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Meta-Analysis
. 2013 May 7:6:184.
doi: 10.1186/1756-0500-6-184.

Tranexamic acid and the reduction of blood loss in total knee and hip arthroplasty: a meta-analysis

Rajiv Gandhi  1 , Heather M K Evans, Safiyyah R Mahomed, Nizar N Mahomed
Affiliations
Meta-Analysis

Tranexamic acid and the reduction of blood loss in total knee and hip arthroplasty: a meta-analysis

Rajiv Gandhi et al. BMC Res Notes. .

Abstract

Background: Tranexamic acid (TXA) is an antifibrinolytic drug used as a blood-sparing technique in many surgical specialties. The principal objective of our meta-analysis was to review randomized, controlled trials (RCT) comparing total blood loss and the number of patients receiving allogeneic blood transfusions with and without the use of TXA for knee (TKA) and hip (THA) arthroplasty.

Methods: Studies were included if patients underwent primary unilateral TKA or THA; the study involved the comparison of a TXA treatment group to a control group who received either a placebo or no treatment at all; outcome measures included total blood loss TBL, number of patients receiving allogeneic blood transfusions, and/or incidence of thromboembolic complications; the study was a published or unpublished RCT from 1995 - July 2012.

Results: Data were tested for publication bias and statistical heterogeneity. Combined weighted mean differences in blood loss favoured TXA over control for TKA and THA patients respectively [ -1.149 (p < 0.001; 95% CI -1.298, -1.000), -0.504 (p < 0.001; 95% CI, -0.672, -0.336)]. Combined odds ratios favoured fewer patients requiring allogeneic transfusions for TKA and THA with the use of TXA respectively [0.145 (p < 0.001; 95% CI, 0.094, 0.223), 0.327 (p < 0.001; 95% CI, 0.208, 0.515)]. Combined odds ratios indicated no increased incidence of DVT with TXA use in TKA and THA respectively [1.030 (p = 0.946; 95% CI, 0.439, 2.420), 1.070 (p = 0.895; 95% CI, 0.393, 2.911)].

Conclusions: TXA should be considered for routine use in primary knee and hip arthroplasty to decrease blood loss.

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Figures

Figure 1
Figure 1
Funnel plot of standard error by weighted difference in means.
Figure 2
Figure 2
Funnel plot of standard error by log odds ratio.
Figure 3
Figure 3
Forest plot of combined WMD values for total blood loss in knee arthroplasty.
Figure 4
Figure 4
Forest plot of combined WMD values for total blood loss in hip arthroplasty.
Figure 5
Figure 5
Forest plot of combined OR values for the number of patients requiring allogeneic transfusions in knee arthroplasty studies.
Figure 6
Figure 6
Forest plot of combined OR values for the number of patients requiring allogeneic transfusions in hip arthroplasty studies.
Figure 7
Figure 7
Forest plot of combined OR values for the number of patients who developed a DVT in knee arthroplasty studies.
Figure 8
Figure 8
Forest plot of combined OR values for the number of patients who developed a DVT in hip arthroplasty studies.
See this image and copyright information in PMC

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References

    1. Jones CA, Voaklander DC, Johnston DWC, Suarez-Alamazor ME. The effect of age on pain, function, and quality of life after total hip and knee arthroplasty. Arch Intern Med. 2001;161:454–60. doi: 10.1001/archinte.161.3.454. - DOI - PubMed
    1. Jansen AJ, Andreica S, Claeys M, D’Haese J, Camu F, Jochmans K. Use of Tranexamic acid for an effective blood conservation strategy after total knee arthroplasty. Br J Anaesth. 1999;83:596–601. doi: 10.1093/bja/83.4.596. - DOI - PubMed
    1. Veien M, Sørensen JV, Madsen F, Juelsgaard P. Tranexamic acid given intraoperatively reduces blood loss after total knee replacement: a randomized controlled study. Acta Anaesthesiol Scand. 2002;46:1206–1211. doi: 10.1034/j.1399-6576.2002.461007.x. - DOI - PubMed
    1. Kakar PN, Gupta N, Govil P, Shah V. Efficacy and safety of Tranexamic acid in control of bleeding following TKR: a randomized clinical trial. Indian J Anesth. 2009;53:667–671. - PMC - PubMed
    1. Orpen NM, Little C, Walker G, Crawfurd EJP. Tranexamic acid reduces early post-operative blood loss after total knee arthroplasty: a prospective, randomized, controlled trial of 29 patients. Knee. 2006;13:106–10. doi: 10.1016/j.knee.2005.11.001. - DOI - PubMed

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