title: Tranexamic Acid Reduces Hidden Blood Loss in Patients Undergoing Total Knee Arthroplasty: A Comparative Study and Meta-Analysis.
abstract: BACKGROUND
  To explore the efficacy of tranexamic acid (TXA) on reducing hidden blood loss (HBL) in total knee arthroplasty (TKA) by conducting a comparative study and meta-analysis.
  
  
  METHODS
  A total of 108 patients underwent TKA was equally distributed to experimental and control groups. The only difference between two groups was the administrations of 15 mg of TXA mixed in 100 mL normal saline for experimental group and 100 mL of normal saline for control group. The volumes of blood loss, red blood loss (RBL) were recorded, calculated and analyzed. Stata 12.0 software was applied for data analysis.
  
  
  RESULTS
  The intraoperative and postoperative blood loss volume in experimental group were remarkably reduced compared with those in control group (intraoperative: 105.1±12.1 mL vs. 185.5±20.3 mL, P<0.001; postoperative: 220.7±16.8 mL vs. 290.5±22.4 mL, P<0.001). Accordingly, the control group had significantly higher transfusion rate than experimental group (3.7% vs.25.9%, P=0.001). Our results also found that both the measured and hidden RBL were obviously reduced in experimental group compared with control group (measured RBL: 96.9±11.8 mL vs. 135.2±13.5 mL, P<0.001; hidden RBL: 170.8±37.2 mL vs. 364.2±41.5 mL, P<0.001). Furthermore, meta-analysis confirmed that TXA can notably decrease HBL (SMD=2.68, 95%CI=1.55~3.80, P<0.001).
  
  
  CONCLUSIONS
  TXA can significantly reduce the intraoperative and postoperative blood loss and HBL, therefore decreasing the transfusion need in TKA.
authors.affiliation: Department of Orthopedics, West China Center of Medical Sciences, Sichuan University, Chengdu, Sichuan, China (mainland).
authors.forename: Guang-Ping
authors.initials: GP
authors.lastname: Huang
authors.affiliation: Department of Orthopedics, Jianyang People's Hospital, Jianyang, Sichuan, China (mainland).
authors.forename: Xu-Feng
authors.initials: XF
authors.lastname: Jia
authors.affiliation: Department of Orthopedics, West China Center of Medical Sciences, Sichuan University, Chengdu, Sichuan, China (mainland).
authors.forename: Zhou
authors.initials: Z
authors.lastname: Xiang
authors.affiliation: Department of Orthopedics, Jianyang People's Hospital, Jianyang, Sichuan, China (mainland).
authors.forename: Yong
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Department of Orthopedics, Jianyang People's Hospital, Jianyang, Sichuan, China (mainland).
authors.forename: Guo-Yong
authors.initials: GY
authors.lastname: Wu
authors.affiliation: Department of Orthopedics, Jianyang People's Hospital, Jianyang, Sichuan, China (mainland).
authors.forename: Yi
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Orthopedics, West China Center of Medical Sciences, Sichuan University, Chengdu, Sichuan, China (mainland).
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Orthopedics, West China Center of Medical Sciences, Sichuan University, Chengdu, Sichuan, China (mainland).
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001777:Blood Coagulation / Q000187:drug effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D014148:Tranexamic Acid / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D006454:Hemoglobins; D014148:Tranexamic Acid