Intravenous vs. Topical Tranexamic Acid in Revision THA (VITALITY-X)

Inclusion Criteria: * Age ≥ 18 years at the time of surgery. * Consent for transfusion of blood or blood-related products. * No contraindication to use of tranexamic acid. * Revision hip arthroplasty performed at MSH. * Indication for surgery including osteolysis, component failure, prosthetic joint infection, aseptic/septic loosening, periprosthetic fracture, recurrent instability/dislocation, polyethylene wear and abductor insufficiency. * Revision hip arthroplasty procedure performed including acetabular component revision, femoral component revision, impaction bone grafting, proximal femoral allograft, proximal femoral replacement, removal of hardware (excluding head/liner exchanges). * Direct lateral (transgluteal, Hardinge) approach utilized, including augmentation with extended trochanteric osteotomy (ETO), trochanteric slide and modified trochanteric slide. Exclusion Criteria: * Age \< 18 years at the time of surgery. * Posterior (Moore, Southern) or Anterior (Smith-Peterson) operative approach utilized. * Implantation of surgical drain. * Patients undergoing any isolated combination of femoral head exchange, acetabular liner exchange and abductor repair. * Patients with an absolute contraindication to tranexamic acid use including: * Allergy to TXA or previous adverse reaction to TXA/its constituents. * Thrombolytic events \<1 year prior to surgery (myocardial infarction, cerebrovascular accident, pulmonary embolus). * Active thrombolytic event and/or on lifelong …