The efficacy and safety of combined administration of intravenous and topical tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Six randomized controlled trials were included in this meta-analysis, which sought to compare efficacy and safety measures between combined intravenous and topical tranexamic acid administration and intravenous tranexamic acid administration alone in total knee arthroplasty. Pooled analyses on total blood loss and maximum hemoglobin drop significantly favoured combined IV-IA TXA groups, though no significant difference in the rate of transfusion was observed. Rate of deep vein thrombosis also did not significantly differ between groups.