Topical and Intravenous Tranexamic Acid Are Equivalent in Decreasing Blood Loss in Total Shoulder Arthroplasty

Abstract

Introduction: Tranexamic acid (TXA) has been shown to be an effective modality to decrease blood loss in total shoulder arthroplasty (TSA). However, the most effective method of TXA administration remains controversial. The purpose of this study was to directly compare the use intravenous and topical TXA to determine which regimen was more effective in improving postoperative hemoglobin (Hb), transfusion rates, and patient outcomes after primary TSA. Methods: We conducted a retrospective review of 3 sequential cohorts of patients undergoing primary TSA with no TXA, intravenous TXA, or topical TXA. Postoperative data collection included daily Hb levels (g/dL), transfusions, thromboem- bolic events, length of stay, and discharge disposition. One-way analysis of variance was used to compare data between the 3 groups with post hoc Tukey honestly significant difference test for differences between pairs. Results: Average change in Hb was 2.36 g/dL in the IV TXA group and 2.27 g/dL in the Topical TXA group which was not statistically significant (P¼.69). Average change in Hb in the control group was 3.27 g/dL which was significant when compared to both TXA groups (P