A Systematic Review and Meta-Analysis of Tranexamic Acid in Total Knee Replacement
Hatim Mohammed ALShareef1, Wafa M. Imran2* and Salwa M. Imran3
1King Fahad Armed Forces Hospital, Saudi Arabia.
2Shandong First Medical University, China.
3Xuzhou Medical University, China.
*Corresponding Author: Dr. Wafa M. Imran, Shandong First Medical University, China.
Received: September 30, 2022 Published: November 16, 2022
Abstract
Background: This study aims to examine the effects of tranexamic acid (TXA) on blood loss and transfusion needs in patients with total knee replacements (TKR). TXA is commonly used to prevent excessive bleeding. In a TKR, goal is to minimize blood loss and associated risks in a variety of surgical procedures, including TKR, such as infection and deep vein thrombosis.
Purpose: To investigate influence of TXA in TKR, dosing such as single dose, IV/topical TXA, side effects, contraindications, safety, and efficacy of using TXA in comorbidities like diabetics, obese, and smokers.
Methods: A comprehensive literature search of databases including PubMed-Medline, Ovid-EMBASE, and Cochrane Library was performed to collect related literature. We analyzed all RCTs. 48 articles were included in the study. The outcomes like post-operative blood loss and TXA use in comorbid conditions were extracted from the study along with effective dosages and methods of application.
Results: Multiple intravenous TXA doses can reduce postoperative blood loss and improve functional outcome in total knee arthroplasty without a tourniquet (1). There is no major difference in mechanism of action, coagulation, and fibrinolytic profile between topical TXA and a single dose of IV TXA, it may be simpler to use a single dose of IV TXA when safety is a concern (2).
Conclusion: TXA reduces postoperative blood loss and improves functional outcome in TKR. TXA is safe to use in comorbid health issues such as smoking, diabetes, and obesity.
Keywords: Osteoarthritis, tranexamic acid (TXA), Total Knee Replacement
Citation: Alshareef HM, Imran WM, Imran SM. “A Systematic Review and Meta-Analysis of Tranexamic Acid in Total Knee Replacement” SVOA Orthopaedics 2022, 2:6, 118-129.