title: Efficiency and Safety of Intravenous Tranexamic Acid in Simultaneous Bilateral Total Knee Arthroplasty: A Systematic Review and Meta-analysis.
abstract: The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of i.v. tranexamic acid (TXA) in simultaneous bilateral total knee arthroplasty (TKA). Potentially relevant published reports were identified from the following electronic databases: Medline, PubMed, Embase, ScienceDirect and Cochrane Library. RevMan v5.3was used to pool data. Two randomized controlled trials and four case-control studies met the inclusion criteria. The current meta-analysis identified significant differences between TXA group and control groups in terms of postoperative hemoglobin concentration (P < 0.01), drainage volume (P < 0.01), transfusion rate (P < 0.01) and units transfused (P = 0.006). There were no significant differences in length of stay (P = 0.66), operation time (P = 0.81) or and incidence of adverse effects such as infection (P = 0.42), deep venous thrombosis (DVT) (P = 0.88) and pulmonary embolism (PE) (P = 0.11). Our results show that i.v. administration of TXA in simultaneous bilateral TKA reduces postoperative drops in hemoglobin concentration, drainage volume, and transfusion requirements and does not prolong length of stay or operation time. Moreover, no adverse effects, such as infection, DVT or PE, were associated with TXA.
authors.affiliation: Graduate School of General Hospital, Tianjin Medical University, Tianjin, China.|Department of Orthopaedics, Tianjin Hospital, Tianjin, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Graduate School of General Hospital, Tianjin Medical University, Tianjin, China. 15922028810@163.com.|Department of Orthopaedics, Tianjin Hospital, Tianjin, China. 15922028810@163.com.
authors.forename: Xin-Long
authors.initials: XL
authors.lastname: Ma
authors.affiliation: Department of Orthopaedics, Tianjin Hospital, Tianjin, China.
authors.forename: Jian-Xiong
authors.initials: JX
authors.lastname: Ma
mesh_terms: D061605:Administration, Intravenous; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D014148:Tranexamic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: Blood loss; Meta analysis; Total knee arthroplasty; Tranexamic acid