Tranexamic Acid Is Beneficial to Patients Undergoing Open-Wedge High Tibial Osteotomy

Chen, Desheng; Wang, Tong-Fu; Zhu, Bo; Feng, Cai-Hong

doi:10.1155/2020/2514207

Cited by 11 publications

(31 citation statements)

References 47 publications

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“…A total of 23 articles were collected through a systematic search, among which 11 were from Medline, eight were from Embase, and four were from the Cochrane Central Register of Controlled Trials. Six studies, 16 , 17 , 22 , 23 , 24 , 25 involving 608 patients, were included after screening. The details of the inclusion and exclusion criteria are shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Effect of Tranexamic Acid on Blood Management during a High Tibial Osteotomy: A Systematic Review and Meta‐analysis

Fang

Zhang

Wang

et al. 2022

Orthopaedic Surgery

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This study aimed to evaluate the efficiency and safety of tranexamic acid for blood management during high tibial osteotomy (HTO). A systematic search was conducted in Medline, Embase, and the Cochrane library database. Six studies and 208 patients were included in this meta‐analysis using Review Manager V.5.3 and Stata 15.1 software. For primary outcomes, tranexamic acid lowered the total blood loss (WMD = –219.47, 95% CI [−355.61, −83.33], P = 0.002). For secondary outcomes, a significant reduction was found for decreased hemoglobin (POD1: WMD = –9.86, 95% CI [−13.45, −6.28], P < 0.05; POD2: WMD = –8.41, 95% CI [−11.50, −5.32], P < 0.05; POD5: WMD = –11.48, 95% CI [−14.56, −8.39], P < 0.05) and drainage (total: WMD = –105.93, 95% CI [−187.08, −24.78], P < 0.05; POD1: WMD = –122.195, 95% CI [−168.902, −75.488], P < 0.05). The sex difference (male/female ratio) was determined (total blood loss: P = 0.025; total drainage amount: p = 0.018) using meta‐regression analysis. Females benefited more from tranexamic acid in terms of total blood loss (M/F > 40%: WMD = –53.11, 95% CI [−100.16, −6.05], P = 0.03; 40% ≥ M/F ≥ 20%: WMD = –362.20, 95% CI [−423.96, −300.45], P < 0.05; M/F < 20%: WMD = –263.00, 95% CI [−277.17, −248.83], P < 0.05) and total drainage (M/F > 40%: WMD = –7.11, 95% CI [−10.75, −3.47], P < 0.05; 40% ≥ M/F ≥ 20%: WMD = –104.72, 95% CI [−155.36, −54.08], P < 0.05; M/F < 20%: WMD = –222.00, 95% CI [−297.42, −146.58], P < 0.05). No significant differences were found for drainage on POD2 and POD3, wound complications, orthromboembolic events. In conclusion, tranexamic acid is effective and safe for blood management during HTO. Females appeared to benefit more from it, and an additional postoperative dose is suggested fora better effect.

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Section: Resultsmentioning

confidence: 99%

Effect of Tranexamic Acid on Blood Management during a High Tibial Osteotomy: A Systematic Review and Meta‐analysis

Fang

Zhang

Wang

et al. 2022

Orthopaedic Surgery

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“…All tests were twosided, and P < 0.05 was considered statistically significant. In previous reports, the mean difference in total blood loss between the TXA group and control group varied from 90 to 260 ml [25,26]. Based upon these reports, we set the mean difference between two groups for the detection of sample size to 170 ml and calculated that 29 patients per group would be required for this trial.…”

Section: Statistical Analyses and Sample Sizementioning

confidence: 99%

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Iseki

Kanto

et al. 2023

J Orthop Surg Res

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Background This randomized controlled study was undertaken to investigate the efficacy of intravenous tranexamic acid (TXA) administration in reducing perioperative blood loss in patients undergoing medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO). It was hypothesized that TXA would reduce perioperative blood loss in MOWDTO. Methods A total of 61 knees in 59 patients who underwent MOWDTO during the study period were randomly assigned to either of the groups with intravenous TXA administration (TXA group) or without TXA administration (control group). In the TXA group, patients received 1000 mg of TXA intravenously before skin incision and 6 h after the first dose. The primary outcomes was the volume of perioperative total blood loss which calculated using the blood volume and hemoglobin (Hb) drop. The Hb drop was calculated as the difference between preoperative Hb and postoperative Hb at days 1, 3, and 7. Results The perioperative total blood loss was significantly lower in the TXA group (543 ± 219 ml vs. 880 ± 268 ml, P < 0.001). The Hb drop was significantly lower at postoperative days 1, 3 and 7 in the TXA group than in the control group (day 1: 1.28 ± 0.68 g/dl vs. 1.91 ± 0.69 g/dl, P = 0.001; day 3: 1.54 ± 0.66 g/dl vs. 2.69 ± 1.00 g/dl, P < 0.001; day 7: 1.74 ± 0.66 g/dl vs. 2.83 ± 0.91 g/dl, P < 0.001). Conclusion Intravenous TXA administration in MOWDTO could reduce the perioperative blood loss. Trial registration The study was approved by the institutional review board. (Registered on 26/02/2019 Registration Number 3136). Level of Evidence Level I, randomized controlled trial.

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“…Evidence from the literature: To evaluate the hemostatic effect of tranexamic acid in HTO, Chen et al 39 . retrospectively analyzed 100 patients who underwent open wedge HTO.…”

Section: Clinical Questionsmentioning

confidence: 99%

“…Evidence from the literature: To evaluate the hemostatic effect of tranexamic acid in HTO, Chen et al . 39 retrospectively analyzed 100 patients who underwent open wedge HTO. The length of hospital stay (days), hemoglobin level, and blood transfusion rate in the group receiving an intravenous infusion of 1 g of tranexamic acid during surgery plus local application of 1 g of tranexamic acid before the end of the surgery were better than those in the group without tranexamic acid during surgery.…”

Section: Clinical Questionsmentioning

confidence: 99%

Chinese Clinical Practice Guidelines in Treating Knee Osteoarthritis by Periarticular Knee Osteotomy

Wang

2022

Orthopaedic Surgery

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Unicompartmental knee osteoarthritis (UKOA) is the early stage of knee joint degeneration, which is characterized by unicompartmental degeneration and mostly occurs in medial compartment. Pain and limited motion are main symptoms, which affect patients' life quality. Periarticular knee osteotomy (PKO) for lower extremity alignment correction is an effective treatment for UKOA with abnormal alignment, which could relieve pain and improve joint function by adjusting lower extremity alignment. At present, no clinical guidelines are available for the treatment of UKOA by PKO for lower extremity alignment correction. Experts from the Clinical New Technology Application Committee of the Chinese Hospital Association, Joint Surgery Study Group of the Chinese Orthopaedic Association of the Chinese Medical Association, and Osteoarthritis Study Group of the Chinese Association of Orthopaedic Surgeons of the Chinese Medical Doctor Association formulated these guidelines. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) grading system and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) were adopted to select 25 most concerning questions. Finally, 25 recommendations were formulated through evidence retrieval, evidence quality evaluation, and the determination of directions and strength of recommendations. Recommendation items 1–5 are indications and contraindications for PKO for lower extremity alignment correction, items 6–21 are surgical methods and principles, item 22 describes 3D printing corrective osteotomy technique, and items 23–25 address the perioperative period, follow‐up management, and other content. These guidelines are designed to improve the normalization and standardization of KOA treatment by PKO for lower extremity alignment correction.

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Tranexamic Acid Is Beneficial to Patients Undergoing Open-Wedge High Tibial Osteotomy

Cited by 11 publications

References 47 publications

Effect of Tranexamic Acid on Blood Management during a High Tibial Osteotomy: A Systematic Review and Meta‐analysis

Effect of Tranexamic Acid on Blood Management during a High Tibial Osteotomy: A Systematic Review and Meta‐analysis

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Chinese Clinical Practice Guidelines in Treating Knee Osteoarthritis by Periarticular Knee Osteotomy

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