Meta-analysis of Temporary Versus No Clamping in TKA

Huang, ZeYu; Ma, Jun; Pei, Fuxing; Yang, Jing; Zhou, Zongke; Kang, Pengde; Shen, Bin

doi:10.3928/01477447-20130624-11

Cited by 32 publications

(24 citation statements)

References 25 publications

(102 reference statements)

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“…Each domain was measured as low bias, unclear bias, or high bias. The methodologic quality of the RCTs was evaluated using the modified Jadad scale, [15] which is a numeric scale that evaluates the quality of the randomization, double blinding, and withdraws and dropouts. Studies scoring 4 or more out of a total possible of 8 were considered to be of high quality.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of tranexamic acid plus drain-clamping to reduce blood loss in total knee arthroplasty

Zhang¹,

Zhang²,

Wang³

2017

Medicine

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Background:Perioperative blood loss is still an unsolved problem in total knee arthroplasty (TKA). The efficacy of the preoperative use of tranexamic acid (TXA) plus drain-clamping to reduce blood loss in TKA has been debated. This meta-analysis aimed to illustrate the efficacy of TXA plus drain-clamping to reduce blood loss in patients who underwent a TKA.Methods:In February 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar. Data from patients prepared for TKA in studies that compared TXA plus drain-clamping versus TXA alone, drain-clamping alone, or controls were retrieved. The primary endpoint was the need for transfusion. The secondary outcomes were total blood loss, blood loss in drainage, the decrease in hemoglobin, and the occurrence of deep venous thrombosis. After testing for publication bias and heterogeneity between studies, data were aggregated for random-effects models when necessary.Results:Ultimately, 5 clinical studies with 618 patients (TXA plus drain-clamping group = 249, control group = 130, TXA-alone group = 60, and drain-clamping group = 179) were included. TXA plus drain-clamping could decrease the need for transfusion, total blood loss, blood loss in drainage, and the decrease in hemoglobin than could the control group, the TXA-alone group, and the drain-clamping group (P < .05). There was no significant difference between the occurrence of deep venous thrombosis between the included groups (P > .05).Conclusions:TXA plus drain-clamping can achieve the maximum effects of hemostasis in patients prepared for primary TKA. Because the number and the quality of the included studies were limited, more high-quality randomized controlled trials are needed to identify the optimal dose of TXA and the clamping hours in patients prepared for TKA.

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Section: Methodsmentioning

confidence: 99%

Efficacy of tranexamic acid plus drain-clamping to reduce blood loss in total knee arthroplasty

Zhang¹,

Zhang²,

Wang³

2017

Medicine

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“…We assessed the methodological quality of the trials independently. The quality of the studies was assessed using the modified Jadad scale (Table ) . Studies achieving four or more points (from a maximum of eight) were considered to be of high quality.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of low‐level laser therapy in the treatment of TMDs: a meta‐analysis of 14 randomised controlled trials

Chen

Huang

et al. 2014

J of Oral Rehabilitation

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This study was designed to evaluate the efficacy of low-level laser therapy (LLLT) in the treatment of temporomandibular disorders (TMDs). We searched electronic databases and references lists of relevant articles, retrieved all of the published randomised controlled trials in regard to these issues and then performed a meta-analysis. Fourteen highly qualified RCTs reporting on a total of 454 patients, which evaluated the effectiveness of LLLT for patients suffering from TMDs were retrieved. The results indicated that LLLT was not better than placebo in reducing chronic TMD pain (weighted mean difference = -19·39; 95% confidence interval = -40·80-2·03; P < 0·00001; I(2) = 99%). However, the LLLT provided significant better functional outcomes in terms of maximum active vertical opening (MAVO) (weighted mean difference = 4·18; 95% confidence interval = 0·73-7·63; P = 0·006; I(2) = 73%), maximum passive vertical opening (MPVO) (weighted mean difference = 6·73; 95% confidence interval = 01·34-12·13; P = 0·06; I(2) = 73%), protrusion excursion (PE) (weighted mean difference = 1·81; 95% confidence interval = 0·79-2·83; P = 0·59; I(2) = 0%) and right lateral excursion (RLE) (weighted mean difference = 2·86; 95% confidence interval = 1·27-4·45; P = 0·01; I(2) = 73%). The results of our meta-analysis have provided the best evidence on the efficacy of LLLT in the treatment of TMDs. This study indicates that using LLLT has limited efficacy in reducing pain in patients with TMDs. However, LLLT can significantly improve the functional outcomes of patients with TMDs.

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“…At the same time, a recent meta‐analysis has confirmed that autologous shed blood transfusion is an effective method to reduce allogeneic blood transfusion . Other techniques used to reduce the blood loss are clamping the drain, retrograde injection of TXA through the drain, and closure without a drain . The current study by Oremus and coworkers suggests that TXA could potentially eliminate the need for surgical drains and autologous shed blood transfusion.…”

mentioning

confidence: 99%