ACL ReconstructionPhase 4TXANCT07332910
Study the Anti-inflammatory Effect of Tranexamic Acid When Used in Anterior Cruciate Ligament Reconstruction.
A Phase 4 study testing Tranexamic Acid (TXA) in people with ACL Reconstruction and Hemarthrosis, run by Chirec at 1 site in Belgium.
Trial summary
Tranexamic acid (TXA) is widely used in orthopedic surgery to reduce perioperative blood loss, particularly in total hip and knee arthroplasty, due to its antifibrinolytic mechanism, low cost, broad availability, and established safety profile. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- ACL Reconstruction, Hemarthrosis
- What is being tested?
- Tranexamic Acid (TXA)
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 60 participants
- Where
- 1 siteBelgium
- Study dates
- 20 Jan 2026to 1 Jun 2026
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults aged 18 years or older.
- Male or female patients scheduled for primary anterior cruciate ligament (ACL) reconstruction.
- Surgery performed under spinal anesthesia, combined with a postoperative adductor canal block for analgesia.
- American Society of Anesthesiologists (ASA) physical status I or II.
- Procedure performed by a single, standardized surgical team.
- Ability to provide written informed consent.
Who cannot join
- Age under 18 years.
- Pregnancy or breastfeeding.
- Preoperative treatment with anticoagulant or antiplatelet therapy that cannot be safely discontinued.
- Known coagulation disorders or history of abnormal bleeding.
- Known hypersensitivity or allergy to tranexamic acid.
- History of seizure disorders or epilepsy.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Touihri Clanet, Anesthesia contact
Belgium1 site
Chirec Delta
Brussels, 1160
Céline El Haddad, Anesthesia, +32 475 46 66 55, celineelha@outlook.fr
Matthieu Clanet, Anesthesia, matthieuclanet@gmail.com
About this study
Official title: Tranexaminc Acid : Single Dose vs Placebo to Modulate Postoperative Inflammation After ACL Reconstruction : A Prospective, Randomized, Double-blind Trial
Tranexamic acid (TXA) is widely used in orthopedic surgery to reduce perioperative blood loss, particularly in total hip and knee arthroplasty, due to its antifibrinolytic mechanism, low cost, broad availability, and established safety profile. Its use has recently expanded to minimally invasive procedures such as knee arthroscopy and ACL reconstruction, where postoperative hemarthrosis-rather than intraoperative bleeding-is a major cause of pain, swelling, reduced range of motion, delayed rehabilitation, and impaired early recovery.
Randomized trials and meta-analyses in arthroscopic ACL reconstruction show that TXA, administered intravenously, intra-articularly, or both, reduces postoperative hemarthrosis, joint swelling, drainage volume, and early pain, while improving early functional outcomes. These benefits are mainly short term, with no consistent long-term differences, and no increased risk of thromboembolic events. Evidence in arthroscopic meniscectomy is more limited but suggests modest improvements in early recovery, which may still be clinically meaningful given TXA's favorable risk-benefit profile.
Beyond its antifibrinolytic effects, TXA may influence inflammatory pathways by inhibiting plasmin, which is involved in complement activation and inflammatory modulation. However, existing data are conflicting, with reports of both anti- and pro-inflammatory effects depending on surgical context and dosing. Importantly, most arthroscopy studies focus on clinical outcomes rather than systemic inflammation. To date, no study has comprehensively evaluated perioperative inflammatory responses to TXA in arthroscopic knee surgery, making this low-trauma setting an ideal model to investigate its potential inflammatory effects.
Read the detailed description
Over the past decade, tranexamic acid (TXA) has been widely adopted in orthopedic surgery to reduce perioperative blood loss and transfusion requirements, particularly in total hip and knee arthroplasty. TXA is a synthetic lysine analogue that inhibits the activation of plasminogen to plasmin, thereby preventing fibrin degradation and limiting fibrinolysis. Due to its low cost, wide availability, and well-established safety profile when administered intravenously, TXA is now routinely used in many countries for procedures associated with a high risk of bleeding.
In recent years, interest has expanded beyond major joint replacement toward minimally invasive orthopedic procedures, such as knee arthroscopy and anterior cruciate ligament (ACL) reconstruction. Although these procedures are generally associated with limited intraoperative blood loss, postoperative hemarthrosis remains the most frequent complication of knee arthroscopy and accounts for a substantial proportion of postoperative morbidity. Hemarthrosis has been shown to induce transient histological changes in articular cartilage and synovial tissue and is associated with increased postoperative pain, joint swelling, reduced range of motion (ROM), delayed rehabilitation, and impaired early functional recovery.
Several randomized controlled trials have investigated the role of TXA in arthroscopic knee surgery. In arthroscopic ACL reconstruction, multiple studies and subsequent systematic reviews and meta-analyses have demonstrated that TXA administration-whether intravenous, intra-articular, or combined-reduces postoperative hemarthrosis, joint swelling, drainage volume, and early postoperative pain, while improving early functional outcomes such as ROM and knee scores. These benefits appear most pronounced during the first postoperative weeks, with no consistent differences observed at longer-term follow-up. Importantly, these studies have not demonstrated an increased incidence of thromboembolic events or major complications associated with TXA use.
In the setting of arthroscopic meniscectomy, data are more limited. A double-blind randomized controlled trial evaluating intravenous TXA in routine arthroscopic meniscectomy suggested modest improvements in early functional recovery, particularly during the immediate postoperative period, despite minimal expected blood loss. Editorial commentaries and systematic reviews have emphasized that, although the absolute benefit of TXA in low-risk arthroscopic procedures may be small, even modest reductions in hemarthrosis and early inflammation may be clinically relevant given the low cost and favorable safety profile of the drug.
Beyond its antifibrinolytic properties, increasing experimental and clinical evidence suggests that TXA may exert biological effects on inflammation and coagulation pathways. Plasmin is known to play a role not only in fibrinolysis but also in the activation of the complement system and modulation of inflammatory mediators. By inhibiting plasmin generation, TXA may influence postoperative inflammatory responses. However, the available evidence remains conflicting. While some studies suggest anti-inflammatory effects, others-particularly in major orthopedic procedures such as total knee arthroplasty-have reported paradoxical increases in circulating pro-inflammatory cytokines following TXA administration.
These discordant findings highlight the complexity of the interaction between coagulation, fibrinolysis, and inflammation, and suggest that the effects of TXA on inflammatory pathways may depend on surgical context, tissue trauma, and dosing strategy. Importantly, most existing studies in arthroscopic surgery have focused primarily on clinical outcomes such as hemarthrosis, pain, and function, with very limited assessment of systemic inflammatory markers.
To date, no study has comprehensively evaluated the perioperative inflammatory response to TXA in arthroscopic knee surgery using serial cytokine measurements and integrated inflammatory burden assessment. Arthroscopic procedures, characterized by limited surgical trauma and low baseline inflammatory activation, represent an ideal clinical model to investigate the potential anti-inflammatory-or pro-inflammatory-effects of TXA in a controlled and sensitive manner.
- Conditions
- ACL Reconstruction, Hemarthrosis
- Being tested
- Tranexamic Acid (TXA), Placebo (NaCl 0,9%)
- Medical subject headings
- Hemarthrosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Tranexamic Acid (TXA)Drug
Also called TXA
1 dose of Tranexamic Acid 15 mg/kg
Placebo (NaCl 0,9%)Drug
Also called Placebo
This arm will receive NaCl 0,9% at the same volume as calculated for 15mg/kg of tranexamic acid
| Study group | Role | What they receive |
|---|---|---|
| Tranexamin acid | Active comparator | This group will receive 1 dose of tranexamic acid during the induction phase, before the surgical tourniquet Receives: Drug: Tranexamic Acid (TXA) |
| Placebo | Placebo comparator | This arm will receive NaCl 0,9% at the same volume as calculated for 15mg/kg of tranexamic acid (before the surgical tourniquet) Receives: Drug: Placebo (NaCl 0,9%) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Anti-inflammatory response: Variation of IL-6 over 24 hours
To evaluate the effect of a single intravenous dose of tranexamic acid on the perioperative inflammatory response, assessed by serial plasma interleukin-6 (IL-6) concentrations measured preoperatively, at 6 hours, and at 24 hours postoperatively, with quantification of the inflammatory burden using the area under the curve (AUC) over the first 24 postoperative hours.
Measured: 24 hours
Secondary outcomes (7)
Hidden blood loss
To quantify hidden blood loss (HBL) using perioperative hemoglobin and hematocrit measurements obtained preoperatively, at 24 hours, and on postoperative day 3.
Total blood loss (TBL) will be estimated using validated hematocrit-based formulas incorporating postoperative day-3 hematocrit and estimated blood volume, and hidden blood loss will be calculated as HBL = TBL - intraoperative blood loss (IBL).
Measured: 3 days
Anti-inflammatory response
To characterize the perioperative inflammatory profile associated with tranexamic acid administration by measuring plasma levels of TNF-α, IL-8, IFN-γ, IL-1α, IL-1β, IL-2, IL-4, IL-10, and C-reactive protein (CRP)at baseline, 6 hours, and 24 hours postoperatively.
Measured: 24 hours
Fibrinolysis
To assess the effect of tranexamic acid on perioperative fibrinolysis, evaluated through serial measurements of D-dimer levels obtained preoperatively, at 6 hours, and at 24 hours postoperatively.
Measured: 24 hours
Rehabilitation score
- KOOS score: Knee Injury and Osteoarthritis Outcome Score - 0 (worse score) - 100 (best score).
Measured: 1 week
Rehabilitation score
IKDC score (International Knee Documentation Committee) - evaluate impact of treatement in everyday activities: 0 (worse score) - 100 (best score).
Measured: 1 week
Rehabilitation
Range of motion: 0-150 % (extension to flexion)
Measured: 1 week
adverse effect
One of these described: Arterial or venous thrombosis, Seizures, Hypersensitivity reactions (including anaphylaxis), Gastrointestinal adverse effects, Acute renal failure 0 = Not described
1 = described
Measured: 1 week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jan 2026
- Study start20 Jan 2026 (estimated)
- Primary completion1 Jun 2026 (estimated)
- Study completion1 Jun 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (16)Papers the sponsor has linked to this study.
- Other trials for ACL ReconstructionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Group 1: 1 dose of tranexamic acid (15mg/kg) during induction Group 2: No tranexamic acid
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Chirec
- Sponsor type
- University, hospital or other
- Collaborators
- Centre Hospitalier Universitaire Brugmann, Erasme University Hospital
- Responsible party
- Principal investigator, matthieu clanet, Chirec
- Investigators
- Karim Touihri, Principal investigator
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07332910
- Sponsor's protocol ID
- Chirec
- Acronym
- TXA
- Status last verified
- Dec 2025
- First submitted
- 17 Dec 2025
- Last updated
- 12 Jan 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Prudovsky I, Kacer D, Zucco VV, Palmeri M, Falank C, Kramer R, Carter D, Rappold J. Tranexamic acid: Beyond antifibrinolysis. Transfusion. 2022 Aug;62 Suppl 1:S301-S312. doi: 10.1111/trf.16976. Epub 2022 Jul 14.
PubMed 35834488Alkhatib N, AlNouri M, Abdullah ASA, Ahmad Alzobi OZ, Alkaramany E, Sasaki E, Ishibashi Y. Tranexamic Acid Use in Anterior Cruciate Ligament Reconstruction Decreases Bleeding Complications: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Arthroscopy. 2022 Feb;38(2):506-518.e6. doi: 10.1016/j.arthro.2021.07.030. Epub 2021 Aug 4.
PubMed 34358640Grant AL, Letson HL, Morris JL, McEwen P, Hazratwala K, Wilkinson M, Dobson GP. Tranexamic acid is associated with selective increase in inflammatory markers following total knee arthroplasty (TKA): a pilot study. J Orthop Surg Res. 2018 Jun 18;13(1):149. doi: 10.1186/s13018-018-0855-5.
PubMed 29914535Johns WL, Walley KC, Hammoud S, Gonzalez TA, Ciccotti MG, Patel NK. Tranexamic Acid in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Am J Sports Med. 2021 Dec;49(14):4030-4041. doi: 10.1177/0363546521988943. Epub 2021 Feb 25.
PubMed 33630652Fried JW, Bloom DA, Hurley ET, Baron SL, Popovic J, Campbell KA, Strauss EJ, Jazrawi LM, Alaia MJ. Tranexamic Acid Has No Effect on Postoperative Hemarthrosis or Pain Control After Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft: A Double-Blind, Randomized, Controlled Trial. Arthroscopy. 2021 Jun;37(6):1883-1889. doi: 10.1016/j.arthro.2021.01.037. Epub 2021 Jan 30.
PubMed 33529783Hetsroni I. Tranexamic Acid During Anterior Cruciate Ligament Reconstruction Reduced Drained Blood Volume on Day 1 and Hemarthrosis Up to Day 15 but Did Not Improve Clinical Outcomes at 3 Months. J Bone Joint Surg Am. 2019 Aug 21;101(16):1516. doi: 10.2106/JBJS.19.00514. No abstract available.
PubMed 31436663Goldstein K, Jones C, Kay J, Shin J, de Sa D. Tranexamic Acid Administration in Arthroscopic Surgery Is a Safe Adjunct to Decrease Postoperative Pain and Swelling: A Systematic Review and Meta-analysis. Arthroscopy. 2022 Apr;38(4):1366-1377.e9. doi: 10.1016/j.arthro.2021.10.001. Epub 2021 Oct 14.
PubMed 34655767Mousavi H, Akbari-Aghdam H, Entezari R. The effect of tranexamic acid injection during anterior cruciate ligament reconstruction surgery on postoperative bleeding, pain and swelling. Eur J Orthop Surg Traumatol. 2023 Apr;33(3):639-644. doi: 10.1007/s00590-022-03318-8. Epub 2022 Jul 2.
PubMed 35779145Ma R, Wu M, Li Y, Wang J, Wang W, Yang P, Wang K. The comparative efficacies of intravenous administration and intra-articular injection of tranexamic acid during anterior cruciate ligament reconstruction for reducing postoperative hemarthrosis: a prospective randomized study. BMC Musculoskelet Disord. 2021 Jan 26;22(1):114. doi: 10.1186/s12891-021-03990-7.
PubMed 33499848Felli L, Revello S, Burastero G, Gatto P, Carletti A, Formica M, Alessio-Mazzola M. Single Intravenous Administration of Tranexamic Acid in Anterior Cruciate Ligament Reconstruction to Reduce Postoperative Hemarthrosis and Increase Functional Outcomes in the Early Phase of Postoperative Rehabilitation: A Randomized Controlled Trial. Arthroscopy. 2019 Jan;35(1):149-157. doi: 10.1016/j.arthro.2018.07.050.
PubMed 30611343Cen L, Liu H, Li M, Zhang YF, Zhang HJ, Huang ZY. Intraoperative tranexamic acid reduces postoperative haemarthrosis and improves early functional outcomes in double-bundle anterior cruciate ligament reconstruction. J Orthop. 2024 Dec 10;65:51-56. doi: 10.1016/j.jor.2024.12.005. eCollection 2025 Jul.
PubMed 39801905Tan TK, Ng KT, Lim HJ, Radic R. Effect of tranexamic acid in arthroscopic anterior cruciate ligament repair: A systematic review and meta-analysis of randomised clinical trials. J Orthop Surg (Hong Kong). 2021 May-Aug;29(2):23094990211017352. doi: 10.1177/23094990211017352.
PubMed 34027721Alaia MJ, Gipsman AM. Editorial Commentary: The Benefits of Tranexamic Acid May Outweigh Risks in Arthroscopy and Sports Medicine. Arthroscopy. 2021 Apr;37(4):1334-1336. doi: 10.1016/j.arthro.2021.01.027.
PubMed 33812531Nugent M, May JH, Parker JD, Kieser DC, Douglas M, Pereira R, Lim KS, Hooper GJ. Does Tranexamic Acid Reduce Knee Swelling and Improve Early Function Following Arthroscopic Meniscectomy? A Double-Blind Randomized Controlled Trial. Orthop J Sports Med. 2019 Aug 29;7(8):2325967119866122. doi: 10.1177/2325967119866122. eCollection 2019 Aug.
PubMed 31497612Na Y, Jia Y, Shi Y, Liu W, Han C, Hua Y. Administration of Tranexamic Acid to Reduce Intra-articular Hemarthrosis in ACL Reconstruction: A Systematic Review. Orthop J Sports Med. 2022 Jan 28;10(1):23259671211061726. doi: 10.1177/23259671211061726. eCollection 2022 Jan.
PubMed 35111862
Study at a glance
From the registry record, last updated by the sponsor on 12 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Tranexaminc Acid : Single Dose vs Placebo to Modulate Postoperative Inflammation After ACL Reconstruction : A Prospective, Randomized, Double-blind Trial
- ClinicalTrials.gov ID
- NCT07332910
- Acronym / sponsor ID
- TXA / Chirec
- Conditions
- ACL Reconstruction, Hemarthrosis
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- ChirecUniversity, hospital or other
- Collaborators
- Centre Hospitalier Universitaire Brugmann, Erasme University Hospital
- Study start
- 20 Jan 2026 (estimated)
- Primary completion
- 1 Jun 2026 (estimated)
- Study completion
- 1 Jun 2026 (estimated)
- First posted
- 12 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Tranexamic acid (TXA) is widely used in orthopedic surgery to reduce perioperative blood loss, particularly in total hip and knee arthroplasty, due to its antifibrinolytic mechanism, low cost, broad availability, and established safety profile. Its use has recently expanded to minimally invasive procedures such as knee arthroscopy and ACL reconstruction, where postoperative hemarthrosis-rather than intraoperative bleeding-is a major cause of pain, swelling, reduced range of motion, delayed rehabilitation, and impaired early recovery.
Randomized trials and meta-analyses in arthroscopic ACL reconstruction show that TXA, administered intravenously, intra-articularly, or both, reduces postoperative hemarthrosis, joint swelling, drainage volume, and early pain, while improving early functional outcomes. These benefits are mainly short term, with no consistent long-term differences, and no increased risk of thromboembolic events. Evidence in arthroscopic meniscectomy is more limited but suggests modest improvements in early recovery, which may still be clinically meaningful given TXA's favorable risk-benefit profile.
Beyond its antifibrinolytic effects, TXA may influence inflammatory pathways by inhibiting plasmin, which is involved in complement activation and inflammatory modulation. However, existing data are conflicting, with reports of both anti- and pro-inflammatory effects depending on surgical context and dosing. Importantly, most arthroscopy studies focus on clinical outcomes rather than systemic inflammation. To date, no study has comprehensively evaluated perioperative inflammatory responses to TXA in arthroscopic knee surgery, making this low-trauma setting an ideal model to investigate its potential inflammatory effects.
Detailed description
Over the past decade, tranexamic acid (TXA) has been widely adopted in orthopedic surgery to reduce perioperative blood loss and transfusion requirements, particularly in total hip and knee arthroplasty. TXA is a synthetic lysine analogue that inhibits the activation of plasminogen to plasmin, thereby preventing fibrin degradation and limiting fibrinolysis. Due to its low cost, wide availability, and well-established safety profile when administered intravenously, TXA is now routinely used in many countries for procedures associated with a high risk of bleeding.
In recent years, interest has expanded beyond major joint replacement toward minimally invasive orthopedic procedures, such as knee arthroscopy and anterior cruciate ligament (ACL) reconstruction. Although these procedures are generally associated with limited intraoperative blood loss, postoperative hemarthrosis remains the most frequent complication of knee arthroscopy and accounts for a substantial proportion of postoperative morbidity. Hemarthrosis has been shown to induce transient histological changes in articular cartilage and synovial tissue and is associated with increased postoperative pain, joint swelling, reduced range of motion (ROM), delayed rehabilitation, and impaired early functional recovery.
Several randomized controlled trials have investigated the role of TXA in arthroscopic knee surgery. In arthroscopic ACL reconstruction, multiple studies and subsequent systematic reviews and meta-analyses have demonstrated that TXA administration-whether intravenous, intra-articular, or combined-reduces postoperative hemarthrosis, joint swelling, drainage volume, and early postoperative pain, while improving early functional outcomes such as ROM and knee scores. These benefits appear most pronounced during the first postoperative weeks, with no consistent differences observed at longer-term follow-up. Importantly, these studies have not demonstrated an increased incidence of thromboembolic events or major complications associated with TXA use.
In the setting of arthroscopic meniscectomy, data are more limited. A double-blind randomized controlled trial evaluating intravenous TXA in routine arthroscopic meniscectomy suggested modest improvements in early functional recovery, particularly during the immediate postoperative period, despite minimal expected blood loss. Editorial commentaries and systematic reviews have emphasized that, although the absolute benefit of TXA in low-risk arthroscopic procedures may be small, even modest reductions in hemarthrosis and early inflammation may be clinically relevant given the low cost and favorable safety profile of the drug.
Beyond its antifibrinolytic properties, increasing experimental and clinical evidence suggests that TXA may exert biological effects on inflammation and coagulation pathways. Plasmin is known to play a role not only in fibrinolysis but also in the activation of the complement system and modulation of inflammatory mediators. By inhibiting plasmin generation, TXA may influence postoperative inflammatory responses. However, the available evidence remains conflicting. While some studies suggest anti-inflammatory effects, others-particularly in major orthopedic procedures such as total knee arthroplasty-have reported paradoxical increases in circulating pro-inflammatory cytokines following TXA administration.
These discordant findings highlight the complexity of the interaction between coagulation, fibrinolysis, and inflammation, and suggest that the effects of TXA on inflammatory pathways may depend on surgical context, tissue trauma, and dosing strategy. Importantly, most existing studies in arthroscopic surgery have focused primarily on clinical outcomes such as hemarthrosis, pain, and function, with very limited assessment of systemic inflammatory markers.
To date, no study has comprehensively evaluated the perioperative inflammatory response to TXA in arthroscopic knee surgery using serial cytokine measurements and integrated inflammatory burden assessment. Arthroscopic procedures, characterized by limited surgical trauma and low baseline inflammatory activation, represent an ideal clinical model to investigate the potential anti-inflammatory-or pro-inflammatory-effects of TXA in a controlled and sensitive manner.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- Group 1: 1 dose of tranexamic acid (15mg/kg) during induction Group 2: No tranexamic acid
| Arm | Type | Receives |
|---|---|---|
| Tranexamin acid | Active comparator | Drug: Tranexamic Acid (TXA)This group will receive 1 dose of tranexamic acid during the induction phase, before the surgical tourniquet |
| Placebo | Placebo comparator | Drug: Placebo (NaCl 0,9%)This arm will receive NaCl 0,9% at the same volume as calculated for 15mg/kg of tranexamic acid (before the surgical tourniquet) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Adults aged 18 years or older.
- Male or female patients scheduled for primary anterior cruciate ligament (ACL) reconstruction.
- Surgery performed under spinal anesthesia, combined with a postoperative adductor canal block for analgesia.
- American Society of Anesthesiologists (ASA) physical status I or II.
- Procedure performed by a single, standardized surgical team.
Key exclusion criteria (6 listed)
- Age under 18 years.
- Pregnancy or breastfeeding.
- Preoperative treatment with anticoagulant or antiplatelet therapy that cannot be safely discontinued.
- Known coagulation disorders or history of abnormal bleeding.
- Known hypersensitivity or allergy to tranexamic acid.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Tranexamic Acid (TXA)Also: TXA1 dose of Tranexamic Acid 15 mg/kg | Drug | Tranexamin acid |
| Placebo (NaCl 0,9%)Also: PlaceboThis arm will receive NaCl 0,9% at the same volume as calculated for 15mg/kg of tranexamic acid | Drug | Placebo |
Primary outcome
Anti-inflammatory response: Variation of IL-6 over 24 hours
Time frame: 24 hours
To evaluate the effect of a single intravenous dose of tranexamic acid on the perioperative inflammatory response, assessed by serial plasma interleukin-6 (IL-6) concentrations measured preoperatively, at 6 hours, and at 24 hours postoperatively, with quantification of the inflammatory burden using the area under the curve (AUC) over the first 24 postoperative hours.
7 secondary outcomes
Hidden blood loss
Time frame: 3 days
Anti-inflammatory response
Time frame: 24 hours
Fibrinolysis
Time frame: 24 hours
Rehabilitation score
Time frame: 1 week
Rehabilitation score
Time frame: 1 week
Rehabilitation
Time frame: 1 week
adverse effect
Time frame: 1 week
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Jan 2026.
- Background: PubMed 35834488Prudovsky I, Kacer D, Zucco VV, Palmeri M, Falank C, Kramer R, Carter D, Rappold J. Tranexamic acid: Beyond antifibrinolysis. Transfusion. 2022 Aug;62 Suppl 1:S301-S312. doi: 10.1111/trf.16976. Epub 2022 Jul 14.
- Background: PubMed 34358640Alkhatib N, AlNouri M, Abdullah ASA, Ahmad Alzobi OZ, Alkaramany E, Sasaki E, Ishibashi Y. Tranexamic Acid Use in Anterior Cruciate Ligament Reconstruction Decreases Bleeding Complications: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Arthroscopy. 2022 Feb;38(2):506-518.e6. doi: 10.1016/j.arthro.2021.07.030. Epub 2021 Aug 4.
- Background: PubMed 29914535Grant AL, Letson HL, Morris JL, McEwen P, Hazratwala K, Wilkinson M, Dobson GP. Tranexamic acid is associated with selective increase in inflammatory markers following total knee arthroplasty (TKA): a pilot study. J Orthop Surg Res. 2018 Jun 18;13(1):149. doi: 10.1186/s13018-018-0855-5.
- Background: PubMed 33630652Johns WL, Walley KC, Hammoud S, Gonzalez TA, Ciccotti MG, Patel NK. Tranexamic Acid in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Am J Sports Med. 2021 Dec;49(14):4030-4041. doi: 10.1177/0363546521988943. Epub 2021 Feb 25.
- Background: PubMed 33529783Fried JW, Bloom DA, Hurley ET, Baron SL, Popovic J, Campbell KA, Strauss EJ, Jazrawi LM, Alaia MJ. Tranexamic Acid Has No Effect on Postoperative Hemarthrosis or Pain Control After Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft: A Double-Blind, Randomized, Controlled Trial. Arthroscopy. 2021 Jun;37(6):1883-1889. doi: 10.1016/j.arthro.2021.01.037. Epub 2021 Jan 30.
- Background: PubMed 31436663Hetsroni I. Tranexamic Acid During Anterior Cruciate Ligament Reconstruction Reduced Drained Blood Volume on Day 1 and Hemarthrosis Up to Day 15 but Did Not Improve Clinical Outcomes at 3 Months. J Bone Joint Surg Am. 2019 Aug 21;101(16):1516. doi: 10.2106/JBJS.19.00514. No abstract available.
- Background: PubMed 34655767Goldstein K, Jones C, Kay J, Shin J, de Sa D. Tranexamic Acid Administration in Arthroscopic Surgery Is a Safe Adjunct to Decrease Postoperative Pain and Swelling: A Systematic Review and Meta-analysis. Arthroscopy. 2022 Apr;38(4):1366-1377.e9. doi: 10.1016/j.arthro.2021.10.001. Epub 2021 Oct 14.
- Background: PubMed 35779145Mousavi H, Akbari-Aghdam H, Entezari R. The effect of tranexamic acid injection during anterior cruciate ligament reconstruction surgery on postoperative bleeding, pain and swelling. Eur J Orthop Surg Traumatol. 2023 Apr;33(3):639-644. doi: 10.1007/s00590-022-03318-8. Epub 2022 Jul 2.
- Background: PubMed 33499848Ma R, Wu M, Li Y, Wang J, Wang W, Yang P, Wang K. The comparative efficacies of intravenous administration and intra-articular injection of tranexamic acid during anterior cruciate ligament reconstruction for reducing postoperative hemarthrosis: a prospective randomized study. BMC Musculoskelet Disord. 2021 Jan 26;22(1):114. doi: 10.1186/s12891-021-03990-7.
- Background: PubMed 30611343Felli L, Revello S, Burastero G, Gatto P, Carletti A, Formica M, Alessio-Mazzola M. Single Intravenous Administration of Tranexamic Acid in Anterior Cruciate Ligament Reconstruction to Reduce Postoperative Hemarthrosis and Increase Functional Outcomes in the Early Phase of Postoperative Rehabilitation: A Randomized Controlled Trial. Arthroscopy. 2019 Jan;35(1):149-157. doi: 10.1016/j.arthro.2018.07.050.
- Background: PubMed 39801905Cen L, Liu H, Li M, Zhang YF, Zhang HJ, Huang ZY. Intraoperative tranexamic acid reduces postoperative haemarthrosis and improves early functional outcomes in double-bundle anterior cruciate ligament reconstruction. J Orthop. 2024 Dec 10;65:51-56. doi: 10.1016/j.jor.2024.12.005. eCollection 2025 Jul.
- Background: PubMed 34027721Tan TK, Ng KT, Lim HJ, Radic R. Effect of tranexamic acid in arthroscopic anterior cruciate ligament repair: A systematic review and meta-analysis of randomised clinical trials. J Orthop Surg (Hong Kong). 2021 May-Aug;29(2):23094990211017352. doi: 10.1177/23094990211017352.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Touihri Clanet, Anesthesia contact
Karim Touihri principal investigator
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Tranexamic Acid (TXA) in people with ACL Reconstruction and Hemarthrosis, run by Chirec at 1 site in Belgium.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 12 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Céline El Haddad, Anesthesia (+32 475466655, celineelha@outlook.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Anti-inflammatory response: Variation of IL-6 over 24 hours (time frame: 24 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07332910, which also lists 16 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jan 2026.