The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trial
Abstract Background Oral tranexamic acid (TXA) has been demonstrated to reduce the blood loss in primary total knee and hip arthroplasty, but the optimal regimen of oral TXA administration is still unknown. This study aimed to find the best number of administrations of oral TXA for primary total kne...
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01983-1 |
| _version_ | 1798041670427607040 |
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| author | Wei Ye Yafang Liu Wei Feng Liu Xiao Long Li Jianshu Shao |
| author_facet | Wei Ye Yafang Liu Wei Feng Liu Xiao Long Li Jianshu Shao |
| author_sort | Wei Ye |
| collection | DOAJ |
| description | Abstract Background Oral tranexamic acid (TXA) has been demonstrated to reduce the blood loss in primary total knee and hip arthroplasty, but the optimal regimen of oral TXA administration is still unknown. This study aimed to find the best number of administrations of oral TXA for primary total knee and hip arthroplasty. Methods The PubMed, Embase, and Cochrane Library databases were searched for relevant studies published before March 20, 2020. Studies clearly reporting a comparison of multiple administrations of oral TXA for total hip/knee replacement were included, and the total blood loss (TBL), intraoperative blood loss (IBL), decline in hemoglobin (DHB), deep vein thrombosis (DVT), intramuscular venous thrombosis (IVT), length of hospital stay (LOS), and transfusion rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed effects or random effects model. Results Nine studies involving 1678 patients were included in this meta-analysis (TXA 1363 (one administration, 201; two administrations, 496; three administrations, 215; four administrations, 336; five administrations, 115); placebo 315); the results show that compared with placebo groups, oral TXA could significantly reduce the TBL, IBL, DHB, LOS, and transfusion rate. In addition, the incidences of IVT and DVT were similar between the TXA and placebo groups. Moreover, two administrations of oral TXA significantly reduced the TBL and DHB compared with one administration, three administrations of oral TXA were better than two administrations, and four administrations of oral TXA were better than three administrations. Conclusion Our results suggested that oral TXA could significantly reduce the blood loss and the length of hospital stay but could not increase the incidence of DVT and IVT for total joint replacement patients; additionally, the effectiveness of oral TXA administration increased as the number of administrations increased. |
| first_indexed | 2024-04-11T22:24:47Z |
| format | Article |
| id | doaj.art-8cbe9564ae0f465e968cdbd16df82862 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T22:24:47Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-8cbe9564ae0f465e968cdbd16df828622022-12-22T03:59:50ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-10-011511910.1186/s13018-020-01983-1The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trialWei Ye0Yafang Liu1Wei Feng Liu2Xiao Long Li3Jianshu Shao4Department of Orthopedics Medicine, Wujin Hospital Affiliated with Jiangsu UniversityDepartment of Respiratory Medicine, The Wujin Clinical college of Xuzhou Medical UniversityDepartment of Orthopedics Medicine, Wujin Hospital Affiliated with Jiangsu UniversityDepartment of Orthopedics Medicine, Wujin Hospital Affiliated with Jiangsu UniversityDepartment of Orthopedics Medicine, Wujin Hospital Affiliated with Jiangsu UniversityAbstract Background Oral tranexamic acid (TXA) has been demonstrated to reduce the blood loss in primary total knee and hip arthroplasty, but the optimal regimen of oral TXA administration is still unknown. This study aimed to find the best number of administrations of oral TXA for primary total knee and hip arthroplasty. Methods The PubMed, Embase, and Cochrane Library databases were searched for relevant studies published before March 20, 2020. Studies clearly reporting a comparison of multiple administrations of oral TXA for total hip/knee replacement were included, and the total blood loss (TBL), intraoperative blood loss (IBL), decline in hemoglobin (DHB), deep vein thrombosis (DVT), intramuscular venous thrombosis (IVT), length of hospital stay (LOS), and transfusion rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed effects or random effects model. Results Nine studies involving 1678 patients were included in this meta-analysis (TXA 1363 (one administration, 201; two administrations, 496; three administrations, 215; four administrations, 336; five administrations, 115); placebo 315); the results show that compared with placebo groups, oral TXA could significantly reduce the TBL, IBL, DHB, LOS, and transfusion rate. In addition, the incidences of IVT and DVT were similar between the TXA and placebo groups. Moreover, two administrations of oral TXA significantly reduced the TBL and DHB compared with one administration, three administrations of oral TXA were better than two administrations, and four administrations of oral TXA were better than three administrations. Conclusion Our results suggested that oral TXA could significantly reduce the blood loss and the length of hospital stay but could not increase the incidence of DVT and IVT for total joint replacement patients; additionally, the effectiveness of oral TXA administration increased as the number of administrations increased.http://link.springer.com/article/10.1186/s13018-020-01983-1OralMultiple doseTranexamic acidTotal knee/hip arthroplasty |
| spellingShingle | Wei Ye Yafang Liu Wei Feng Liu Xiao Long Li Jianshu Shao The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trial Journal of Orthopaedic Surgery and Research Oral Multiple dose Tranexamic acid Total knee/hip arthroplasty |
| title | The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trial |
| title_full | The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trial |
| title_fullStr | The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trial |
| title_full_unstemmed | The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trial |
| title_short | The optimal regimen of oral tranexamic acid administration for primary total knee/hip replacement: a meta-analysis and narrative review of a randomized controlled trial |
| title_sort | optimal regimen of oral tranexamic acid administration for primary total knee hip replacement a meta analysis and narrative review of a randomized controlled trial |
| topic | Oral Multiple dose Tranexamic acid Total knee/hip arthroplasty |
| url | http://link.springer.com/article/10.1186/s13018-020-01983-1 |
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