Many prospective studies and meta-analyses in major orthopedic surgery have shown that tranexamic acic (TA) reduces blood losses significantly without major complications. Notwithstanding , concern remains regarding the risk of thromboembolic events (TE), particularly when less aggressive thromboprophylaxis is used (aspirin, warfarin). This is a recent retrospective study in total hip and knee replacement that compares the incidence of TEs in patients having received TA and one of three types of thromboembolic prophylaxis regimens (aspirin, warfarin and dalteparin). Despite the low level of evidence of this study, very few TE events occured in lower limb arthroplasty with TXA and no difference between the three regimens was detected. However, it must be taken into account that patients at high risk of TE events were normally excluded.

– Elvira Bisbe