Short answerYes. In trials of knee and hip replacement, tranexamic acid cut blood loss and the need for a donor blood transfusion, without an increase in blood clots in the legs.
Good evidence it helps
What it is
Knee and hip replacement operations cause bleeding, and some people need a blood transfusion afterwards. Tranexamic acid is a medicine that slows the breakdown of blood clots. It is given into a vein, placed in the joint or the wound, or taken as a tablet around the time of surgery.
What the research shows
pooled 33 randomised trials with 1,957 people having a first knee or hip replacement. Tranexamic acid was compared with a placebo or with nothing. Most of the trials gave it into a vein. Total blood loss was lower with tranexamic acid in both knee and hip replacement. The odds of needing a donor blood transfusion were about 85 percent lower in knee replacement and about 67 percent lower in hip replacement.
The review found no increase in deep vein thrombosis, which is a blood clot in the leg, with tranexamic acid. The odds were about the same as without it in both knee and hip replacement. Reporting of other complications was incomplete, so the authors could not pool it. They said that larger trials are still needed to confirm safety.
Risks and effort
The concern with any medicine that helps blood clot is a rise in clots in the legs or lungs. The review found no clear rise. Your surgeon and anaesthetist will check whether it suits you, for example if you have had a clot or have heart or vessel disease. It is given by the surgical team, so it takes no effort from you.
What usually works instead
Other ways to reduce blood loss include careful surgical technique and treating anaemia before surgery. See Total Knee Replacement and What is a Total Hip Replacement?.
Questions people ask
Do I need a blood transfusion after a joint replacement?
Many people do not. Tranexamic acid lowers the chance, and your blood level before surgery also matters.
How is it given?
Most trials gave it into a vein. Others placed it in the joint or wound, or gave it by mouth. The review pooled these methods together.
Is it safe if I take blood thinners?
Ask your surgeon and anaesthetist. They will weigh the benefits and risks for you.
Sources
Select a source to read what the study or guideline found, in plain words, with a link to the original.
Last reviewed 24 October 2026. Next review due October 2028.
