Does Intravenous or Intraarticular Tranexamic Acid (TXA) Reduce Joint Bleeding Following Arthroscopic Anterior Cruciate Ligament (ACL) Reconstruction and Arthroscopic Meniscectomy? Can Intraarticular Use be Harmful to Chondrocytes?

Document Type : EDITORIAL


Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain


Arthroscopic knee surgery to perform partial meniscectomy and anterior cruciate ligament (ACL) reconstruction is frequent and effective, although a possible complication is postoperative intra-articular bleeding. When this complication occurs, in addition to the associated pain, the patient usually requires an arthrocentesis to avoid loss of joint mobility. Sometimes this problem ends up associated with a poor result of surgery due to loss of knee mobility. Therefore, recently, the use of tranaexamic acid (TXA) has been considered in order to reduce postoperative bleeding and its potential associated complications.


1. Karaaslan F, Karao─člu S, Yurdakul E. Reducing
intra-articular hemarthrosis after arthroscopic
anterior cruciate ligament reconstruction by the
administration of intravenous tranexamic acid: a
prospective, randomized controlled trial. Am J Sports
Med. 2015; 43(11):2720-6.
2. Felli L, Revello S, Burastero G, Gatto P, Carletti A,
Formica M, Alessio-Mazzola M. Single intravenous
administration of tranexamic acid in anterior cruciate
ligament reconstruction to reduce postoperative
hemarthrosis and increase functional outcomes
in the early phase of postoperative rehabilitation:
a randomized controlled trial. Arthroscopy. 2019;
3. Chiang ER, Chen KH, Wang ST, Ma HL, Chang MC, Liu CL,
Chen TH. Intra-articular injection of tranexamic acid
reduced postoperative hemarthrosis in arthroscopic
anterior cruciate ligament reconstruction: A
prospective randomized study. Arthroscopy. 2019;
4. Parker JD, Lim KS, Kieser DC, Woodfield TB, Hooper
GJ. Is tranexamic acid toxic to articular cartilage when
administered topically? What is the safe dose? Bone
Joint J. 2018; 100(3):404-12.
5. Nugent M, May JH, Parker JD, Kieser DC, Douglas
M, Pereira R, et al. Does tranexamic acid reduce
knee swelling and improve early function following
arthroscopic meniscectomy? A double-blind
randomized controlled trial. Orthop J Sports Med.
2019; 7(8):2325967119866122.