Stroke Clinical Trial
To evaluate whether there is a difference in symptomatic thromboembolism events in the subset of patients with a history of, or risk factors for thromboembolic disease for topically applied tranexamic acid in total joint arthroplasty.
Tranexamic acid (TXA) has been used successfully to stop bleeding after dental procedures,
removal of tonsils, prostate surgery, heavy menstrual bleeding, and eye injuries, as well as
in patients with hemophilia. Intravenous TXA has also been shown to reduce blood loss, reduce
transfusion requirements, and decrease length of stay for patients undergoing total knee
arthroplasty and total hip arthroplasty. These benefits occur without increasing risks of
thromboembolism events such as pulmonary embolism, deep venous thrombosis, myocardial
infarctions, and cerebrovascular events in patients without history of, or risk factors for
thromboembolic disease. Topical TXA in TJA has also been demonstrated to show the above
benefits without any increase risks, as well as systemic absorption of the medication that is
below the effective therapeutic plasma concentration.
Preliminary retrospective studies has demonstrated that IV TXA to be safe and effective in
patients with risk factors for thromboembolic events and patients with American Society of
Anesthesiologists score III or IV.
Currently, there are no prospective studies on the use of either IV or topical TXA in these
higher risk patients. The goal of this study is to evaluate whether there is a difference in
symptomatic thromboembolism events in the subset of patients with a history of, or risk
factors for thromboembolic disease for topically applied TXA in total joint arthroplasty
(TJA).
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