Wurtz J, et al. - The present study was undertaken to assess early pain following total hip arthroplasty (THA) conducted with and without topical tranexamic acid (TXA). Researchers compared a consecutive series of 213 THAs performed without TXA with 169 THAs performed with topical TXA. In comparison with individuals who did not receive TXA, individuals who received topical TXA reported higher mean 24-hour pain scores. Individuals with topical TXA requested opioids significantly sooner. In primary THA individuals, topical TXA use was correlated with greater early postoperative pain and opioid consumption. Findings were encouraged by the magnitude of observed impacts and the likelihood of clinical relevance. In elective settings, replication and consideration of potential adverse consequences of TXA use is encouraged.