Efficacy and safety of multiple boluses of oral versus intravenous tranexamic acid at reducing blood loss after primary total knee arthroplasty without a tourniquet: A prospective randomized clinical trial

118 patients scheduled for total knee arthroplasty without a tourniquet and intravenous tranexamic acid administration prior to incision were randomized to three postoperative doses of either 2g oral tranexamic acid or 1g intravenous tranexamic acid. Patients were assessed primarily for drop in hemoglobin and hematocrit levels, as well as for secondary outcomes of total blood loss, hidden blood loss, transfusion rate, and incidence of venous thromboembolism. Results demonstrated no significant differences between groups in any outcome measure over the first 3 days postoperatively. Of note, no patient in either group required a transfusion, no patient developed pulmonary embolism, and a total of three cases of deep vein thrombosis were noted among the entire patient cohort.