What is the rationale for tranexamic acid protocols in arthroplasty?

• A. Maximize thromboembolic risk
• B. Rely on hemostasis only
• C. Maximize blood-sparing while minimizing thromboembolic risk
• D. Minimize bleeding and thromboembolism completely

Answer: (D)

TXA works by blocking the breakdown of clots, so it helps stabilize hemostasis during and after joint replacement. The rationale for using TXA protocols in arthroplasty is to minimize perioperative blood loss and the need for transfusion while keeping the risk of thromboembolic events as low as possible. In other words, the goal is to maximize blood-sparing benefits without meaningfully increasing clot-related complications. This approach recognizes that while bleeding can be reduced, and transfusion avoided, there is no way to guarantee zero bleeding or zero thromboembolism, so protocols are designed to balance efficacy with safety.