Investigating the effect of tranexamic acid on recovery time in patients undergoing total knee replacements

This is a randomised non-blinded pilot study for the use of Tranexamic Acid in patients that are undergoing Total Knee Arthroscopy, performed as per hospital policy. A total of 40 participants per treatment arm will be examined, 80 in total. This allows for an estimated drop-out rate of 15%. Participants will be screened and eligibility assessed from surgeons preoperative list. Once consent is completed a baseline visit will be completed including blood tests (including baseline Heamoglobin -Hb) as standard of care. Day 0- Preoperatively the following assessments will be completed: Oxford Knee Score, knee girth, range of motion, pain assessment by the anesthetist. These assessments will be repeated throughout the post operative phase whist the participant is in hospital on Day 1,2,3,4 by the physiotherapist and ward Registered nurse. All participants will receive intravenous Tranexamic acid which is standard practice Day 0- pre operatively before undergoing TKA. The alternative treatments will be randomly allocated with a 1:1 allocation to groups. Participants will be randomised at study entry. An independent statistician will conduct randomisation. Arm 1: Tranexamic Acid 1.0 gram Intravenously, on induction of anaesthesia by the anesthetist. Arm 2: Tranexamic Acid 1.0 gram Intravenously, on induction of anaesthesia by the anaesthetist. A further 6 doses of oral Tranexamic Acid 2.0 grams every 8 hours post-operatively will be administered by registered nurses on the ward. Preoperative, intraoperative and post operative procedural information, will be reviewed and the dosage of TXA and will be recorded by study staff in the source documentation. This is to verify the pre operative dosing of Intravenous TXA has been administered. This will be done on day 1,2,3,4 or day of discharge. During the post operative phase on Day 1,2,3 and 4 the inpatient medication chart will be reviewed by the anesthetist or study staff to verify that the oral doses of TXA have been administered, this will be documented in the source data. Blood Draw on day 4 or on discharge if< day 4, to assess blood loss by calculating the difference between baseline (heamoglobin (Hb) and the lowest post-operative Hb during hospital stay. As per standard of care participants will be discharged on day 4 post operatively with follow up at 6 weeks during the standard follow up surgical appointment, the Oxford Knee Score will be recorded and range of motion will be completed by the Surgeon. Final follow up at 6 months with the final Oxford Knee Score assessment by the Study Co-Ordinator. A total duration of participation in the study is 6 months.