title: Topical application of tranexamic acid in primary total hip arthroplasty: a systemic review and meta-analysis.
abstract: OBJECTIVE
  A systematic review of randomized controlled trials (RCTs) and non-RCTs was performed to evaluate efficacy for the reduction of postoperative blood loss and transfusion requirements of topical use of tranexamic acid in patients undergoing primary total hip arthroplasty.
  
  
  METHODS
  Potential articles were identified from Medline (1966 - September 2014), Embase (1980 - September 2014), Pubmed (1980 - September 2014) and The Cochrane Central Register of Controlled Trials. Other internet databases are also searched to find trials according to the Cochrane Collaboration guidelines. Moreover, gray literatures are also selected from the reference list of the included studies. High quality randomized controlled trials (RCTs) and non-RCTs were selected. The software RevMan 5.1 was used for the mate-analysis.
  
  
  RESULTS
  Four RCTs and four non-RCT meet the inclusion criteria. There were significant differences in hemoglobin, total blood loss, transfusion requirements and postoperative drainage volume between TXA groups and control groups. There were no significant differences in length of stay, incidence of wound infection, deep vein thrombosis (DVT) and pulmonary embolism (PE) between treatment and control groups.
  
  
  CONCLUSIONS
  Present meta-analysis indicates that the antifibrinolytic agent, also known as tranexamic acid, could reduce hemoglobin decline, volume of drainage, total blood loss and transfusion requirements after THA, and is not related to adverse reactions or complications such as wound infection, DVT and PE.
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China; Tianjin Medical University, Tianjin 300070, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Tianjin Hospital, Tianjin 300211, People's Republic of China.
authors.forename: Gui-jun
authors.initials: GJ
authors.lastname: Xu
authors.affiliation: Department of Orthopedics, Tianjin Hospital, Tianjin 300211, People's Republic of China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Han
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China.
authors.forename: Jian-xiong
authors.initials: JX
authors.lastname: Ma
authors.affiliation: Department of Orthopedics, Tianjin Hospital, Tianjin 300211, People's Republic of China. Electronic address: orthodoc969@gmail.com.
authors.forename: Xin-long
authors.initials: XL
authors.lastname: Ma
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Biomechanics Labs of Orthopaedics Institute, Tianjin Hospital, Tianjin 300050, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000287:Administration, Topical; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001803:Blood Transfusion; D006801:Humans; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D011655:Pulmonary Embolism / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014148:Tranexamic Acid / Q000008:administration & dosage*; D020246:Venous Thrombosis / Q000209:etiology
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: Meta-analysis; Topical; Total hip arthroplasty; Tranexamic acid