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Meta-Analysis
. 2017 Oct 27;12(1):159.
doi: 10.1186/s13018-017-0660-6.

The efficacy of tranexamic acid using oral administration in total knee arthroplasty: a systematic review and meta-analysis

Lu-Kai Zhang  1   2 , Jian-Xiong Ma  1 , Ming-Jie Kuang  1 , Jie Zhao  1 , Bin Lu  1 , Ying Wang  1 , Xin-Long Ma  3   4 , Zheng-Rui Fan  1
Affiliations
Meta-Analysis

The efficacy of tranexamic acid using oral administration in total knee arthroplasty: a systematic review and meta-analysis

Lu-Kai Zhang et al. J Orthop Surg Res. .

Abstract

Background: Total knee arthroplasty (TKA) is gradually regarded as an effective choice for end-stage osteoarthritis or rheumatic arthritis. In the past, the management of tranexamic acid (TXA) using intravenous injection or topical application has been extensively researched. However, several studies have reported that oral TXA has an effect on blood loss. Therefore, a meta-analysis should be performed to determine whether oral TXA helps to prevent blood loss.

Methods: Randomized controlled trials or retrospective cohort studies about relevant studies were searched in PubMed (1996-April 2017), Embase (1980-April 2017), and the Cochrane Library (CENTRAL, April 2017). Six studies that compared oral TXA to non-TXA were included in our meta-analysis. Meta-analyses (PRISMA) guidelines, the Cochrane Handbook, and the Jadad scale were used to evaluate the included studies and the results to ensure that the meta-analysis was viable.

Results: In accordance with inclusion and exclusion, six studies with 2553 patients (oral TXA = 1386, without TXA = 1167) were eligible and accepted into this meta-analysis. Pooled data indicated that the oral TXA group was effective compared to the without TXA group in terms of hemoglobin (Hb) drop (P < 0.05), blood loss at 24 h (P < 0.05), total blood loss (P < 0.05), and the transfusion rate (P < 0.05). No significant differences were found in the length of hospital stay (P = 0.96) and complications (P = 0.39).

Conclusion: Compared to the non-TXA group, the oral TXA group showed effects of blood sparing. Considering the cost and effectiveness, oral TXA is useful for TKA.

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

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
The search results and selection procedure
Fig. 2
Fig. 2
a A funnel plot of the Hb drop. b A funnel plot of the blood loss. c A funnel plot of the transfusion rate. d A funnel plot of the complications. e A funnel plot of the length of hospital stay
Fig. 3
Fig. 3
A forest plot diagram showing the Hb drop (g/dL)
Fig. 4
Fig. 4
A forest plot diagram showing the blood loss (mL)
Fig. 5
Fig. 5
A forest plot diagram showing the transfusion rate (%)
Fig. 6
Fig. 6
A forest plot diagram showing the complications (%)
Fig. 7
Fig. 7
A forest plot diagram showing the length of hospital stay (days)
See this image and copyright information in PMC

References

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