Topical versus intravenous tranexamic acid in total knee arthroplasty

Hamlin, Brian R.; DiGioia, Anthony M.; Plakseychuk, Anton; Levison, Tim J.

doi:10.1016/j.arth.2014.10.007

Cited by 48 publications

(46 citation statements)

References 20 publications

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“…Calculated losses were based on fixed day hemoglobin value in most series (2 nd or 4 th day). As concluded by most authors, we also found that the use of TXA is safe over described drug dosages [11,13,16,17,19] . In present study pre operative hemoglobin was higher as compared to post operative hemoglobin at 2 nd and 4 th day of surgery in Group 1 as well as in Group 2.…”

Section: Discussionsupporting

confidence: 61%

See 1 more Smart Citation

Result of tranexamic acid in controlling blood loss in total knee and hip replacement surgery

Saini¹,

Singh²,

Sinha³

2018

Int. J. Orthop. Sci.

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Section: Discussionsupporting

confidence: 61%

“…Drains in most series have been removed at fixed point of time i.e. 24-48 h, similarly in present study also we removed it after 48 hours [15][16][17][18] . Calculated losses were based on fixed day hemoglobin value in most series (2 nd or 4 th day).…”

Section: Discussionmentioning

confidence: 93%

Result of tranexamic acid in controlling blood loss in total knee and hip replacement surgery

Saini¹,

Singh²,

Sinha³

2018

Int. J. Orthop. Sci.

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“…Theoretically, intravenous TXA administration may increase the risk of thrombosis since it is a synthetic antifibrinolytic agent that can prevent plasminogen activation, and fibrinolysis is delayed [51]. However, it has been ascertained that TXA does not inhibit fibrinolytic activity in the vein wall, and its effect on disrupted endothelium remains unknown [52].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effectiveness and safety of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Chen

Jiao

et al. 2017

J Orthop Surg Res

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BackgroundThis study aims to compare the effectiveness and safety of topical versus intravenous tranexamic acid (TXA) in reducing blood loss in primary total knee arthroplasty (TKA).MethodsPubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedicine Literature (CBM), Wanfang Database and China National Knowledge Infrastructure (CNKI), and Google Scholar were searched for randomized controlled studies (RCTs) that compared topical versus intravenous TXA in terms of reducing blood loss during TKA from their inception to September 2015. This systematic review and meta-analysis was performed according to PRISMA criteria.ResultsTwelve studies reporting 12 RCTs comprising 1130 patients were included. Compared with the intravenous administration of TXA, the topical administration of TXA showed no significant differences in total blood loss (MD 2.08, 95% CI −68.43 to 72.60, P = 0.95), blood loss in drainage (MD 18.49, 95% CI −40.01 to 76.98, P = 0.54), hidden blood loss (MD 4.75, 95% CI −337.94 to 347.44, P = 0.99), need for transfusion (RR = 0.92, 95% CI 0.67~1.25, P = 0.58), hemoglobin (Hb) decline (MD −0.42, 95% CI −0.89 to 0.05, P = 0.08), and DVT occurrence (RR = 1.17, 95% CI 0.55~2.50, P = 0.68).ConclusionsCompared with intravenous administration TXA, topical administration TXA exhibits comparable effectiveness and safety in terms of reducing blood loss during TKA. Due to the poor quality of the included studies, more high-quality RCTs are needed to identify the optimal method and dose of TXA after TKA.

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“…Clouding the issue is the fact that several studies show that topical TXA administration is more effective than IV TXA. In a retrospective study Hamlin and colleague found that patients with 3 g of topical TXA had a 0% RBC transfusion rate while an 1 g IV TXA had a 2.4% transfusion rate without any changes in venous thrombotic events. Further support for topical TXA was demonstrated by Seo and colleagues, who found that 1.5 g topical TXA group had lower postoperative blood loss, transfusion rates, and transfusion volume.…”

Section: Discussionmentioning

confidence: 99%

Intravenous administration of tranexamic acid effectively reduces blood loss in primary total knee arthroplasty in a 610‐patient consecutive case series

et al. 2015

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This study demonstrates a significant benefit from the routine use of TXA for total knee arthroplasty and is one of the first studies to demonstrate a small but significant benefit for IV administration in comparison to intraarticular administration. The routine use of TXA as a central element of a PBMP provides a cost savings and can help reduce the rate of transfusions for total knee arthroplasty.

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Topical versus intravenous tranexamic acid in total knee arthroplasty

Cited by 48 publications

References 20 publications

Result of tranexamic acid in controlling blood loss in total knee and hip replacement surgery

Result of tranexamic acid in controlling blood loss in total knee and hip replacement surgery

Comparison of the effectiveness and safety of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Intravenous administration of tranexamic acid effectively reduces blood loss in primary total knee arthroplasty in a 610‐patient consecutive case series

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