What is the role of tranexamic acid in arthroplasty, and what are common routes of administration?

• A. Increases bleeding; only oral
• B. Provides analgesia; topical
• C. Reduces infection risk; intravenously or topically
• D. Reduces perioperative blood loss; intravenously or topically

Answer: (D)

Tranexamic acid works as an antifibrinolytic, blocking the conversion of plasminogen to plasmin and thereby stabilizing clots. In arthroplasty, this helps reduce intraoperative and early postoperative bleeding, which lowers perioperative blood loss and the need for transfusions. The most common ways to administer it are intravenously or topically. IV dosing is typically given around the time of surgery, while topical use involves applying the drug directly in the surgical field or by irrigation. Oral dosing exists in some protocols but is less commonly used due to slower absorption and more variable levels.