Topical and intravenous tranexamic acid reduce blood loss compared to routine hemostasis in total knee arthroplasty: a multicenter, randomized, controlled trial

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150 patients undergoing primary total knee arthroplasty (TKA) were randomized to receive 1 g of topical tranexamic acid (TXA), 2 g of intravenous TXA, or routine hemostasis. The purpose of the study was to determine which TXA administration modality more effectively reduced total blood loss 24 post-surgery and the need for subsequent blood transfusions. Findings indicated that although a significant reduction in 24h postoperative blood loss and need for blood transfusion was seen with tranexamic acid administration, no differences were seen between topical and intravenous administration techniques.