Jimin Ma1, Hanli Lu1, Xinxing Chen1, Dasai Wang1, Qiang Wang2. 1. Department of Orthopedics, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China. 2. Department of Orthopedics, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China. 13909636163@126.com.
Abstract
OBJECTIVE: The present meta-analysis was conducted to evaluate the efficacy and safety of the application of tranexamic acid (TXA) in patients undergoing high tibial osteotomy (HTO). METHODS: PubMed (MEDLINE), EMBASE, and Cochrane Library were systematically searched for relevant literature from inception until 1 February 2021. A combined searching strategy of subject words and random words was adopted. After testing for potential publication bias and/or heterogeneity, we aggregated variables by using the random-effect model. The primary comparison outcome measures were total blood loss, hemoglobin decrease, drain output, wound complications, thrombotic events, and blood transfusion rate of the TXA group versus control. The meta-analysis was performed using the RevMan 5.3 software. RESULTS: A total of 5 studies were included involving 532 patients. The results showed that there were significant differences in the two groups concerning total blood loss (95% confidence interval [CI] - 332.74 to - 146.46, P < 0.00001), hemoglobin decrease on postoperative day (POD) 1, 2, and 5 (POD 1 95% CI - 1.34 to - 0.63, P < 0.00001; POD 2 95% CI - 1.07 to - 0.68, P < 0.00001; POD 5 95% CI - 1.46 to - 0.84, P < 0.00001), drain output (POD total 95% CI - 195.86 to - 69.41, P < 0.00001) and wound complications (RR = 0.34, 95% CI 0.12 to 0.97, P = 0.04). Nonsignificant differences were found in the incidence of thromboembolic events (RR = 0.46, 95% CI 0.09 to 2.41, P = 0.36) and blood transfusion rate (RR = 0.25, 95% CI 0.03 to 2.27, P = 0.22). CONCLUSIONS: This meta-analysis of the available evidence demonstrated that TXA could reduce total blood loss, hemoglobin decrease, drain output, and wound complications without increasing the incidence of thromboembolic events in patients undergoing HTO. But there is no obvious evidence that TXA could reduce blood transfusion rates. Further studies, including more large-scale and well-designed randomized controlled trials, are warranted to assess the efficacy and safety issues of routine TXA use in HTO patients.
OBJECTIVE: The present meta-analysis was conducted to evaluate the efficacy and safety of the application of tranexamic acid (TXA) in patients undergoing high tibial osteotomy (HTO). METHODS: PubMed (MEDLINE), EMBASE, and Cochrane Library were systematically searched for relevant literature from inception until 1 February 2021. A combined searching strategy of subject words and random words was adopted. After testing for potential publication bias and/or heterogeneity, we aggregated variables by using the random-effect model. The primary comparison outcome measures were total blood loss, hemoglobin decrease, drain output, wound complications, thrombotic events, and blood transfusion rate of the TXA group versus control. The meta-analysis was performed using the RevMan 5.3 software. RESULTS: A total of 5 studies were included involving 532 patients. The results showed that there were significant differences in the two groups concerning total blood loss (95% confidence interval [CI] - 332.74 to - 146.46, P < 0.00001), hemoglobin decrease on postoperative day (POD) 1, 2, and 5 (POD 1 95% CI - 1.34 to - 0.63, P < 0.00001; POD 2 95% CI - 1.07 to - 0.68, P < 0.00001; POD 5 95% CI - 1.46 to - 0.84, P < 0.00001), drain output (POD total 95% CI - 195.86 to - 69.41, P < 0.00001) and wound complications (RR = 0.34, 95% CI 0.12 to 0.97, P = 0.04). Nonsignificant differences were found in the incidence of thromboembolic events (RR = 0.46, 95% CI 0.09 to 2.41, P = 0.36) and blood transfusion rate (RR = 0.25, 95% CI 0.03 to 2.27, P = 0.22). CONCLUSIONS: This meta-analysis of the available evidence demonstrated that TXA could reduce total blood loss, hemoglobin decrease, drain output, and wound complications without increasing the incidence of thromboembolic events in patients undergoing HTO. But there is no obvious evidence that TXA could reduce blood transfusion rates. Further studies, including more large-scale and well-designed randomized controlled trials, are warranted to assess the efficacy and safety issues of routine TXA use in HTO patients.
Authors: Robin Martin; Trevor B Birmingham; Kevin Willits; Robert Litchfield; Marie-Eve Lebel; J Robert Giffin Journal: Am J Sports Med Date: 2014-03-14 Impact factor: 6.202
Authors: Sebastian Bierke; Martin Häner; Mats Bentzin; Hi Un Park; Wolf Petersen Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-03-27 Impact factor: 4.342
Authors: Antonio Benjumea; Marta Díaz-Navarro; Rama Hafian; Emilia Cercenado; Mar Sánchez-Somolinos; Javier Vaquero; Francisco Chana; Patricia Muñoz; María Guembe Journal: Front Microbiol Date: 2022-06-30 Impact factor: 6.064