Topical versus intravenous tranexamic acid in total knee arthroplasty.
The aim of this meta-analysis is to examine the efficacy and safety of intra-articular tranexamic acid (TXA) when compared to intravenous (IV) route.



The literature search was conducted using PubMed, Cochrane Library, MEDLINE, EMBASE and China National Knowledge Infrastructure (CNKI). All randomized controlled trials evaluating the effectiveness of topical route and IV route of TXA administration were included.



Eight randomized clinical trials comprising of 857 patients were included in this analysis. We found no statistically significant difference in terms of total blood loss, drain output, transfusion requirement, thromboembolic complication, tourniquet time and surgical duration.



Topical TXA has a similar efficacy to IV-TXA in reducing total blood loss, drain output, transfusion rate and haemoglobin drop without any increase in thromboembolic complications.
1 Department of Orthopaedics, Lady Hardinge Medical College and Associated Hospitals, Connaught Place, New Delhi, India.
Sanjay
S
Meena
2 Clinica Ortopedica e Traumatologica, Universita degli Studi di Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi, Pavia, Italy.
Francesco
F
Benazzo
3 Department of Orthopaedics, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India.
Saumitra
S
Dwivedi
2 Clinica Ortopedica e Traumatologica, Universita degli Studi di Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi, Pavia, Italy.
Matteo
M
Ghiara
D061605:Administration, Intravenous; D000287:Administration, Topical; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D014148:Tranexamic Acid / Q000008:administration & dosage*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
knee; knee arthroplasty; knee replacement; systematic review; tranexamic acid