Comparison of oral versus intravenous tranexamic acid in total knee and hip arthroplasty: A GRADE analysis and meta-analysis
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2020;8(22):11 Medicine (Baltimore) . 2020 Oct 30;99(44):e22999What this means for my practice?
The pooled results suggest that blood loss and the incidence of adverse events is similar with oral and IV TXA for patients undergoing a THA or TKA. There are some limitations to this meta-analysis, including the small number of included studies and sample size, as well as the variability in dosage and timing of administering the TXA. Therefore, future studies with large numbers of patients and consistency in dosage and timing of treatment are of interest.
Study Summary
Ten randomized controlled trials with a total of 1080 patients undergoing a total hip arthroplasty (THA) or total knee arthroplasty (TKA) were included in this meta-analysis comparing oral tranexamic acid (TXA) or intravenous (IV) TXA. The primary outcomes of interest included Hemoglobin (Hb) drop, total blood loss, and transfusion rate. Secondary outcomes of interest included drain blood loss, length of hospital stay, incidence of deep venous thrombosis (DVT), and the incidence of calf muscular vein thrombosis (CMVT). The pooled results demonstrated no statistically significantly differences between the oral or IV TXA groups in all primary or secondary outcomes.
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