Tranexamic acid in orthopedic surgery

Abstract

Perioperative bleeding may require blood transfusions, which are sometimes not without complications and risks, with the subsequent increase in health care costs. Among other prevention methods, treatment with tranexamic acid (ATX) has shown to be effective in reducing surgical blood loss, especially in the immediate postoperative period. In this regard, studies evaluating ATX in orthopedic surgery show that it is effective and safe when administered intravenously or intra-articularly. The usual evaluated intravenous doses range between 10mg/kg and 20mg/kg or a fixed dose of 1–2g; while intra-articularly, it varies between 250mg and 3g. ATX, as an anti-fibrinolytic, has a potential thrombotic effect; thus it is contraindicated in those patients at risk or with a history of thrombosis. Its topical administration may be safer, but studies are needed to confirm this.