Extended Oral Tranexamic Acid After Primary Total Knee Arthroplasty

Inclusion criteria

• Patients are candidates for elective primary total knee arthroplasty.
• Patients ≥18 years of age
• Patients have been medically evaluated and scheduled for primary total knee arthroplasty.
• Patients undergo primary total knee arthroplasty with spinal anesthesia
• Patients receive 1g IV TXA prior to incision and 1g IV TXA at closure
• Patients are prescribed aspirin 81mg twice a day for postoperative VTE prophylaxis

Exclusion criteria

• Patients with an allergy to TXA
• Patients taking a preoperative anticoagulant other than aspirin
• Patients with a history of VTE
• Patients with chronic kidney disease
• Patients with active malignancy
• Current use of combined hormonal contraception (pill, patch, or ring)
• eGFR <60 mL/min/1.73 m² or other clinically significant renal impairment
• Use of Factor IX complex concentrates, anti-inhibitor coagulant concentrates, or all-trans retinoic acid (tretinoin)
• Anticipated need for tissue plasminogen activator (tPA) during the 7-day dosing period
• Individuals who are pregnant or breastfeeding, have a positive pre operative pregnancy test, or plan pregnancy during the 7 day dosing window. Women of childbearing potential must have a negative pre operative pregnancy test and use effective contraception through postoperative day . Individuals who are on hormonal contraceptives or hormone replacement therapies, with the exception of Progestin, are to be excluded.