Study Summary

Eight randomized controlled trials including 927 patients undergoing knee arthroplasty were included in this systematic review and meta-analysis comparing oral tranexamic acid versus intravenous tranexamic acid. Pooled outcomes of interest included postoperative hemoglobin levels, hemoglobin drop, hematocrit levels, intraoperative blood loss, transfusion rates, complications, operation time, and length of hospital stay. Overall, pooled analyses demonstrated no statistically significant differences between oral and intravenous TXA across most clinical outcomes, including hemoglobin measures, blood loss, transfusion rates, complications, operative duration, and hospital stay. One subgroup analysis suggested that postoperative intravenous TXA administration was associated with slightly longer operative time compared with oral TXA. Collectively, these findings suggest that oral TXA provides comparable efficacy and safety to intravenous TXA in knee arthroplasty and may represent a practical alternative route of administration.