Abstract
A theoretical drawback of the use of antifibrinolytics in total joint arthroplasty (TJA), and tranexamic acid (TXA) specifically, has been the concern regarding an increase in venous thromboembolism (VTE). This has probably been the single-most important factor affecting the slow uptake and usage of this drug, despite the large amount of published literature demonstrating efficacy and safety going back to the late 1990s1,2. A number of early studies were published mainly in the European anesthesia literature, and as a result, received little readership among North American orthopaedic surgeons. Over the next 10 years, numerous attempts to limit postoperative transfusions following TJA, such as preoperative administration of erythropoietin, preoperative autologous donation for postoperative transfusion, intraoperative blood salvage, and postoperative reinfusion, failed to result in a substantial decrease in the transfusion rate. In the mid 2000s, …
Published Version
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