Comparison of topical and intravenous Tranexamic acid for high tibial osteotomy

Bian, Jichao; Deng, Bin; Wang, Zhimeng; Yuan, Long; Li, Sen; Zhao, Xiaowei; Zhang, Yuanmin; Wang, Guodong

doi:10.1097/md.0000000000026884

Cited by 6 publications

(26 citation statements)

References 20 publications

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“…Eight studies monitored wound complications, including hematoma (Figure 6A) and infection (Figure 6B). 4,6,17,21,24,28,31,33 The heterogeneity of hematoma studies was not significant (P = .91; I 2 = 0%), and there were no differences between the TXA and control groups (RR, 0.53; 95% CI, 0.20-1.42; P = .21). Subgroup analysis indicated differences according to TXA administration: IV (RR, 0.54; 95% CI, 0.10-2.94; P = .48), topical (RR, 0.93; 95% CI, 0.13-6.62; P = .94), and combined IV/topical (RR, 0.37; 95% CI, 0.08-1.81; P = .22).…”

Section: Wound Complicationsmentioning

confidence: 92%

Clinical Use of Tranexamic Acid in High Tibial Osteotomy: A Systematic Review and Meta-analysis

Xu,

Li,

Xie

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: High tibial osteotomy (HTO) can cause postoperative hemorrhage. The use of tranexamic acid to reduce the hemorrhage is still controversial. Purpose: To investigate the efficacy and safety of tranexamic acid in HTO. Study Design: Systematic review; Level of evidence, 4. Methods: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors conducted a comprehensive search of the Embase, Cochrane Library, PubMed, Web of Science, MEDLINE, and Foreign Medical Literature Retrieval Service databases between their inception and January 1, 2023. All clinical studies comparing the use of tranexamic acid versus no tranexamic acid during HTO were collected. The primary outcome measures were hemoglobin decrease, drainage volume, and blood loss, and the secondary outcome measures were wound complications, blood transfusion, and postoperative thrombosis. All indicators were analyzed using meta-analysis software. Results were reported as mean differences or risk ratios with 95% confidence intervals. Results: Of 152 initial results, 9 studies involving 908 patients were included. The tranexamic acid group had lower indicators for total blood loss, hemoglobin decrease, and total drainage volume ( P < .00001 for all). There were no differences between patients with versus without tranexamic acid in wound complications, including hematoma ( P = .21) or infection ( P = .18), nor were there any group differences in the prevalence of blood transfusion ( P = .21) or postoperative thrombosis ( P = .36). Conclusion: Tranexamic acid was able to effectively reduce postoperative hemorrhage in patients undergoing HTO without affecting the rates of wound complications, blood transfusion, or postoperative thrombosis.

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Section: Wound Complicationsmentioning

confidence: 92%

Clinical Use of Tranexamic Acid in High Tibial Osteotomy: A Systematic Review and Meta-analysis

Xu,

Li,

Xie

et al. 2024

Orthopaedic Journal of Sports Medicine

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“…[16][17][18][19] Many studies have reported TXA administration in the perioperative period of MOWHTO to reduce surgical blood loss. 16,[18][19][20][21][22] Most of the studies adopted intravenous application 18 or combination of intravenous and topical applications, 22,23 and have shown that TXA can reduce surgical blood loss in patients undergoing MOWHTO. However, there are few studies focusing on the simple topical use of TXA in MOWHTO, and the modality and dosage of topical use of TXA varied.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have reported TXA administration in the perioperative period of MOWHTO to reduce surgical blood loss 16,18–22 . Most of the studies adopted intravenous application 18 or combination of intravenous and topical applications, 22,23 and have shown that TXA can reduce surgical blood loss in patients undergoing MOWHTO.…”

Section: Introductionmentioning

confidence: 99%

“…Most of the studies adopted intravenous application 18 or combination of intravenous and topical applications, 22,23 and have shown that TXA can reduce surgical blood loss in patients undergoing MOWHTO. However, there are few studies focusing on the simple topical use of TXA in MOWHTO, and the modality and dosage of topical use of TXA varied 21,24 . Therefore, it is necessary to study the topical use of TXA in MOWHTO to determine the necessity of topical use of TXA and the best use strategy.…”

Section: Introductionmentioning

confidence: 99%

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Topical Use of Low‐dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study

Zheng,

Han,

Zhao

et al. 2024

Orthopaedic Surgery

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ObjectiveMany studies reported that tranexamic acid (TXA) was effective in reducing surgical blood loss in the perioperative period of medial open wedge high tibial osteotomy (MOWHTO). However, few studies focused on the simple topical use of TXA in MOWHTO, and the modality and dosage of topical use of TXA varied. The purpose of this study was to observe the effect of topical use of low‐dose TXA on drainage volume after MOWHTO, and to analyze the related influencing factors.MethodsData of patients who underwent MOWHTO combined with arthroscopic knee surgery in our department from January 2019 to September 2021 were retrospectively analyzed. A total of 105 patients (38 males and 67 females, aged 57.7 ± 7.5 years) were included in this study who received topical TXA or no TXA. The patients were divided into three groups: control group (39 cases), 0.5 g TXA group (40 cases), 1 g TXA group (26 cases). Postoperative drainage volume, wound healing, incidence of hematoma and deep venous thrombosis (DVT) were observed and analyzed in the three groups. The effects of gender, hypertension and diabetes on postoperative drainage volume were analyzed using a t‐test. The correlation between age, body mass index (BMI), osteotomy gap and postoperative drainage volume were analyzed using the Pearson correlation coefficient.ResultsThe average postoperative drainage volume of the control group was 259.54 ± 226.33 mL, that of the 0.5 g TXA group was 277.18 ± 177.68 mL, and that of the 1 g TXA group was 229.15 ± 219.93 mL. There was no statistically significant difference in postoperative drainage volume among the three groups (F = 0.423, p = 0.656). There was no local hematoma and wound infection in the three groups. The wound fat liquefaction was found in one patient of the control group. The incidence of DVT was 38.9% (7/18) and 57.1% (8/14) in the control group and 0.5 TXA group, respectively. There was no significant difference in the incidence of DVT between the above two groups (p = 0.476). The average postoperative drainage volume of male patients in the three groups was higher than that of female patients, and the differences were statistically significant (p < 0.05). There was no correlation between age, BMI, osteotomy gap and postoperative drainage volume in the three groups (p > 0.05).ConclusionTopical use of low‐dose TXA has no significant effect on drainage volume after MOWHTO. The drainage volume after MOWHTO in male patients was more than that in female patients. Topical administration of low‐dose TXA does not increase postoperative complications, such as DVT and hematoma.

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“…TXA has been widely administered among patients with bleeding disorders, trauma and among patients undergoing various types of surgery, for example, osteotomy, obstetrics, cardiovascular surgery, and hernia surgery [6,[15][16][17][18]. However, evidence suggested that TXA administration was found to be associated with increased risk of myocardial ischemia/infarction and other thrombotic complications (e.g.…”

Section: Introductionmentioning

confidence: 99%

The effect of tranexamic acid on myocardial injury in cardiac surgical patients: a systematic review and meta-analysis

Wang

et al. 2022

Blood Coagulation &Amp; Fibrinolysis

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Tranexamic acid (TXA) is one of the most commonly used antifibrinolytic agents for surgical patients. However, the effect of TXA on myocardial injury remains controversial. We systemically reviewed literature regarding the effectiveness of TXA on myocardial injury in patients who have undergone a cardiac surgery. We included all randomized controlled trials (RCTs) comparing TXA and control (saline) in cardiac surgical patients. Relevant studies were identified by a comprehensive electronic literature search from database inception to 15 August 2021. A standardized data extraction form was used to collect methodological and outcome variables from each eligible study. We conducted a meta-analysis to estimate the pooled effect size of TXA administration on myocardial injury. In total, eight RCTs were identified, with 292 patients in the TXA group, and 241 patients in saline or control group. The meta-analysis demonstrated that patients in the TXA group had lower levels of CK-MB and cTnI within 24 h postoperatively (CK-MB: P = 0.005; cTnI: P = 0.01), compared with the saline group. No significant difference was found with respect to AST level (P = 0.71) between TXA and saline groups within 24 h postoperatively. TXA administration was found to be associated with less myocardial injury among patients who have undergone cardiac surgery. High-quality randomized controlled trials are warranted to further examine the cardioprotective effects of TXA.

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Comparison of topical and intravenous Tranexamic acid for high tibial osteotomy

Cited by 6 publications

References 20 publications

Clinical Use of Tranexamic Acid in High Tibial Osteotomy: A Systematic Review and Meta-analysis

Clinical Use of Tranexamic Acid in High Tibial Osteotomy: A Systematic Review and Meta-analysis

Topical Use of Low‐dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study

The effect of tranexamic acid on myocardial injury in cardiac surgical patients: a systematic review and meta-analysis

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