title: A meta-analysis of the effectiveness and safety of using tranexamic acid in primary unilateral total knee arthroplasty.
abstract: BACKGROUND
  To evaluate the effectiveness and safety of tranexamic acid (TEA) treatment in reducing perioperative blood loss and transfusion for patients receiving primary unilateral total knee arthroplasty (TKA) and to explore the most effective and safe protocol.
  
  
  METHODS
  This study was based on Cochrane methodology for conducting meta-analyses. Only randomized controlled trials were eligible for this study. The participants were adults who had undergone primary unilateral TKA. The Review Manager Database (RevMan version 5.0, The Cochrane Collaboration, 2008) was used to analyze selected studies.
  
  
  RESULTS
  Nineteen randomized controlled trials involving 1114 patients were included. The use of TEA reduced postoperative drainage by a mean of 290 mL (95% confidence interval [CI] -385 to -196], total blood loss by a mean of 570 mL (95% CI -663 to -478), the number of blood transfusions per patient by 0.96 units (95% CI -1.32 to -0.59), and the volumes of blood transfusions per patient -440 mL (95% CI -518 to -362). TEA led to a significant reduction in the proportion of patients requiring blood transfusion (relative risk 0.39). There were no significant differences in venous thromboembolism or other adverse events among the study groups.
  
  
  CONCLUSIONS
  Intravenous TEA could significantly reduce perioperative blood loss and blood transfusion requirements following primary unilateral TKA. Its application is not associated with increased risk of venous thromboembolisms or other adverse events.
authors: Department of Emergency and Critical Care Medicine, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.
authors: Jixiang
authors: J
authors: Tan
authors: Hong
authors: H
authors: Chen
authors: Qin
authors: Q
authors: Liu
authors: Cheng
authors: C
authors: Chen
authors: Wei
authors: W
authors: Huang
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000453:epidemiology
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: Arthroplasty; Meta-analysis; Total knee; Tranexamic acid