Perioperative Blood Loss in Cementless Versus Cemented Total Knee Arthroplasty With Local Tranexamic Acid Administration

Under a standardized local-only TXA protocol, cementless TKA achieved perioperative blood loss comparable to cemented TKA without increasing symptomatic thromboembolic events. These findings suggest the feasibility of a standardized local TXA protocol for cementless TKA. Importantly, fixation method was fully collinear with implant design (cementless: low contact stress (LCS) limited-box; cemented: posterior-stabilized (PS) open-box), and femoral box geometry can influence bleeding; therefore, results should be interpreted within this implant- and protocol-specific context.