loss, and hemoglobin drop without increasing thromboembolic or hematoma risks. These findings suggest that TXA, particularly when administered pre-operatively and as a 10 mg/kg bolus dose, may be an effective strategy to reduce perioperative blood loss in extracapsular hip fractures.