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Paulo Diogo Cunha Orthopedic Surgery Department, Hospital de Braga, Portugal

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Tiago P Barbosa Orthopedic Surgery Department, Hospital de Braga, Portugal

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Guilherme Correia Orthopedic Surgery Department, Hospital de Braga, Portugal

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Rafaela Silva Anesthesiology Department, Hospital de Braga, Portugal

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Nuno Cruz Oliveira Orthopedic Surgery Department, Hospital de Braga, Portugal

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Pedro Varanda Orthopedic Surgery Department, Hospital de Braga, Portugal
Life and Health Science Research Institute, University of Minho, Portugal

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Bruno Direito-Santos Orthopedic Surgery Department, Hospital de Braga, Portugal
Life and Health Science Research Institute, University of Minho, Portugal

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depress them, in order to obtain a good lateral x-ray film ( 14 , 15 ) ( Fig. 2 ). Figure 2 Supine position for anterior approach of the cervical spine. To decrease pressure on the lower part of the back, hips and knees can be flexed

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Hua Luo Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Chaojun Shen Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Tongyou Qu Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang China

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Lin Chen Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Yue Sun Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Yu Ren Department of Pharmacy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang China

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intravenous drip for intraoperative hemostasis during artificial joint replacement surgery. However, there is no unified standard on the route of administration, dose, timing, and way to improve the safety of TXA. Even if the drug is given locally, it should

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Hua Luo Department of Orthopedic, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Xuelei Zhang Department of Ultrasound, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Chengxin Xie Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Department of Endocrinology, Ministry of Education, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
Department of Orthopedic, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Luxia Wu Department of Orthopedic, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Guoping Cai Department of Orthopedic, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Yu Ren Department of Pharmacy, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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topical TXA (tTXA) than intravenous TXA, and the advantages of tTXA have been demonstrated in other types of surgery such as hip replacement, knee replacement, and thoracic surgery ( 10 , 11 , 12 ). Studies have produced inconsistent results on whether

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