Efficacy and safety of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials

Total knee arthroplasty (TKA) often leads to substantial perioperative blood loss and postoperative hemoglobin decline, frequently requiring allogeneic transfusions. Tranexamic acid (TXA) effectively reduces bleeding, but debate persists regarding whether topical or intravenous (IV) administration provides superior clinical outcomes.This systematic review and meta-analysis evaluated the efficacy and safety of topical versus IV TXA in primary TKA using pooled data from randomized controlled trials (RCTs).