A randomized comparative study of topical versus intravenous tranexamic acid administration in enhanced recovery after surgery (ERAS) total knee replacement

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90 patients scheduled for total knee arthroplasty were randomized to one of three groups; one group was administered 1g of tranexamic acid intravenously; one group was administered 1g of tranexamic acid topically; one group underwent surgery without tranexamic acid administration. Calculated blood loss, the incidence of transfusion, and complications, which included venous thromboembolic events were assessed. Results demonstrated significantly lower blood loss and transfusion requirement in both the IV TXA group and the topical TXA group compared to the control group. No incidents of venous thromboembolic complications were recorded.