Fillingham YA, et al. - Herein, the goal was to assess and establish a basis for the safety 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 tranexamic acid (TXA) in primary total joint arthroplasty (TJA). Most studies included in this analysis did not include the patients with a history of prior thromboembolic events, findings supported the lack of evidence of harm from TXA administration in patients who underwent TJA. The safety of TXA in patients undergoing TKA with an ASA score of 3 or greater was supported by moderate evidence. The potential risks of thromboembolic events were seen to be outweighed by the benefits of using TXA even in patients with a higher comorbidity burden as the number needed to potentially harm with a venous thromboembolic events (VTE) from TXA administration was 983 patients whereas the number required to treat and to prevent a transfusion was only 3 to 4 patients. Since the number needed to potentially harm with a VTE from TXA administration was 983 patients while the number needed to treat to prevent a transfusion was only 3 to 4 patients, the benefits of using TXA appeared to outweigh the potential risks of thromboembolic events even in patients with a higher comorbidity burden.