Intravenous tranexamic acid ("TXA") and its effect on operating conditions, blood loss, post-operative pain and complications in patients undergoing total shoulder replacement.

INTERVENTION: Group 1 (TXA group) will receive 2000mg (20ml) of Tranexamic Acid (TXA) intravenously 5 minutes before incision. CONDITION: Blood loss in total shoulder arthroplasty PRIMARY OUTCOME: Change in haemaglobin level as measured by the difference between pre‐operative and post‐operative levels as assessed by serum assay. Change in haemocrit as measured by the difference between pre‐operative and post‐operative levels as assessed by serum assay. SECONDARY OUTCOME: Drain output measured in cc. Infection rates as measured by data linkage to patient medical records. Operative field visibility rating as measured by the operating surgeon selecting either "excellent", "good", "fair"or "poor" on a checklist. Operative time defined as time from induction of anaesthesia until wound closure as timed by surgical assistant with stopwatch. Pain assessment using visual analogue score. Passive shoulder range of motion by using a goniometer. Post‐operative haematoma occurrence as measured by data linkage to patient medical records. Procedure complexity rating as measured by the operating surgeon selecting either "more complex than usual", "as usual" or "less complex than usual" on a checklist. Thromboembolic adverse events as measured by data linkage to patient medical records. Time spent in hospital as measured by the difference between date of admission to date of discharge. Time spent in recovery room as measured by the difference between time of arrival to time of departure. Transfusion requirement as measured by data linkage to patient medical records. INCLUSION CRITERIA: 1. Patients who have consented for anatomic or reverse shoulder arthroplasty under one of the principal investigators. 2. Patients who are capable of and have given informed consent for their participation in this study.