The effect of tranexamic acid on blood loss and use of blood products in total knee arthroplasty: a meta-analysis

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Haoran ZhangWenzhong Que

Abstract

Studies have shown that tranexamic acid (TXA) reduces blood loss and transfusion need in patients undergoing total knee arthroplasty (TKA). However, no single study has been large enough to definitively determine whether the drug is safe and effective. We report a systematic review and meta-analysis of randomised controlled trials evaluating the efficacy and safety of TXA in reducing blood loss and transfusion in TKA. A comprehensive literature search was done in Cochrane Library, MEDLINE, EMBASE, and CNKI. Two reviewers independently identified the eligible studies, assessed their methodological quality, and extracted data. The data were evaluated using the generic evaluation tool designed by the Cochrane Bone, Joint and Muscle Trauma Group. The relevant data were analyzed using RevMan 5.0. Fifteen randomized controlled trials involving 842 patients were included. The use of TXA reduced total blood loss by a mean of 487 ml [95% confidence interval (CI) -629 to -344], intra-operative blood loss by a mean of 127 ml (95% CI -313-59), and post-operative blood loss by a mean of 245 ml (95% CI -410 to -80). TXA led to a significant reduction in the proportion of patients requiring blood transfusion (risk difference -0.4). There were...Continue Reading

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Citations

Mar 16, 2012·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Shuvendu Prosad RoyOnkar Nath Nagi
Apr 18, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Tae Kyun KimSun Hyung Lee
May 23, 2012·BMJ : British Medical Journal·Katharine KerIan Roberts
Apr 2, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Tae Kyun KimIn Jun Koh
Sep 3, 2014·Archives of Orthopaedic and Trauma Surgery·Luigi SabatiniAlessandro Massè
Dec 20, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Chen Zhao-YuZhang Ying-Ze
Dec 24, 2013·The Journal of Arthroplasty·Mohammad R RasouliJonathan H Waters
Aug 21, 2013·The Journal of Arthroplasty·Kevin M SmitJames L Howard
Aug 3, 2013·The Journal of Arthroplasty·Andrew G GeorgiadisMichael W Laker
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