Study Summary

Nine randomized controlled trials including 906 patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) were included in this systematic review and meta-analysis comparing multi-dose tranexamic acid (TXA) vs low-dose TXA. Pooled outcomes of interest included interleukin 6 (IL-6) at 24 and 48 hours, C-reactive protein (CRP) at 24 and 48 hours, length of stay, and thromboembolic events. Multi-dose TXA significantly reduced IL-6 at 24 hours and 48 hours, as well as CRP at 24 hours and 48 hours. Length of stay was also reduced, with no difference in thromboembolic events. These findings suggest multi-dose TXA provides greater anti-inflammatory effects and may enhance recovery without increasing thromboembolic risk.