scholarly journals Is tranexamic acid effective and safe for patients undergoing revision total hip and knee arthroplasty: a meta-analysisIs

2019 ◽  
Author(s):  
Qian Wu ◽  
Jiang nan Xu ◽  
Lu jie Zong ◽  
Sheng hao Wang ◽  
Wu Xu ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Hospital Stay ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Revision Total Knee Arthroplasty ◽  
Joint Arthroplasty ◽  
Secondary Outcome ◽  
Thromboembolic Complications ◽  
Total Knee

Abstract Background: The use of tranexamic acid (TXA) during primary total joint arthroplasty （pTJA） is well documented. However, whether TXA is safe for patients undergoing revision total joint arthroplasty (rTJA) remains to be resolved. Methods: This meta-analysis included 12 studies that involved 2195 cases. The primary outcomes were indicators of TXA effectiveness during perioperative perid, including blood loss, haemoglobin (Hb) level changes, allogeneic blood transfusion (ABT) rate, and number of red blood cell (RBC) units transfused per patient. The secondary outcomes included thromboembolic complications, non-thromboembolic complications, and length of hospital stay. Results: TXA administration was associated with statistically significant decreases in the primary outcomes, including ABT rate (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.14–0.41; P < 0.00001), change in Hb level (mean difference [MD], −0.84; 95% CI, −1.28 to −0.41; P=0.002), and number of RBC units transfused per patient (MD, −0.49; 95% CI, −0.61 to −0.38; P < 0.00001) in the patients undergoing rTJA. Secondary outcome assessments showed no statistically significant differences in venous thromboembolism (OR, 0.99; 95% CI, 0.31–3.14; P=0.98) and non-thromboembolic complications (OR, 0.54; 95% CI, 0.18–1.68; P=0.29) between the patients who received and those who did not receive TXA in the revision total knee arthroplasty subgroup, while a significant decrease in length of hospital stay was found in those who received TXA (MD, −2.89; 95% CI, −4.85 to −0.93; P=0.004). Conclusion: In this meta-analysis, we found that the use of TXA acid can effectively reduce the number of blood transfusions in patients undergoing TJA without increasing the complication rate.

scholarly journals Tranexamic acid lowers transfusion requirements and hospital length of stay following revision total hip or knee arthroplasty

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Bishoy N. Saad ◽  
Luke G. Menken ◽  
Sherif Elkattaway ◽  
Frank A. Liporace ◽  
Richard S. Yoon
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Hospital Stay ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Length Of Hospital Stay ◽  
Joint Arthroplasty ◽  
Thromboembolic Complications ◽  
Revision Tha ◽  
Revision Tka

Abstract Backgroud Intravenous tranexamic acid (TXA) has been shown to reduce blood loss in patients undergoing total joint arthroplasty without systemic complications. There is limited evidence of its effectiveness in revision procedures. This study evaluated intravenous TXA effect on blood loss, transfusion rates, and length of hospital stay in revision joint replacement. Methods One-hundred revision total joint arthroplasty patients were retrospectively reviewed [44 revision total hip arthroplasty (THA) and 54 revision total knee arthroplasty (TKA)] who underwent surgery from 2013 to 2016. Fifty-four revision joint patients (23 THA and 31 TKA) received intravenous TXA intra-operatively, while 46 revision joint patients (23 THA/TKA) did not. Primary outcome measures were blood loss, transfusion rates, and length of hospital stay. Results The mean blood loss difference between revision THA patients who received TXA vs. not receiving TXA was 180ml in revision THA patients (p < .005). Mean length of hospital stay was 6 days in non-TXA vs. 3 days in TXA patients (p < .001). Eighteen patients received transfusions in the non-TXA revision TKA group compared to nine patients in the TXA revision TKA group (p < .001). Average length of hospital stay was 5 days in the non-TXA revision TKA group compared to 3 days in the TXA revision TKA group (p < .003). There was no increased risk of thromboembolic complications in TXA groups for either procedure. Conclusions Intravenous TXA reduced length of hospital stay in both revision cohorts, decreased blood loss in revision THA and decreased the rate of transfusion in revision TKA without an increase in thromboembolic complications. Level of Evidence Level III (Case-control study)

scholarly journals Letter to the Editor on “The Safety of Tranexamic Acid in Total Joint Arthroplasty: A Direct Meta-Analysis”

2018 ◽  
Vol 33 (10) ◽  
pp. 3365-3368.e1 ◽  
Author(s):  
Xiang-Dong Wu ◽  
Ke-Jia Hu ◽  
Ya-Ying Sun ◽  
Yu Chen ◽  
Wei Huang
Keyword(s):  
Tranexamic Acid ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Arthroplasty ◽  
Letter To The Editor

scholarly journals The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trial

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Wei Ye ◽  
Yafang Liu ◽  
Wei Feng Liu ◽  
Xiao Long Li ◽  
Jianshu Shao
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Transfusion Rate ◽  
Total Knee ◽  
Knee And Hip Arthroplasty ◽  
Primary Total Knee ◽  
Optimal Regimen ◽  
Better Than

Abstract Background Oral tranexamic acid (TXA) has been demonstrated to reduce the blood loss in primary total knee and hip arthroplasty, but the optimal regimen of oral TXA administration is still unknown. This study aimed to find the best number of administrations of oral TXA for primary total knee and hip arthroplasty. Methods The PubMed, Embase, and Cochrane Library databases were searched for relevant studies published before March 20, 2020. Studies clearly reporting a comparison of multiple administrations of oral TXA for total hip/knee replacement were included, and the total blood loss (TBL), intraoperative blood loss (IBL), decline in hemoglobin (DHB), deep vein thrombosis (DVT), intramuscular venous thrombosis (IVT), length of hospital stay (LOS), and transfusion rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed effects or random effects model. Results Nine studies involving 1678 patients were included in this meta-analysis (TXA 1363 (one administration, 201; two administrations, 496; three administrations, 215; four administrations, 336; five administrations, 115); placebo 315); the results show that compared with placebo groups, oral TXA could significantly reduce the TBL, IBL, DHB, LOS, and transfusion rate. In addition, the incidences of IVT and DVT were similar between the TXA and placebo groups. Moreover, two administrations of oral TXA significantly reduced the TBL and DHB compared with one administration, three administrations of oral TXA were better than two administrations, and four administrations of oral TXA were better than three administrations. Conclusion Our results suggested that oral TXA could significantly reduce the blood loss and the length of hospital stay but could not increase the incidence of DVT and IVT for total joint replacement patients; additionally, the effectiveness of oral TXA administration increased as the number of administrations increased.

scholarly journals Response to Letter to the Editor on “The Safety of Tranexamic Acid in Total Joint Arthroplasty: A Direct Meta-Analysis”

2018 ◽  
Vol 33 (10) ◽  
pp. 3368-3369 ◽  
Author(s):  
Yale A. Fillingham ◽  
Dipak B. Ramkumar ◽  
David S. Jevsevar ◽  
Adolph J. Yates ◽  
Peter Shores ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Arthroplasty ◽  
Letter To The Editor
Sign in / Sign up

Export Citation Format

Share Document