Effects of Oral Tranexamic Acid Following Total Knee Arthroplasty

Inclusion Criteria:

• All patients undergoing either manual or robotic primary total kneearthroplasty (TKA)

• Performed by participating Connecticut Joint Replacement Institute (CJRI) surgeons (Dr. Matthew Grosso, Dr. Robert McAllister, Dr. Chad Daniel, Dr. Eric Silverstein,Dr. Alex Dukas, Dr. Michael Joyce, Dr. Brett Wasserlauf).

• Male and female patient age 18-89

• Primary diagnosis of knee osteoarthritis

Exclusion Criteria:

• Revision TKA

• No exclusion based on gender

• Patients <18 and >89 years old

• Exclusion for IV oral tranexamic acid (TXA):

• TXA allergy - there are NO absolute contraindications for TXA use.

• History of stent placed within one year of surgery - patient will receivetopical TXA as an alternative.

• Exclusion for oral TXA: o Actively treated cancer or deep vein thrombosis (DVT)

• Chronic opioid use (opioid use within the 4 weeks prior to surgery)

• Allergies to nonsteroidal Anti-inflammatory drugs (NSAIDs) and acetaminophen

• Patients with clinically significant drug interactions

• Pre-existing neuropathy

• Current or previous venous thrombosis (DVT or venous stasis disease)

• Immuno-compromised secondary to medical condition

• Immune-suppressive medications, chemotherapy

• Pregnancy, breast feeding

• History of pain catastrophizing. Major depressive disorder

• History of suspected or known addiction to or abuse of illicit drug(s), prescriptionmedicine(s), or alcohol within the past 2 years.

• Currently on a neuroleptic agent [e.g., gabapentin, pregabalin (Lyrica), duloxetine (Cymbalta) etc.].

• Non-English speaking and reading patient populations

• Any clinically significant event or condition uncovered during the surgery (e.g.,excessive bleeding, acute sepsis) that, in the opinion of the investigator, rendersthe subject medically unstable or complicates the subject's post-operative course.