IV and topical tranexamic acid protocols reduce blood loss and transfusion needs in THA .
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The Efficacy of Tranexamic Acid in Total Hip Arthroplasty: A Network Meta-analysis
J Arthroplasty. 2018 Oct;33(10):3083-3089.e4. doi: 10.1016/j.arth.2018.06.023Data from 31 randomized controlled trials on blood loss, and from 16 randomized controlled trials on transfusion rate, were included in this network metaanalysis comparing outcome between various tranexamic acid (TXA) administration strategies, including intravenous (IV), intraarticular/topical (IA), and oral TXA, and placebo in patients who underwent total hip arthroplasty. When assessing blood loss volume, high-dose IV TXA, low-dose IV TXA, high-dose IA TXA, combined IV-IA TXA, and oral TXA were significantly favoured compared to placebo, while low-dose IA TXA demonstrated no significant difference. When assessing transfusion rate, high-dose IV TXA, low-dose IV TXA, high-dose IA TXA, low-dose IA TXA, and combined IV-IA TXA were significantly favoured compared to placebo, while oral TXA demonstrated no significant difference. For both outcome measures, point estimates of effect were greatest among groups administered combined intravenous and topical TXA.
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