The Efficacy and Safety of Tranexamic Acid in Revision Total Knee and Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

Study Summary

27 studies involving 10248 patients undergoing revision total hip arthroplasty (rTHA) or revision total knee arthroplasty (rTKA) were included in this systematic review, of which 25 were included in the meta-analysis comparing tranexamic acid (TXA) with no TXA administration. Pooled outcomes included postoperative haemoglobin (Hb) reduction, calculated blood loss, blood transfusion rates, red blood cell (RBC) transfusion requirements, and venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). TXA significantly reduced postoperative Hb decline, blood transfusion rates, and RBC transfusion requirements in both rTHA and rTKA. However, calculated blood loss was not significantly reduced in the pooled rTHA analysis, and VTE rates did not differ significantly between groups. Overall, TXA appeared effective in reducing transfusion requirements during revision hip and knee arthroplasty without an observed increase in thromboembolic complications, although the optimal administration route and dosage remained uncertain.