Effect of Topical and Intravenous Tranexamic Acid (TXA) on Thrombogenic Markers in Patients Undergoing Knee Replacement (TXA Knee)
Osteoarthritis, Knee
About this trial
This is an interventional treatment trial for Osteoarthritis, Knee focused on measuring Tranexamic Acid, Total Knee Arthroplasty, Total Knee Replacement
Eligibility Criteria
Inclusion Criteria:
- Patients undergoing primary unilateral total knee replacement with a participating surgeon
- Patients aged 18-80
Exclusion Criteria:
- All patients on steroid therapy regardless of dose, duration, or treatment or those requiring stress-dose steroids preoperatively
- Patients who will require postoperative use of Coumadin, Xarelto, or Plavix
- Use of non-steroidal anti-inflammatory drugs (NSAIDs) within 1 week of surgery
- Hypersensitivity to tranexamic acid
- Renal dysfunction (Creatinine clearance < 40 ml/min)
- Hepatic dysfunction (AST or ALT 2x upper limit of normal)
- Cardiac exclusions: coronary stent, history of myocardial infarction, positive stress test, atrial fibrillation, advanced coronary artery disease
- Advanced chronic obstructive pulmonary disease or advanced interstitial lung disease
- History of venous thromboembolism
- Hypercoagulability (e.g. antiphospholipid syndrome, genetic hypercoagulability with or without prior venous thromboembolism)
- History of stroke or transient ischemic attack
Sites / Locations
- Hospital for Special Surgery
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Intravenous tranexamic acid
Topical tranexamic acid
Patients will receive 1g tranexamic acid in 100mL solution intravenously in the operating room before inflation of the tourniquet. They will again receive the same IV solution in the post-anesthesia care unit, approximately 3 hours after the first solution was given. They will also receive a 75cc topical saline solution approximately 5 minutes before the tourniquet is released.
Patients will receive 3g tranexamic acid in 75mL solution topically in the operating room, approximately 5 minutes before the tourniquet is released. It will sit for 5 minutes before the solution is suctioned off by the surgeon. They will also receive 2 intravenous saline solutions: one in the operating room before inflation of the tourniquet, and one in the post-anesthesia care unit 3 hours after the first solution was given.