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Does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis

BACKGROUND/OBJECTIVE: : Effective hemostasis has the potential to reduce inflammation and pain, leading to potential benefits in the early rehabilitation of patients who undergo elbow arthrolysis. In the present study, we aim to assesse the effects of tranexamic acid (TXA) on elbow arthrolysis posto...

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Autores principales: Nejat, Mohammad Hadi, Khayami, Amirhosein, Daliri, Mahla, Ebrahimzadeh, Mohammad H., Sadeghi, Masoumeh, Moradi, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557324/
https://www.ncbi.nlm.nih.gov/pubmed/37803371
http://dx.doi.org/10.1186/s12891-023-06835-7
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author Nejat, Mohammad Hadi
Khayami, Amirhosein
Daliri, Mahla
Ebrahimzadeh, Mohammad H.
Sadeghi, Masoumeh
Moradi, Ali
author_facet Nejat, Mohammad Hadi
Khayami, Amirhosein
Daliri, Mahla
Ebrahimzadeh, Mohammad H.
Sadeghi, Masoumeh
Moradi, Ali
author_sort Nejat, Mohammad Hadi
collection PubMed
description BACKGROUND/OBJECTIVE: : Effective hemostasis has the potential to reduce inflammation and pain, leading to potential benefits in the early rehabilitation of patients who undergo elbow arthrolysis. In the present study, we aim to assesse the effects of tranexamic acid (TXA) on elbow arthrolysis postoperative blood loss, patients’ pain perception according to the visual analog scale (VAS), elbow range of motion (ROM), and complications. METHODS: We systematically searched PubMed, Web of Science, SCOPUS, and Cochrane Library. We included controlled trials, either randomized (RCT) or non-randomized studies of intervention (NRSI) comparing the effects of intravenous tranexamic acid (TXA) treatment with placebo/no treatment on postoperative blood loss, pain VAS score, elbow ROM, and complications, in patients who underwent open or closed elbow arthrolysis surgery. RESULTS: One RCT, and three NRSIs met eligibility criteria. The meta-analysis determined that tranexamic acid application reduced drain output 34 mm on average (WMD: -34.00; 95% CI: -49.45, -18.55). There was a discrepancy among included articles in terms of intra-operative blood loss; although the study with the largest sample size (291 and 296 patients in the case and control groups, respectively) reported reduced intra-operative blood loss in patients who received TXA. The pooled estimation for the pain VAS score on the first day post-operatively indicates a reduction in pain among patients in the TXA group (WMD: -0.82; 95% CI: -1.36, -0.28). Results for ROM, and complications’ rate such as hematoma and ulnar nerve palsy were not different between the two groups. CONCLUSION: TXA may be beneficial to reduce elbow arthrolysis bleeding volume. However, it dose not seem to affect final elbow ROM and patients’ pain score. Further high-quality clinical trials are needed to draw a robust conclusion on this topic. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-06835-7.
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spelling pubmed-105573242023-10-07 Does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis Nejat, Mohammad Hadi Khayami, Amirhosein Daliri, Mahla Ebrahimzadeh, Mohammad H. Sadeghi, Masoumeh Moradi, Ali BMC Musculoskelet Disord Research BACKGROUND/OBJECTIVE: : Effective hemostasis has the potential to reduce inflammation and pain, leading to potential benefits in the early rehabilitation of patients who undergo elbow arthrolysis. In the present study, we aim to assesse the effects of tranexamic acid (TXA) on elbow arthrolysis postoperative blood loss, patients’ pain perception according to the visual analog scale (VAS), elbow range of motion (ROM), and complications. METHODS: We systematically searched PubMed, Web of Science, SCOPUS, and Cochrane Library. We included controlled trials, either randomized (RCT) or non-randomized studies of intervention (NRSI) comparing the effects of intravenous tranexamic acid (TXA) treatment with placebo/no treatment on postoperative blood loss, pain VAS score, elbow ROM, and complications, in patients who underwent open or closed elbow arthrolysis surgery. RESULTS: One RCT, and three NRSIs met eligibility criteria. The meta-analysis determined that tranexamic acid application reduced drain output 34 mm on average (WMD: -34.00; 95% CI: -49.45, -18.55). There was a discrepancy among included articles in terms of intra-operative blood loss; although the study with the largest sample size (291 and 296 patients in the case and control groups, respectively) reported reduced intra-operative blood loss in patients who received TXA. The pooled estimation for the pain VAS score on the first day post-operatively indicates a reduction in pain among patients in the TXA group (WMD: -0.82; 95% CI: -1.36, -0.28). Results for ROM, and complications’ rate such as hematoma and ulnar nerve palsy were not different between the two groups. CONCLUSION: TXA may be beneficial to reduce elbow arthrolysis bleeding volume. However, it dose not seem to affect final elbow ROM and patients’ pain score. Further high-quality clinical trials are needed to draw a robust conclusion on this topic. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-023-06835-7. BioMed Central 2023-10-06 /pmc/articles/PMC10557324/ /pubmed/37803371 http://dx.doi.org/10.1186/s12891-023-06835-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Nejat, Mohammad Hadi
Khayami, Amirhosein
Daliri, Mahla
Ebrahimzadeh, Mohammad H.
Sadeghi, Masoumeh
Moradi, Ali
Does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis
title Does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis
title_full Does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis
title_fullStr Does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis
title_full_unstemmed Does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis
title_short Does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis
title_sort does tranexamic acid diminish hemorrhage and pain in open elbow arthrolysis? a systematic review and meta-analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557324/
https://www.ncbi.nlm.nih.gov/pubmed/37803371
http://dx.doi.org/10.1186/s12891-023-06835-7
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