Evidence map›Paper›PMID 36526484›Full record

Trial reportBritish journal of anaesthesia2023

Effectiveness of oral versus intravenous tranexamic acid in primary total hip and knee arthroplasty: a randomised, non-inferiority trial.

Christopher J DeFrancesco, Julia F Reichel, Ejiro Gbaje, Marko Popovic, Carrie Freeman, Marisa Wong, Danya DeMeo, Jiabin Liu, Alejandro Gonzalez Della Valle, Amar Ranawat and 20 more

Erratum issued Registry-linked trialOpen access · greenAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of anaesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07614087 (A Prospective Randomized Controlled Trial Comparing Plasma Concentrations of Intraosseous and Intravenous Tranexamic Acid in Patients Undergoing Joint Arthroplasty), which is not on this map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 pooled it
6.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07614087 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

A Prospective Randomized Controlled Trial Comparing Plasma Concentrations of Intraosseous and Intravenous Tranexamic Acid in Patients Undergoing Joint Arthroplasty

TypeinterventionalSponsorHua LuoRan2026 to 2026Enrolled80ConditionsOsteoarthritisArmsTranexamic Acid
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
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  9. Intravenous versus oral tranexamic acid in shoulder arthroplasty.Archives of orthopaedic and trauma surgery · 2026
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  10. Review
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  17. One Dose Versus Two Doses of Intravenous Tranexamic Acid in Revision Total Joint Arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors at 2 institutions in 1 country.

Christopher J DeFrancescoDepartment of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Julia F ReichelDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
Ejiro GbajeDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
Marko PopovicDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
Carrie FreemanDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
Marisa WongDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
Danya DeMeoDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
Jiabin LiuDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Alejandro Gonzalez Della ValleDepartment of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Amar RanawatDepartment of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Michael CrossOrthoIndy Hospital, Indianapolis, IN, USA.
Peter K SculcoDepartment of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Stephen HaskinsDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
David KimDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Daniel MaaloufDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Meghan KirkseyDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Kethy Jules-ElyseeDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Ellen M SoffinDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Kanupriya KumarDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Jonathan BeatheDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Mark FiggieDepartment of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Allan InglisDepartment of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Sean GarvinDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Michael AlexiadesDepartment of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Kathryn DelPizzoDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Linda A RussellDepartment of Rheumatology, Hospital for Special Surgery, New York, NY, USA.
Alexandra SiderisDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
Jawad SalehPharmacy Department, Hospital for Special Surgery, New York, NY, USA.
Haoyan ZhongDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA.
Stavros G MemtsoudisDepartment of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA; Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA. Electronic address: memtsoudiss@hss.edu.
Hospital for Special Surgery · USIndiana Orthopaedic Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranexamic acid (TXA) reduces rates of blood transfusion for total hip arthroplasty (THA) and total knee arthroplasty (TKA). Although the use of oral TXA rather than intravenous (i.v.) TXA might improve safety and reduce cost, it is not clear whether oral administration is as effective.

methodsThis noninferiority trial randomly assigned consecutive patients undergoing primary THA or TKA under neuraxial anaesthesia to either one preoperative dose of oral TXA or one preoperative dose of i.v. TXA. The primary outcome was calculated blood loss on postoperative day 1. Secondary outcomes were transfusions and complications within 30 days of surgery.

resultsFour hundred participants were randomised (200 THA and 200 TKA). The final analysis included 196 THA patients (98 oral, 98 i.v.) and 191 TKA patients (93 oral, 98 i.v.). Oral TXA was non-inferior to i.v. TXA in terms of calculated blood loss for both THA (effect size=-18.2 ml; 95% confidence interval [CI], -113 to 76.3; P<0.001) and TKA (effect size=-79.7 ml; 95% CI, -178.9 to 19.6; P<0.001). One patient in the i.v. TXA group received a postoperative transfusion. Complication rates were similar between the two groups (5/191 [2.6%] oral vs 5/196 [2.6%] i.v.; P=1.00).

conclusionsOral TXA can be administered in the preoperative setting before THA or TKA and performs similarly to i.v. TXA with respect to blood loss and transfusion rates. Switching from i.v. to oral TXA in this setting has the potential to improve patient safety and decrease costs.

Indexed as

Antifibrinolytic AgentsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeTranexamic AcidAdministration, IntravenousBlood Loss, SurgicalHumansAntifibrinolytic AgentsTranexamic Acidbleedingblood losscomplicationscost effectivenesstotal hip arthroplastytotal knee arthroplastytranexamic acidtransfusion

Identifiers

PMID36526484
PMCPMC9900725
OpenAlexW4311453698

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.