The effect of single dose, preoperative intravenous tranexamic acid on early postoperative pain scores after rotator cuff repair: a double blind, randomized control trial

Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in rotator cuff repair (RCR) surgery is less defined. This trial assessed the effect of preoperative TXA on early postoperative pain scores. A randomized double-blind trail was conducted in 89 patients undergoing RCR. Patients were randomized to either 2g of intravenous TXA or placebo at induction. The primary outcome was VAS-pain score at day three postoperative with secondary outcomes including VAS-pain, ASES and Constant Score at two weeks, eight weeks, 24 weeks and 52 weeks. There was no significant difference in VAS-pain between groups at day three postoperative. Pain scores were statistically better in the TXA group at 8 weeks. There was no difference between groups at any time point in the ASES or Constant score. The TXA group had improved motion at six months with a reduced rate of secondary adhesive capsulitis. TXA did not improve postoperative pain scores after RCR, however, patients who received the intervention demonstrated greater range of movement at six months with lower rates of secondary adhesive capsulitis.