Comparison of intra-articular versus intravenous application of tranexamic acid in total knee arthroplasty: a meta-analysis of randomized controlled trials
More details
Hide details
Submission date: 2015-05-09
Final revision date: 2015-06-11
Acceptance date: 2015-06-27
Online publication date: 2017-04-20
Publication date: 2017-04-20
Arch Med Sci 2017;13(3):533–540
Introduction: There is much controversy about the optimal application of tranexamic acid (TXA) in total knee arthroplasty (TKA). The purpose of this meta-analysis was to compare the efficacy of the intra-articular and intravenous regimens of TXA in TKA.
Material and methods: A literature search of the PubMed, Embase and Cochrane Library databases was performed. Randomized controlled trials comparing the result of intra-articular and intravenous application of TXA during TKA were included. The focus was on the outcomes of blood loss, transfusion requirement and thromboembolic complications.
Results: Six studies were eligible for data extraction and meta-analysis. We found no statistically significant difference between intra-articular and intravenous administration of tranexamic acid in terms of total blood loss (WMD, 6.01; 95% CI: –96.78 to 108.79; p = 0.91), drain output (WMD = –20.26; 95% CI: –51.34 to 10.82; p = 0.20), hemoglobin drop (WMD = 0.33; 95% CI: –0.31 to 0.98; p = 0.31), or the incidences of transfusion (RR = 0.98; 95% CI: 0.56–1.70; p = 0.93) as well as deep vein thrombosis (RR = 0.49; 95% CI: 0.09–2.73; p = 0.42).
Conclusions: In comparison with intravenous application of TXA, intra-articular application had a comparable effect on reducing blood loss and the transfusion rate without increasing the complication rate.