Tranexamic Acid Decreases Incidence of Blood Transfusion in Simultaneous Bilateral Total Knee Arthroplasty

Bagsby, Deren; Samujh, Christopher; Vissing, Jacqueline L.; Empson, Janene A.; Pomeroy, Donald L.; Malkani, Arthur L.

doi:10.1016/j.arth.2015.06.040

Cited by 31 publications

(38 citation statements)

References 58 publications

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“…Of these, 15 clinical trials with 679 patients (739 knees) were included in the meta-analysis. [9–23] Classification of the remaining studies resulted in a total of 8 RCTs, [12,14–16,19–22] 4 retrospective studies, [9,13,17,18] 1 prospective control study, [11] and 2 case–control studies. [10,23] As 1 study used topical and intravenous TXA to reduce blood loss during bilateral TKA, it was considered as 2 articles, compared with the placebo.…”

Section: Resultsmentioning

confidence: 99%

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The effectiveness and safety of tranexamic acid in bilateral total knee arthroplasty

Weng¹,

Zhang²,

et al. 2016

Medicine

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Objective:A meta-analysis was performed to investigate the effectiveness and safety of tranexamic acid (TXA) for the treatment of blood loss after a bilateral total knee arthroplasty (TKA).Methods:Patients prepared for bilateral TKA and intervention including TXA versus placebo were comprehensively retrieved from MEDLINE (PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science from the time of the establishment of these databases to January 2016. The outcomes were all calculated by Stata 12.0 software. The continuous endpoints (total blood loss and blood loss in drainage) were calculated as mean difference (MD) and 95% confidence intervals (CIs). Binary variables (the need for transfusion, and the occurrence of deep venous thrombosis [DVT]) were calculated as relative risk (RR) with 95% CIs.Results:Pooled results revealed that treatment with TXA associated with less need for transfusion (P = 0.000) and the value of Hb drop postoperatively (P = 0.290) after bilateral TKA. The results also indicated that TXA can decrease the total blood loss and blood loss in drainage after bilateral TKA (P < 0.05). Meanwhile, TXA can decrease the blood units transfused per patient by 1.23 U (P = 0.001). There is no statistically significant difference in terms of the occurrence of DVT between the 2 groups (P = 0.461).Conclusion:Based on the current evidence, TXA can decrease the need for transfusion and the total blood loss without increasing the occurrence of DVT, and its administration is recommended routinely in bilateral TKA.

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Section: Resultsmentioning

confidence: 99%

“…Of the included studies, 12 articles were in English [9–20] and 3 were in Chinese, [21–23] and all were published in 2009 or later. The characteristics of the studies that were included are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

The effectiveness and safety of tranexamic acid in bilateral total knee arthroplasty

Weng¹,

Zhang²,

et al. 2016

Medicine

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“…No gray references were included. Finally, six articles reporting two RCTs and four case‐control studies (CCTs) that had been published between 2011 and 2015 were selected for the present meta‐analysis. These studies contained a total of 274 participants in the experiment groups and 293 control patients.…”

Section: Resultsmentioning

confidence: 99%

“…General anesthesia was used in three studies; the other studies did not provide this information. Tourniquets were routinely utilized in all studies. In two studies a midline skin incision was followed by subvastus or medical parapatellar arthrotomy.…”

Section: Resultsmentioning

confidence: 99%

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

Xuan

2016

Orthopaedic Surgery

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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.

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Risks and Benefits of Bilateral Total Knee Replacement Surgery

Huerfano¹,

Shanaghan²,

Vulcano³

et al. 2020

Perioperative Care of the Orthopedic Patient

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Tranexamic Acid Decreases Incidence of Blood Transfusion in Simultaneous Bilateral Total Knee Arthroplasty

Cited by 31 publications

References 58 publications

The effectiveness and safety of tranexamic acid in bilateral total knee arthroplasty

The effectiveness and safety of tranexamic acid in bilateral total knee arthroplasty

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

Risks and Benefits of Bilateral Total Knee Replacement Surgery

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