The efficacy and safety of tranexamic acid in revision total knee arthroplasty: a meta-analysis

BMC Musculoskeletal Disorders

Research Article

Yu-ting Huang¹  Wen-bin Liu²  Zhi-jun Li³  Gui-jun Xu⁴  Peng Tian⁴  Xin-long Ma⁴ 

[1] Cancer & Immunology Research, Children’s Research Institute, Children’s National Medical Center, 111 Michigan Avenue, NW, 20010, Washington, DC, USA;Department of Joint Surgery, Tianjin Hospital, No. 406, Jiefang Nan Road, 300211, Tianjin, People’s Republic of China;Department of Orthopedics, General Hospital of Tianjin Medical University, No. 154, Anshan Road, 300052, Tianjin, People’s Republic of China;Department of Orthopedics, Tianjin Hospital, No. 406, Jiefang Nan Road, 300211, Tianjin, People’s Republic of China;

关键词: Knee;    Arthroplasty;    Revision;    Tranexamic acid;    Meta-analysis;   

DOI  :  10.1186/s12891-017-1633-y

 received in 2016-12-16, accepted in 2017-06-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThere is no consistent conclusion regarding the efficacy and safety of the intravenous administration of tranexamic acid (TXA) for reducing blood loss in revision total knee arthroplasty (TKA). We performed a meta-analysis of comparative trials to evaluate the efficacy and safety of TXA in revision TKA.MethodsWe conducted a search of PubMed, EMBASE, The Cochrane Library and Web of Science for randomized controlled trials (RCTs) and non-RCTs. Two authors selected the studies, extracted the data, and assessed the risk of bias independently. A pooled meta-analysis was performed using RevMan 5.3 software.ResultsFour non-RCTs met the inclusion criteria. The meta-analysis indicated that the use of TXA was related to significantly less transfusion requirements (RD = −0.25; 95% CI: -0.43 to −0.08; P = 0.005), drainage volume (MD = −321.07; 95% CI: -445.13 to −197.01, P = 0.005), hemoglobin reduction (MD = −0.52; 95% CI: -0.79 to −0.25, P = 0.0001), and length of hospital stay (MD = −2.36; 95% CI: -4.00 to −0.71, P = 0.005). No significant differences in the incidence of deep venous thrombosis (DVT) or pulmonary embolism (PE) were noted.ConclusionsThe use of TXA for patients undergoing revision TKA may reduce blood loss and transfusion requirements without increasing the risk of postoperative venous thromboembolism. Due to the limited quality of the currently available evidence, more high-quality RCTs are required.

【 授权许可】

CC BY   
© The Author(s). 2017