2017
DOI: 10.1177/2309499016684725
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The combined use of oral and topical tranexamic acid is a safe, efficient and low-cost method in reducing blood loss and transfusion rates in total knee arthroplasty

Abstract: Aims: The combined (IV (intravenous) þ topical) use of tranexamic acid (TXA) has been shown to be a safe method and more effective than single (IV or topical) application. The optimal administration method of TXA is still being investigated and safety, efficiency and cost are the three main crucial parameters in achieving the best administration method. We aimed to determine whether combined (oral þ topical) use of TXA reduced blood loss and transfusion rates more than single (topical) administration in TKA an… Show more

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Cited by 17 publications
(13 citation statements)
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“…Cankaya et al found that oral and topical tranexamic acid administration were safe, efficient, and economical methods for reducing blood loss and transfusion rates in patients undergoing TKA. 14 However, most recent studies indicated that the effects of oral and intravenous administration of tranexamic acid were the same. 12 , 13 A recent meta-analysis by Dai et al also found no difference between topical and intravenous tranexamic acid in terms of transfusion rate or total blood loss.…”
Section: Discussionmentioning
confidence: 99%
“…Cankaya et al found that oral and topical tranexamic acid administration were safe, efficient, and economical methods for reducing blood loss and transfusion rates in patients undergoing TKA. 14 However, most recent studies indicated that the effects of oral and intravenous administration of tranexamic acid were the same. 12 , 13 A recent meta-analysis by Dai et al also found no difference between topical and intravenous tranexamic acid in terms of transfusion rate or total blood loss.…”
Section: Discussionmentioning
confidence: 99%
“…Thus, the main purpose of a repeated application of TXA or ε-ACA is to inhibit the fibrinolysis to reduce HBL. 21,34 Few articles have compared TXA and ε-ACA in joint arthroplasties. Whether ε-ACA has comparable hemostatic effects compared with TXA is unknown.…”
Section: Discussionmentioning
confidence: 99%
“…Adverse events were categorized as mild (not interfering with the patients' normal activities), moderate (interfering with normal activities), or severe (preventing normal activities). [32][33][34] The Gross and Nadler formula 35,36 was used to calculate TBL. TBL ¼ patient's blood volume (PBV) Â (Hct pre À Hct post )/Hct ave (Hct pre ¼ the initial preoperative Hct level, Hct post ¼ the Hct on the morning of POD3).…”
Section: Outcome Measurementsmentioning
confidence: 99%
“…26 An alternative method of use is oral TXA, the subject of newer studies, which appears to provide equal efficacy and safety while costing much less than IV and IA in TKA. 27 Perreault et al demonstrated in TKA the efficacy and costeffectiveness of oral TXA in the reduction in TR. 28 The oral dose, however, must be taken approximately 2 to 3 hours before surgery to have the greatest effect and percent bioavailability at the time of incision and may differ from patient to patient.…”
Section: Tranexamic Acidmentioning
confidence: 99%
“…34,35 A combination of oral and IA TXA was compared with IA only and proved to be significantly better with regard to TR, TBL, and Hgb levels. 27 It appears from the large number of studies that TXA is safe and effective in many different regimens of use. IV usage looks to be the easiest to administer and is less expensive than IA, while oral TXA currently has unanswered questions about dose and timing.…”
Section: Tranexamic Acidmentioning
confidence: 99%