eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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SCImago Journal & Country Rank
3/2017
vol. 13
 
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abstract:
Systematic review/Meta-analysis

Comparison of intra-articular versus intravenous application of tranexamic acid in total knee arthroplasty: a meta-analysis of randomized controlled trials

Yaming Liu
,
Fantao Meng
,
Gang Yang
,
Lingde Kong
,
Yong Shen

Arch Med Sci 2017; 13, 3: 533–540
Online publish date: 2017/04/20
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Introduction: There is much controversy about the optimal application of tranexamic acid (TXA) in total knee arthroplasty (TKA). The purpose of this meta-analysis was to compare the efficacy of the intra-articular and intravenous regimens of TXA in TKA.

Material and methods: A literature search of the PubMed, Embase and Cochrane Library databases was performed. Randomized controlled trials comparing the result of intra-articular and intravenous application of TXA during TKA were included. The focus was on the outcomes of blood loss, transfusion requirement and thromboembolic complications.

Results: Six studies were eligible for data extraction and meta-analysis. We found no statistically significant difference between intra-articular and intravenous administration of tranexamic acid in terms of total blood loss (WMD, 6.01; 95% CI: –96.78 to 108.79; p = 0.91), drain output (WMD = –20.26; 95% CI: –51.34 to 10.82; p = 0.20), hemoglobin drop (WMD = 0.33; 95% CI: –0.31 to 0.98; p = 0.31), or the incidences of transfusion (RR = 0.98; 95% CI: 0.56–1.70; p = 0.93) as well as deep vein thrombosis (RR = 0.49; 95% CI: 0.09–2.73; p = 0.42).

Conclusions: In comparison with intravenous application of TXA, intra-articular application had a comparable effect on reducing blood loss and the transfusion rate without increasing the complication rate.
keywords:

tranexamic acid, intra-articular, intravenous, total knee arthroplasty, meta-analysis

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