Tranexamic Acid Use in Anterior Cruciate Ligament Reconstruction Decreases Bleeding Complications: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Alkhatib, Nedal; AlNouri, Mason; Abdullah, Abdullah Saad Abdulfattah; Alzobi, Osama; Alkaramany, Eslam; Sasaki, Eiji; Ishibashi, Yasuyuki

doi:10.1016/j.arthro.2021.07.030

Cited by 12 publications

(3 citation statements)

References 46 publications

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“…As a countermeasure for postoperative bleeding, tranexamic acid (TXA) administration plays a key role in various surgical fields [11,12]. In recent years, a number of randomized controlled studies have revealed the effectiveness of TXA in reducing perioperative blood loss in patients undergoing total joint arthroplasty [13,14], and a consensus has been reached regarding its efficacy in this patient population.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Iseki

Kanto

et al. 2023

J Orthop Surg Res

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Background This randomized controlled study was undertaken to investigate the efficacy of intravenous tranexamic acid (TXA) administration in reducing perioperative blood loss in patients undergoing medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO). It was hypothesized that TXA would reduce perioperative blood loss in MOWDTO. Methods A total of 61 knees in 59 patients who underwent MOWDTO during the study period were randomly assigned to either of the groups with intravenous TXA administration (TXA group) or without TXA administration (control group). In the TXA group, patients received 1000 mg of TXA intravenously before skin incision and 6 h after the first dose. The primary outcomes was the volume of perioperative total blood loss which calculated using the blood volume and hemoglobin (Hb) drop. The Hb drop was calculated as the difference between preoperative Hb and postoperative Hb at days 1, 3, and 7. Results The perioperative total blood loss was significantly lower in the TXA group (543 ± 219 ml vs. 880 ± 268 ml, P < 0.001). The Hb drop was significantly lower at postoperative days 1, 3 and 7 in the TXA group than in the control group (day 1: 1.28 ± 0.68 g/dl vs. 1.91 ± 0.69 g/dl, P = 0.001; day 3: 1.54 ± 0.66 g/dl vs. 2.69 ± 1.00 g/dl, P < 0.001; day 7: 1.74 ± 0.66 g/dl vs. 2.83 ± 0.91 g/dl, P < 0.001). Conclusion Intravenous TXA administration in MOWDTO could reduce the perioperative blood loss. Trial registration The study was approved by the institutional review board. (Registered on 26/02/2019 Registration Number 3136). Level of Evidence Level I, randomized controlled trial.

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Section: Introductionmentioning

confidence: 99%

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Iseki

Kanto

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…As a countermeasure for postoperative bleeding, tranexamic acid (TXA) administration plays a key role in various surgical elds [11,12]. In recent years, a number of randomized controlled studies have revealed the effectiveness of TXA in reducing perioperative blood loss in patients undergoing total joint arthroplasty [13,14], and a consensus has been reached regarding its e cacy in this patient population.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intravenous tranexamic acid administration in medial opening wedge distal tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Iseki

Kanto

et al. 2022

Preprint

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Background: This randomized controlled study was undertaken to investigate the efficacy of intravenous tranexamic acid (TXA) administration in reducing perioperative blood loss in patients undergoing medial open-wedge distal tibial tuberosity osteotomy (MOWDTO). It was hypothesized that TXA would reduce perioperative blood loss in MOWDTO. Methods: A total of 61 knees in 59 patients who underwent MOWDTO during the study period were randomly assigned to either of the groups with intravenous TXA administration (TXA group) or without TXA administration (Control group). In the TXA group, patients received 1000 mg of TXA intravenously before skin incision and 6 hours after the first dose. The primary outcomes was the volume of perioperative total blood loss which calculated using the blood volume and hemoglobin (Hb) drop. The Hb drop was calculated as the difference between preoperative Hb and postoperative Hb at day1,3,and 7. Results: The perioperative total blood loss was significantly lower in the TXA group (543±219 ml vs 880±268 ml, P < 0.001). The Hb drop were significantly lower at postoperative days 1, 3 and 7 in the TXA group than in the control group (Day 1: 1.28 ± 0.68 g/dl vs 1.91 ± 0.69 g/dl, P = 0.001; Day 3: 1.54 ± 0.66 g/dl vs 2.69 ± 1.00 g/dl, P < 0.001; Day 7: 1.74 ± 0.66 g/dl vs 2.83 ± 0.91 g/dl, P < 0.001). Conclusion: Intravenous TXA administration in MOWDTO could reduce the perioperative blood loss. Trial registration: The study was approved by the institutional review board. (Registered on 26/02/2019 Registration Number 3136). Level of Evidence: Level I, randomized controlled trial.

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“…However, most of them only focused on its antifibrinolytic effects on short-term outcomes—including hemarthrosis and drain output. 2,29 Currently, a randomized controlled trial (NCT03552705) is investigating the effect of systemic TXA treatment during ACLR surgery on acute joint inflammation and long-term cartilage health in patients with ACL ruptures.…”

mentioning

confidence: 99%

Tranexamic Acid Attenuates the Progression of Posttraumatic Osteoarthritis in Mice

Xie,

Jiang,

Donat

et al. 2024

Am J Sports Med

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Background: Posttraumatic osteoarthritis (OA) is a common disorder associated with a high socioeconomic burden, particularly in young, physically active, and working patients. Tranexamic acid (TXA) is commonly used in orthopaedic trauma surgery as an antifibrinolytic agent to control excessive bleeding. Previous studies have reported that TXA modulates inflammation and bone cell function, both of which are dysregulated during posttraumatic OA disease progression. Purpose: To evaluate the therapeutic effects of systemic and topical TXA treatment on the progression of posttraumatic OA in the knee of mice. Study Design: Controlled laboratory study. Methods: OA was induced via anterior cruciate ligament (ACL) transection on the right knee of female mice. Mice were treated with TXA or vehicle intraperitoneally daily or intra-articularly weekly for 4 weeks, starting on the day of surgery. Articular cartilage degeneration, synovitis, bone erosion, and osteophyte formation were scored histologically. Micro−computed tomography evaluation was conducted to measure the subchondral bone microstructure and osteophyte volume. Cartilage thickness and bone remodeling were assessed histomorphometrically. Results: Both systemic and topical TXA treatment significantly reduced cartilage degeneration, synovitis, and bone erosion scores and increased the ratio of hyaline to calcified cartilage thickness in posttraumatic OA. Systemic TXA reversed ACL transection-induced subchondral bone loss and osteophyte formation, whereas topical treatment had no effect. Systemic TXA decreased the number and surface area of osteoclasts, whereas those of osteoblasts were not affected. No effect of topical TXA on osteoblast or osteoclast parameters was observed. Conclusion: Both systemic and topical TXA exerted protective effects on the progression of posttraumatic OA. Drug repurposing of TXA may, therefore, be useful for the prevention or treatment of posttraumatic OA, particularly after ACL surgery. Clinical Relevance: TXA might be beneficial in patients with posttraumatic OA of the knee.

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Tranexamic Acid Use in Anterior Cruciate Ligament Reconstruction Decreases Bleeding Complications: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 12 publications

References 46 publications

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Efficacy of intravenous tranexamic acid administration in medial opening wedge distal tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Tranexamic Acid Attenuates the Progression of Posttraumatic Osteoarthritis in Mice

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