TRANEXAMIC ACID IN ORTHOPAEDIC AND TRAUMA SURGERY: CURRENT EVIDENCE ON EFFICACY AND SAFETY

Abstract

Abstract. Tranexamic acid (TXA) has become a cornerstone of perioperative blood management. This review summarises the evidence on its efficacy and safety in trauma and orthopaedic surgery, including the CRASH-2 and CRASH-3 trials, meta-analyses and population-based studies in hip and knee arthroplasty, the 2018 multisociety clinical practice guidelines, and the POISE-3 trial in non-cardiac surgery. The data consistently show reduced blood loss and transfusion without a demonstrable increase in thromboembolic events, provided that the drug is given early and dosing is adjusted for renal function.