Bradley KE, Ryan SP, Penrose CT, et al. - A total of 235 patients (90 THA and 145 TKA) were recruited in a prospective, randomized controlled trial at a single tertiary-care referral centre in order to contrast the advantages of intraoperative intravenous tranexamic acid (TXA) with epsilon-aminocaproic acid (EACA). In comparison with patients who received TXA, TKA patients who received EACA had larger drainage, progressed loss of blood volume, and increased hemoglobin difference from the preoperative level. For the THA cohort, no statistically important variations were noted in any hematological outcome measure. One patient in the EACA group needed a transfusion whereas no patient in the TXA group needed a transfusion. No statistically important variances in number or type of postoperative complications or LOS for either THA or TKA patients irrespective of whether they received TXA or EACA, were noted. Thus, for hip and knee arthroplasty procedures, EACA was correlated with progressed perioperative blood loss in comparison with TXA. Nevertheless, there was no important variation in the transfusion rate. While further prospective studies are required to contrast the efficiency of each agent, it was currently suggested that orthopedic surgeons should choose their antifibrinolytic on the basis of cost and regional availability.