Utilization of Tranexamic Acid in Surgical Orthopaedic Practice: Indications and Current Considerations

Haratian, Aryan; Shelby, Tara; Hasan, Laith K; Bolia, Ioanna K; Weber, Alexander E.; Petrigliano, Frank A.

doi:10.2147/orr.s321881

Cited by 7 publications

(6 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In general, whether it is high-dose TXA or low-dose TXA, it can reduce total blood loss and blood transfusion rate without increasing the incidence of DVT in patients. Studies have shown that patients who did not use antifibrinolytic drugs during the perioperative period of major orthopedic surgery are prone to massive blood loss, with blood loss of about 761-1,784 mL [ 5 – 7 ]. Patients with large blood loss usually need a large amount of blood transfusion, and the potential adverse reactions brought by blood transfusion cannot be ignored, such as bloodstream infection and blood transfusion fever reaction.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Efficacy and Safety of Tranexamic Acid in Spinal Surgery

Bao

Lü

Gao

et al. 2022

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Objective. The safety and effectiveness of topical tranexamic acid in spinal surgery has not yet been reached, and further research is needed to confirm it. This study is aimed at detecting the effectiveness and safety on the tranexamic acid in spinal surgery. Methods. The Cochrane Library, PubMed, Embase, CNKI, and other databases were searched. The search time was from 2016 to 2019. All randomized controlled trials comparing the topical tranexamic acid group and the control group were collected. The experimental group used topical application. Tranexamic acid was used to treat bleeding after spinal surgery. The control group was no tranexamic acid or isotonic saline. The total bleeding, blood transfusion rate, and the occurrence of deep vein thrombosis were compared between the two groups. Rev Man 5.2.0 software was used for meta-analysis. Results. A total of 8 randomized controlled trials were included, including 884 patients. Meta-analysis results showed that the total bleeding volume of the tranexamic acid group was lower than that of the control group, and the difference was statistically significant weighted mean difference ( WMD = – 360.27 mL , 95% confidence interval (CI) (–412.68, –307.87) mL, P < 0.00001 ). The blood transfusion rate in the tranexamic acid group was lower than that in the control group (odds ratio OR = 0.22 , 95% CI (0.14, 0.33), P < 0.00001 ). There was no significant difference in the incidence of deep vein thrombosis between the two groups: OR = 1.48 , 95% CI (0.41, 5.34), P = 0.55 . Conclusion. Tranexamic acid can significantly reduce perioperative total blood loss, intraoperative blood loss, and blood transfusion rate during spinal surgery but has no significant effect on blood transfusion and thrombosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Efficacy and Safety of Tranexamic Acid in Spinal Surgery

Bao

Lü

Gao

et al. 2022

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

show abstract

“…Clinical studies show that multiple administrations of tranexamic acid have proven to be useful in reducing patient blood loss, postoperative pain, and markers of inflammation, all without a significant increase in the incidence of thromboembolic events compared to placebo and single-dose tranexamic acid groups. Findings also show a more favourable hospital stay length and a lesser need for expensive blood transfusions which might, in rare cases, lead to unnecessary secondary patient infections (Haratian et al, 2021).…”

Section: Clinical Use Of Tranexamic Acidmentioning

confidence: 88%

The Use of Tranexamic Acid in Orthopaedic Surgery

Kocjančič¹,

Kocjančič²

2023

Socratic Lectures 8

View full text Add to dashboard Cite

New surgical techniques (minimally invasive surgery – (MIS), laparoscopic surgery), meticulous consideration of haemostasis, use of robots, Cell Saver and tranexamic acid, new transfusion criteria and single red blood cell (RBC) unit ordering have greatly changed clinical practices. Implementation of these therapeutic options along with other practices has significantly contributed to the effectiveness of the patient blood management approach to surgical patients. In recent years use of anti-fibrinolytic agent tranexamic acid (TXA) has been introduced at our department and intravenous administration as well as topical TXA administration were successfully implemented. Use of topical TXA was effective at reducing both post-operative red blood cell loss and transfusion rates with good tolerance and no clinically relevant adverse events. Within 6 years of Patient Blood Management (PBM) protocol implementation in our institution, the total number of transfusions was reduced by 76 % and the percentage of patients requiring transfusion fell from 38 % to 9 %. Keywords: Tranexamic acid; Blood loss; Orthopaedic surgery; Endoprosthesis; Joint arthroplasty

show abstract

“…In addition, there were no thromboembolic complications recorded in the TXA group in shoulder surgery. Meanwhile, TXA has been frequently used in the context of major orthopedic surgeries, such as total knee arthroplasty, total hip arthroplasty, and spine operations, and complications associated with these procedures should be noted [ 35 ]. Frozen shoulder after the operation may be related to postoperative rehabilitation and pain control [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Tranexamic Acid in Shoulder Arthroscopic Surgery: A Systematic Review and Meta-Analysis

Sun

Xiao

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Visual clarity during shoulder arthroscopy can ensure an efficient and effective performance of the procedure, and it is highly related to bleeding without a tourniquet. Tranexamic acid (TXA) is widely used in adult reconstruction procedures; however, its use in shoulder arthroscopic operations is a relatively novel topic. Purpose: To analyze the available literature on visual clarity, blood loss, pain control, functional outcomes, and complications after the administration of tranexamic acid in shoulder arthroscopic surgery. Methods: A literature search was performed to retrieve randomized controlled trials examining the use of tranexamic acid at the time of shoulder arthroscopic surgery. The literature search included the MEDLINE, Embase, Web of Science, and Cochrane Library databases. The primary outcomes included visual clarity, blood loss, and visual analog scale scores for pain. Secondary outcomes were operative time, irrigation amount used, postoperative shoulder swelling, the need for pressure increase, mean arterial pressure (MAP), functional outcomes, postoperative adverse effects such as deep venous thrombosis, and pulmonary embolism. The outcomes were pooled to perform a meta-analysis. Results: Seven prospective randomized controlled trials met the inclusion criteria for analysis. All of the included studies performed arthroscopic rotator cuff repair. No significant difference in visual clarity was observed (SMD (standardized mean difference), 0.45 [95% CI(confidence interval), −0.68, 1.59]; p = 0.44) nor in pain score (MD (mean difference), −0.46 [95% CI, −0.97, 0.05]; p = 0.08) between the TXA group and the control group. Two studies found no significant difference in blood loss between the TXA group and the control group. The meta-analysis from five studies demonstrated no significant difference between the TXA and control groups in operative time (MD, −3.51 [95% CI, −15.82, 8.80]; p = 0.58) or irrigation amount used (MD, −2.53 [95% CI, −5.93, 0.87]; p = 0.14). Two trials reported different statistical results in postoperative shoulder swelling. No significant differences regarding the need for pressure increase and MAP were reported between groups. No wound complications or infections or cardiac, thrombotic, or thromboembolic complications were recorded in either group. Conclusion: The use of intravenous or local TXA in shoulder arthroscopic surgery did not increase complications or thromboembolic events, but TXA had no obviously effect of reducing bleeding to obtain a clear visual field or pain release in patients undergoing shoulder arthroscopic surgery.

show abstract

Utilization of Tranexamic Acid in Surgical Orthopaedic Practice: Indications and Current Considerations

Cited by 7 publications

References 84 publications

Meta-Analysis of the Efficacy and Safety of Tranexamic Acid in Spinal Surgery

Meta-Analysis of the Efficacy and Safety of Tranexamic Acid in Spinal Surgery

The Use of Tranexamic Acid in Orthopaedic Surgery

Efficacy and Safety of Tranexamic Acid in Shoulder Arthroscopic Surgery: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About