Do we really need tranexamic acid in total hip arthroplasty? A meta-analysis of nineteen randomized controlled trials

19 randomized control trials (n=1,030) evaluating the use of tranexamic acid (TXA) in total hip arthroplasty (THA) procedures were included in this review to investigate the effectiveness of this treatment in the reduction of blood loss. Results indicated that the use of TXA in THA yielded significantly improved total blood loss, intraoperative blood loss volume, postoperative blood loss, "hidden" blood loss, changes in haemoglobin and hematocrit, as well as the number of patients requiring an allogenic blood transfusion. TXA use in THA did not affect the number of blood units transfused per patient, the incidence of deep vein thrombosis, the incidence of developing a pulmonary embolism , or the duration of hospital stay. Lastly, there was a positive correlation between dosage of TXA and total blood loss.