Efficacy and safety of topical versus intravenous tranexamic acid on total knee arthroplasty: a meta-analysis

doi:10.3969/j.issn.2095-4344.0182

Abstract

Abstract:

BACKGROUND: Total knee arthroplasty is usually administered by intravenous and topical ways. The two ways have been the focus of research in reducing perioperative blood loss and blood transfusion rate.

OBJECTIVE: To evaluate the effects of topical tranexamic acid versus intravenous tranexamic acid on blood loss and blood transfusion rate after total knee arthroplasty and analyze whether they increased the occurrence of postoperative thromboembolic events.

METHODS: Electronic databases: PubMed, Embase, Cochrane library, Wanfang and CNKI from inception to 1 August 2016 were searched for studies on the use of tranexamic acid after total knee arthroplasty. The studies meeting the criteria were included. The quality of the included studies was evaluated. Extracted data were analyzed using Revman 5.3 software for meta-analysis.

RESULTS AND CONCLUSION: (1) Twelve randomized controlled trials involving 1 159 patients (548 cases of topical application; 611 cases of intravenous injection) were included. (2) There were no significant differences in perioperative total blood loss (WMD=-4.22, 95%CI: -10.87–2.43, P > 0.05), postoperative drainage (MD=25.03, 95%CI: -30.58-80.63, P > 0.05), postoperative hemoglobin decline (MD=0.54, 95%CI: 0.11–0.98, P > 0.05), blood transfusion rate (RR=1.15, 95CI: 0.82-1.61, P > 0.05) and incidence of deep venous thrombosis (RR=1.22, 95% CI: 0.512.89, P > 0.05). (3) The best timing for intravenous injection and optimal dose for topical application remain to be further verified.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Knee, Tranexamic Acid, Meta-Analysis, Tissue Engineering

CLC Number:

R318

Shi Zhi-gang, Han Bing, Fu Yu, Wang Yin-sheng, Li Jun, Jing Jue-hua. Efficacy and safety of topical versus intravenous tranexamic acid on total knee arthroplasty: a meta-analysis [J]. Chinese Journal of Tissue Engineering Research, 2018, 22(11): 1798-1804.

Figures/Tables 3

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