Fillingham YA, et al. - Experts evaluated tranexamic acid (TXA) in primary total knee arthroplasty (TKA) as the basis for the efficacy recommendations of the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Medicine on the use of TXA in primary TJA. Findings suggested a strong evidence that supported the effectiveness of TXA to decrease blood loss and the risk of transfusion after primary TKA. The blood sparing properties for TKA were not clearly improved by TXA formulation, dosage, or the number of doses provided. Pre-incision administration of IV TXA to improve efficacy was supported by moderate evidence.