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Meta-Analysis
. 2016 Aug;8(3):285-93.
doi: 10.1111/os.12256.

Efficiency and Safety of Intravenous Tranexamic Acid in Simultaneous Bilateral Total Knee Arthroplasty: A Systematic Review and Meta-analysis

Xuan Jiang  1   2 , Xin-Long Ma  3   4 , Jian-Xiong Ma  2
Affiliations
Meta-Analysis

Efficiency and Safety of Intravenous Tranexamic Acid in Simultaneous Bilateral Total Knee Arthroplasty: A Systematic Review and Meta-analysis

Xuan Jiang et al. Orthop Surg. 2016 Aug.

Abstract

The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of i.v. tranexamic acid (TXA) in simultaneous bilateral total knee arthroplasty (TKA). Potentially relevant published reports were identified from the following electronic databases: Medline, PubMed, Embase, ScienceDirect and Cochrane Library. RevMan v5.3was used to pool data. Two randomized controlled trials and four case-control studies met the inclusion criteria. The current meta-analysis identified significant differences between TXA group and control groups in terms of postoperative hemoglobin concentration (P < 0.01), drainage volume (P < 0.01), transfusion rate (P < 0.01) and units transfused (P = 0.006). There were no significant differences in length of stay (P = 0.66), operation time (P = 0.81) or and incidence of adverse effects such as infection (P = 0.42), deep venous thrombosis (DVT) (P = 0.88) and pulmonary embolism (PE) (P = 0.11). Our results show that i.v. administration of TXA in simultaneous bilateral TKA reduces postoperative drops in hemoglobin concentration, drainage volume, and transfusion requirements and does not prolong length of stay or operation time. Moreover, no adverse effects, such as infection, DVT or PE, were associated with TXA.

Keywords: Blood loss; Meta analysis; Total knee arthroplasty; Tranexamic acid.

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Figures

Figure 1
Figure 1
Search results and selection procedure.
Figure 2
Figure 2
Forest plot diagram showing effect of TXA on postoperative hemoglobin concentration.
Figure 3
Figure 3
Forest plot diagram showing effect of TXA on transfusion rate.
Figure 4
Figure 4
Forest plot diagram showing effect of TXA on units transfused.
Figure 5
Figure 5
Forest plot diagram showing effect of TXA on drainage volume.
Figure 6
Figure 6
Forest plot diagram showing effect of TXA on operation time.
Figure 7
Figure 7
Forest plot diagram showing effect of TXA on length of stay.
Figure 8
Figure 8
Forest plot diagram showing effect of TXA on risk of wound infection.
Figure 9
Figure 9
Forest plot diagram showing effect of TXA on risk of DVT.
Figure 10
Figure 10
Forest plot diagram showing effect of TXA on risk of PE.
See this image and copyright information in PMC

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