title: Use of intravenous tranexamic acid in total knee arthroplasty: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The effect of tranexamic acid (TA) on patients receiving total knee arthroplasty (TKA) has been reported in many small clinical trials. But single trials are not sufficient enough to clarify the effectiveness and safety of TA. So, we carried out a meta-analysis of randomized controlled trials to investigate the efficacy and safety of the intravenous use of TA in TKA.
  
  
  METHODS
  Literatures were retrieved in Cochrane Library, OVID, PubMed, EMBASE, CNKI and Wanfang Data. All the related literatures were checked by two independent investigators and only the high quality randomized controlled trials were enrolled. Relevant data were analyzed using RevMan 5.1 to compare the difference of blood loss, transfusion and complications between TA group and control group.
  
  
  RESULTS
  There were 353 related literatures and only 22 randomized controlled trials met the inclusion criteria. The use of TA in TKA significantly reduced total blood loss by a mean of 435.41 ml (95% CI 300.62-570.21, P less than 0.01), post-operative blood loss by a mean of 406.69 ml (95% CI 333.16-480.22, P less than 0.01). TA also significantly lowered the transfusion rate (risk difference 0.30, 95% CI 0.21-0.39, P less than 0.01) and transfusion volume (mean difference 0.95 unit, 95% CI 0.53-1.37, P less than 0.01). The risks between TA group and control group in developing deep vein thrombosis and pulmonary embolism were not statistically significant.
  
  
  CONCLUSIONS
  TA is beneficial for patients undergoing TKA, which can significantly reduce total blood loss, postoperative blood loss, transfusion rate, and transfusion volume. Meanwhile TA is recommended to reduce deep vein thrombosis and pulmonary embolism following TKA.
authors.affiliation: Centre for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: De-Jie
authors.initials: DJ
authors.lastname: Fu
authors.forename: Cheng
authors.initials: C
authors.lastname: Chen
authors.forename: Lin
authors.initials: L
authors.lastname: Guo
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D006801:Humans; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011655:Pulmonary Embolism / Q000139:chemically induced; D016032:Randomized Controlled Trials as Topic; D014148:Tranexamic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D020246:Venous Thrombosis / Q000139:chemically induced
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid