Clinical Report: Comparison of Intravenous and Oral Tranexamic Acid Administration in Shoulder Arthroplasty

Overview

This study evaluates the effectiveness and safety of oral versus intravenous tranexamic acid (TXA) in patients undergoing shoulder arthroplasty using a large multicenter cohort.

Background

Total shoulder arthroplasty is increasingly performed, yet significant blood loss remains a clinical challenge, with transfusion rates reported between 7.4% and 43%. Tranexamic acid is widely used to mitigate perioperative bleeding, but concerns about intravenous administration persist.

Data Highlights

No numerical data provided in the source material.

Key Findings

• Tranexamic acid is an established agent for reducing blood loss in shoulder arthroplasty.
• IV TXA is the predominant administration route.
• Concerns regarding IV TXA include thromboembolic risk and logistical burdens.
• Data comparing oral and IV TXA in shoulder arthroplasty are limited.
• This study utilizes a large, real-world cohort to compare postoperative outcomes between the two routes.

Clinical Implications

Further research is warranted to confirm these outcomes and address existing concerns regarding IV TXA.

Conclusion

This study compares the effectiveness and safety of oral and IV tranexamic acid in shoulder arthroplasty.

Related Resources & Content

1. Archives of Orthopaedic and Trauma Surgery — Tranexamic acid in high-risk shoulder arthroplasty patients: safety across thromboembolic, cardiac, renal, and neurologic risk profiles
2. Archives of Orthopaedic and Trauma Surgery (Springer) — Tranexamic acid reduces transfusion requirements after pelvic osteotomy: a nationwide propensity score-matched analysis
3. Journal of Surgical Oncology — Tranexamic Acid in Lower Extremity Endoprosthetic Reconstruction for Oncologic Indications: A Retrospective Comparative Study of 617 Patients
4. Administration of Intravenous Tranexamic Acid During Surgery for Femoral Fragility Fractures Significantly Lowers Blood Transfusion Needs by 75%
5. Management of Glenohumeral Joint Osteoarthritis Evidence-Based Clinical Practice Guideline
6. Oral and intravenous tranexamic acid are equivalent at reducing blood loss following shoulder arthroplasty—A multicenter, double-blinded, randomized, placebo-controlled trial
7. Tranexamic acid utilization remains low in anatomical and reverse total shoulder arthroplasty despite decreased postoperative complications: A propensity-matched analysis
8. Management of Glenohumeral Joint Osteoarthritis Evidence-Based Clinical Practice Guideline
9. Oral and intravenous tranexamic acid are equivalent at reducing blood loss following shoulder arthroplasty—A multicenter, double-blinded, randomized, placebo-controlled trial - ScienceDirect
10. Tranexamic acid utilization remains low in anatomical and reverse total shoulder arthroplasty despite decreased postoperative complications: A propensity-matched analysis