Combined versus single application of tranexamic acid in total knee and hip arthroplasty: A meta-analysis of randomized controlled trials

Zhang, M.M. Peng; Li, M.M. Jifeng; Wang, M.M. Xiao

doi:10.1016/j.ijsu.2017.05.065

Cited by 37 publications

(24 citation statements)

References 30 publications

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“…As shown in Table 2 , compared to the other three groups, the results demonstrated that the combined used of TXA combined realized a much higher efficacy in reducing TBL and transfusion rates. Our results were consistent with previous studies, in which the combined use of TXA efficiently minimizes the blood loss in the TKA and THA surgeries [ 25 – 27 ]. The blood loss from lumbar spinal fusion surgery could be generally divided into an acute blood loss period (within 6–8 h post-surgery) and chronic blood loss period (within 24 h post-surgery).…”

Section: Discussionsupporting

confidence: 93%

Combined use of intravenous and topical tranexamic acid efficiently reduces blood loss in patients aged over 60 operated with a 2-level lumbar fusion

Wang

Bai

et al. 2020

J Orthop Surg Res

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Purpose: The current study was conducted to assess the efficacy and safety of the intravenous (IV) administration combined with topical administration of tranexamic acid (TXA)in patients (aged over 60) scheduled for a 2-level lumbar fusion surgery. Methods: Two hundred eighty patients scheduled for a 2-level lumbar fusion surgery were randomized into four groups, including an IV group, a local group, a combined group, and a control group. Patients in the combined group, in the IV group, in the topical group, and in the control group were administrated with 15 mg/kg of IV-TXA + 2 g TXA in local, 15 mg/kg IV-TXA, 2 g TXA in local, and 100 ml IV, respectively. The results of total blood loss (TBL), maximum hemoglobin drop, the transfusion rate, and the number of allogeneic blood units were compared. Deep venous thrombosis (DVT) and pulmonary embolism (PE) events were monitored and recorded.

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Section: Discussionsupporting

confidence: 93%

Combined use of intravenous and topical tranexamic acid efficiently reduces blood loss in patients aged over 60 operated with a 2-level lumbar fusion

Wang

Bai

et al. 2020

J Orthop Surg Res

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“…[11,12] It is reported that the administration of TXA has a proven outcome in major orthopedic surgeries, such as total joint arthroplasty and spine surgery. [13,14]…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid reduces blood loss in intertrochanteric fractures

Wang

2017

Medicine

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“…However, the combined method of TXA has been widely used in TKA and THA. Current studies have confirmed that the combined regimen of intravenous infusion of TXA combined with intra‐articular local injection is superior to the single‐route regimen. Through a prospective study of 150 patients, Huang et al found that the combined regimen of TXA in TKA could reduce the overall effect of perioperative bleeding and even replace the role of the tourniquet.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Combined with Topical Tranexamic Acid Administration Has No Additional Benefits Compared with Intravenous Administration Alone in High Tibial Osteotomy: A Retrospective Case‐Control Study

Guo

et al. 2020

Orthopaedic Surgery

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Objective: To investigate whether intravenous combined with topical administration of tranexamic acid (TXA) is superior to intravenous administration alone in terms of blood loss, incision complications, functional recovery, and pain relief in high tibial osteotomy (HTO). Methods:Clinical data of patients with knee osteoarthritis (OA) treated with unilateral HTO were retrospectively reviewed. The patients were grouped according to the TXA administration method, with 24 patients in the combined group and 21 in the solo group. In the combined group, 100 mL saline containing 1 g TXA was intravenously administered before application of a tourniquet, and 20 mL saline containing 2 g TXA was injected through a drainage tube after closure of the incision. Alternatively, 100 mL of saline containing 1 g TXA was intravenously administered before application of a tourniquet in the solo group. The blood loss and adverse events were compared between the two groups.Results: All patients were followed for more than half a year. The drainage volume on the first day and total blood loss on the second day after surgery in the combined and single treatment groups were 130.06 AE 29.22 and 165.35 AE 43.08 mL (P < 0.05), respectively, and 327.17 AE 64.26 and 385.45 AE 63.31 mL (P < 0.05). There were no blood transfusions in either group. One case of delayed incision healing was observed in the solo group, and no such event occurred in the combined group. There were no significant differences between the two groups in terms of the following factors: the activated partial thromboplastin time (APTT) and prothrombin time (PT); levels of fibrinogen (FIB) and D-dimer on the second day after surgery; numbers of hospitalization days and thromboembolism events; and knee joint function and visual analog score 6 months after surgery.Conclusion: Intravenous combined with topical TXA administration in HTO is superior to intravenous administration alone for reducing postoperative blood loss and drainage volume without thromboembolic complications. However, even with only intravenous TXA administration, no cases of blood transfusion and only 1 case of incision complication occurred. At the same time, the combined use of TXA did not improve the recovery of knee joint function and pain relief after HTO.

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Combined versus single application of tranexamic acid in total knee and hip arthroplasty: A meta-analysis of randomized controlled trials

Cited by 37 publications

References 30 publications

Combined use of intravenous and topical tranexamic acid efficiently reduces blood loss in patients aged over 60 operated with a 2-level lumbar fusion

Combined use of intravenous and topical tranexamic acid efficiently reduces blood loss in patients aged over 60 operated with a 2-level lumbar fusion

Tranexamic acid reduces blood loss in intertrochanteric fractures

Intravenous Combined with Topical Tranexamic Acid Administration Has No Additional Benefits Compared with Intravenous Administration Alone in High Tibial Osteotomy: A Retrospective Case‐Control Study

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