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

Zhang, Haoran; Chen, Junmin; Chen, Fei; Que, Wenzhong

doi:10.1007/s00167-011-1754-z

Cited by 174 publications

(139 citation statements)

References 43 publications

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“…In THA and TKA, the most notable complication reported in the literature is venous thromboembolism. The vast majority of orthopaedic TXA studies show no increase in the rate of venous thromboembolism events [29][30][31]43,44]. Nishihara, et al is the only study in the recently published literature known to the authors that demonstrated a significant increase in venous thromboembolic events after TXA administration in total joint arthroplasty [18].…”

Section: Oral Usementioning

confidence: 99%

Tranexamic acid in adult elective orthopaedic and complex spinal surgery: A review

Walterscheid¹,

O’Neill²,

Carmouche³

2017

Surg Rehabil

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Section: Oral Usementioning

confidence: 99%

Tranexamic acid in adult elective orthopaedic and complex spinal surgery: A review

Walterscheid¹,

O’Neill²,

Carmouche³

2017

Surg Rehabil

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“…Studies carried out with TXA have reported no increase in the number of complications such as DVT or Pulmonary emboli after TKR surgery. 40,21,22 In the meta-analysis they reviewed 19 clinical studies, Alshryda et al found significant decrease in blood transfusion need with TXA application and stated that there was no increase in the risk of DVT and Pulmonary emboli. 40 Another metaanalysis which assessed the efficiency and reliability of TXA showed decreases in the amounts of blood loss without any increase in thrombo emboli rates.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20] Especially in recent years, many studies have suggested that the antifibrinolytic agent, Tranexamic Acid (TXA) can considerably reduce blood loss and the need for blood transfusion after TKR surgeries. 21,22 TXA has been applied locally or systemically. [23][24][25] This study was aimed to ascertain the effectiveness of tranexamic acid in minimizing the intra operative and postoperative blood loss in total knee arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

Effect of intravenous tranexamic acid on blood loss and blood transfusion in total knee replacement: a prospective, randomized study in Indian population

Kerakkanavar

Venkatesh

et al. 2017

Int J Res Orthop

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Background: Tranexamic acid (TXA) is antifibrinolytic drug which has the property to reduce intraoperative and postoperative bleeding. There are several studies supporting the use of tranexamic acid in total knee replacements (TKR) and few in total hip replacements. Our study was intended to establish the effects of tranexamic acid in minimizing the intra operative and post-operative blood loss in uncomplicated primary total knee replacement.Methods: This was a prospective follow up study conducted in Rajarajeshwari Medical College and Hospital Bangalore, over a period of 14 months from June 2015 to August 2016. A total number of 60 patients who underwent unilateral primary total knee replacement were included for this study. They were randomly divided into 2 groups. Group I patients infused (intravenous) with 20 mg/kg TXA before incision and 3 hours after surgery whereas no TXA was administered in Group II. Total blood loss and transfusion rate were used as outcome. Results: Mean amounts of blood loss were 578 ml in Group 1 and 946 ml in Group 2. There was a decrease in blood loss in TXA groups (p<0.001). Transfusion was required in 6 patients of Group I and 17 patients of Group II (p<0.001). No thromboembolic problem was seen in any patients.Conclusions: Since TXA decrease perioperative blood loss and lessen the need for blood transfusion significantly, without increasing thromboembolic events in TKR. We suggest using intravenous (IV) TXA in TKR.

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“…TXA led to a significant reduction in the proportion of patients requiring blood transfusion. 5 Wind TC et all in their study found that there were no transfusions with topical TXA. 6 Sa-ngasoongsong P et all found that the clamping of drain along with tranexamic acid reduce the post-operative blood loss more than 2 the clamping of drain and tranexamic acid alone 7 Soni A et all found that intra-articular tranexamic acid is equally effective as three dose intravenous regimen in reducing blood loss during total knee arthroplasty surgery.…”

Section: Introductionmentioning

confidence: 90%

Total Knee Arthroplasty?; Post Operative Mean Blood Loss With Tranexamic Acid, Is Tranexamic Acid Effective in Reducing Blood Loss. A Randomized Controlled Trial in Tertiary Care Hospital, Pakistan

Khan¹,

Ahmed²,

Umer³

et al. 2017

TPMJ

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ORIGINAL PROF-3861 ABSTRACT… The treatment of choice for osteoarthritic knee is Total knee arthroplasty (TKA) and the most important problem in it is the blood loss. Objectives: To compare the postoperative mean blood loss with Tranexamic acid versus control after Total Knee Arthroplasty. Study Design: Randomized controlled trial. Setting: Ghurki Trust Teaching Hospital Lahore. Period: 01 year. Methodology: 100 patients were included and divided in 2 groups, selected by non-probability purposive sampling, fulfilling inclusion and exclusion criteria. Group T (Tranexamic) received 15mg/kg IV Tranexamic acid 10 minutes before inflating tourniquet and the same dose intravenously 3 hours post-operatively. Group C (control) received placebo (normal saline) intravenously. Blood loss collected in a container was measured with syringe/jar after 24 hours of surgery. Results: In group C there were 23(46%) males and 27(54%) females with male to female ratio 1:1.7 with mean age of 64yrs ± 6.3 yrs. In group T there were 28(56%) males and 22 (44%) females with male to female ratio 1.2:1 with mean age of 65yrs ± 7.4 yrs. After 24 hours Mean blood loss in Group C were 694 ±151 ml with 74 % patient in range of 600-900ml while Mean blood loss in Group T were 388 ml ±105 ml with 76 % patient in range of 300-600ml. Mean decrease in blood loss with the use of tranexamic acid { mean blood loss in T group -mean blood loss in T group } were 306 ml which were statistically significant(p< 0.05) using t Test. Conclusion: Tranexamic acid is a potent anti-fibrinolytic agent and its use in total knee arthroplasty results in decrease in post-operative blood loss thereby decreasing the need of blood transfusion. Key words:Total knee arthroplasty (TKA), Tranexamic Acid (TXA), blood loss, Postoperative. MBBS, FCPS (Orthopedics

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

Abstract: Therapeutic study (Systematic review of Level I studies with inconsistent results), Level II.

Cited by 174 publications

References 43 publications

Tranexamic acid in adult elective orthopaedic and complex spinal surgery: A review

Tranexamic acid in adult elective orthopaedic and complex spinal surgery: A review

Effect of intravenous tranexamic acid on blood loss and blood transfusion in total knee replacement: a prospective, randomized study in Indian population

Total Knee Arthroplasty?; Post Operative Mean Blood Loss With Tranexamic Acid, Is Tranexamic Acid Effective in Reducing Blood Loss. A Randomized Controlled Trial in Tertiary Care Hospital, Pakistan

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