Clinical outcomes of intra-articular route versus intravenous route of tranexamic acid during total knee arthroplasty: a meta-analysis

doi:10.3969/j.issn.2095-4344.2016.35.021

Abstract

Abstract:

BACKGROUND: Tranexamic acid administered either in intra-articular route or in intravenous route can significantly reduce blood loss during total knee arthroplasty. Recent studies are still controversial in application mode of tranexamic acid in the clinic.

OBJECTIVE: To compare the clinical outcomes of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty.

METHODS: PubMed, OVID, Web of Science, and EMBASE were searched to identify randomized controlled trials concerning the comparison of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty published before 1 May 2015. Transfusion rate, hemoglobin decline, drainage volume and thromboembolic complication rate were considered as indexes to evaluate the clinical effect, for meta-analysis.

RESULTS AND CONCLUSION: Six randomized controlled trials involving 847 patients were included. Meta-analysis results showed no significant difference between intra-articular and intravenous administration of tranexamic acid in terms of transfusion rate, hemoglobin decline, drainage volume, total blood loss, and thromboembolic complication rate. Subgroup analysis for dose regimen showed that when occlusion time of drainage tube was < 2 hours. Intra-articular route of tranexamic acid showed high drainage volume and hemoglobin decline compared with the intravenous route of tranexamic acid (P < 0.01). Results confirmed that during total knee arthroplasty, clinical effects of intra-articular and intravenous routes of tranexamic acid are similar during total knee arthroplasty. Moreover, it is recommended that occlusion of drainage tube can be conducted for 2 hours in intra-articular route of tranexamic acid.

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

Zhou Kai-di, Wang Hong-yi, Yan Yu-fei, Hong Wei-xiang, Feng Jian-min. Clinical outcomes of intra-articular route versus intravenous route of tranexamic acid during total knee arthroplasty: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(35): 5313-5320.

Figures/Tables 4

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