Abstract
Objectives
To investigate the value of tranexamic acid (TA) in reducing blood loss and blood transfusion after TKR and other clinical outcomes such as deep venous thrombosis (DVT), pulmonary embolism (PE), ischaemic heart diseases and mortality.
Methods
A systematic review and meta-analysis of published randomised and quasi-randomised trials which used TA to reduce blood loss in knee arthroplasty was conducted. The data was evaluated using the generic evaluation tool designed by the Cochrane Bone, Joint and Muscle Trauma Group.
Results
Blood loss
Fourteen studies (858 patients) were eligible for this outcome. Using TA reduced blood loss by an average of 271 ml (P-value 0.00001, 95% CI (239-303), Heterogeneity I2 90 %.)
Blood transfusion
Fifteen studies (805 patients) were eligible for this outcome. TA led to a reduction in the proportion of patients requiring blood transfusion (Odds Ratio of 0.13, P- value 0.00001, 95% CI (0.09-0.20), Heterogeneity I2 0 %.)
Other outcomes
There were no significant differences in the length of stay, DVT, PE, mortality, wound haematoma or infections between the study groups.
Conclusion
The use of TA in TKR results in significant reduction of blood loss and blood transfusion.
