Abstract
Total joint arthroplasties, trauma, and spine surgery are correlated with a significant amount of bleeding. The severity of the bleeding might be substantial enough to require a blood transfusion to treat the resulting anemia. Antifibrinolytic therapy is used to reduce blood loss in orthopedic surgery. This review aimed to assess the recent research supporting the use of antifibrinolytic therapy to reduce blood loss in orthopedic surgery. In the last 10 years, the published studies determining antifibrinolytic therapy’s effect on orthopedic surgery were searched in Google Scholar and PubMed. Antifibrinolytic agents are used in most surgical operations, including orthopedic surgery. It causes a significant reduction in blood loss and blood transfusion. In addition, antifibrinolytic therapy did not increase the risk of deep vein thrombosis in patients undergoing total joint arthroplasty. Tranexamic acid, epsilon aminocaproic acid, and aprotinin are the most popular fibrinolytic agents. Tranexamic acid is more frequently used in patients undergoing joint replacement, spine and trauma surgery. . Although aminocaproic acid has a more limited history of usage in orthopedic surgery than tranexamic acid, it has a more significant antifibrinolytic effect.

Key words: Antifibrinolytic, tranexamic acid, ε-aminocaproic acid, arthroplasty, spine surgery, fracture, blood transfusion, DVT, post-operative bleeding.