Cargando…

The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis

BACKGROUND: Topical tranexamic acid (TXA) has been shown to be effective in reducing blood loss and the need for transfusion after total knee arthroplasty. However, the effectiveness of topical TXA use in total hip arthroplasty (THA) still remains unclear. The purpose of this meta-analysis is to exa...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, Shubiao, Wu, Kezhou, Kong, Gengbin, Feng, Weili, Deng, Zhihua, Wang, Hu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754977/
https://www.ncbi.nlm.nih.gov/pubmed/26878845
http://dx.doi.org/10.1186/s12891-016-0923-0
_version_ 1782416121153978368
author Chen, Shubiao
Wu, Kezhou
Kong, Gengbin
Feng, Weili
Deng, Zhihua
Wang, Hu
author_facet Chen, Shubiao
Wu, Kezhou
Kong, Gengbin
Feng, Weili
Deng, Zhihua
Wang, Hu
author_sort Chen, Shubiao
collection PubMed
description BACKGROUND: Topical tranexamic acid (TXA) has been shown to be effective in reducing blood loss and the need for transfusion after total knee arthroplasty. However, the effectiveness of topical TXA use in total hip arthroplasty (THA) still remains unclear. The purpose of this meta-analysis is to examine the safety and efficacy of topical use of TXA following THA. Hypothesis: Topical TXA reduces blood loss and transfusion rates without increasing risk of deep vein thrombosis in patients with THA. METHODS: An electronic literature search of PubMed, Embase, the Cochrane Library, Web of Science and Chinese Biomedical Database was performed, to identify studies published before February 2015. All randomized controlled trials and cohort studies evaluating the efficacy of topical TXA during THA were included. Two independent authors identified the eligible studies, assessed their methodological quality, and extracted data. The data were using fixed-effects or random-effects models with (standard) mean differences and risk ratios for continuous and dichotomous variables, respectively. Data were analysed using RevMan 5.3 software. RESULTS: Fourteen studies encompassing 2594 patients met the inclusion criteria for our meta-analysis. Our meta-analysis indicated that when compared with the placebo group, topical use of TXA significantly reduced total blood loss (MD = −297.65 ml, 95 % CI −371.68 ml, 116.08 ml; P < 0.01), drainage loss (MD = −164.68 ml, 95 % CI −236.63 ml, −92.73 ml; P < 0.01), transfusion rate (RR = 0.26, 95 % CI 0.17, 0.40; P < 0.01) and with less of a drop in haemoglobin level (SMD = −0.66, 95 % CI −0.91, −0.41; P < 0.01) after primary THA. No significant difference in length of hospital stay (MD = −0.40, 95 % CI −0.91, 0.11; P = 0.14), deep vein thrombosis (RR = 1.19, 95 % CI 0.40, 3.57; P = 0.16) and pulmonary embolism (RR = 1.11, 95 % CI 0.11, 10.81; P = 0.21) among the study groups. CONCLUSIONS: Topical TXA could significantly reduce total blood loss, drainage loss, transfusion rates and decrease haemoglobin level following THA, without increasing risk of venous thromboembolisms.
format Online
Article
Text
id pubmed-4754977
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-47549772016-02-17 The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis Chen, Shubiao Wu, Kezhou Kong, Gengbin Feng, Weili Deng, Zhihua Wang, Hu BMC Musculoskelet Disord Research Article BACKGROUND: Topical tranexamic acid (TXA) has been shown to be effective in reducing blood loss and the need for transfusion after total knee arthroplasty. However, the effectiveness of topical TXA use in total hip arthroplasty (THA) still remains unclear. The purpose of this meta-analysis is to examine the safety and efficacy of topical use of TXA following THA. Hypothesis: Topical TXA reduces blood loss and transfusion rates without increasing risk of deep vein thrombosis in patients with THA. METHODS: An electronic literature search of PubMed, Embase, the Cochrane Library, Web of Science and Chinese Biomedical Database was performed, to identify studies published before February 2015. All randomized controlled trials and cohort studies evaluating the efficacy of topical TXA during THA were included. Two independent authors identified the eligible studies, assessed their methodological quality, and extracted data. The data were using fixed-effects or random-effects models with (standard) mean differences and risk ratios for continuous and dichotomous variables, respectively. Data were analysed using RevMan 5.3 software. RESULTS: Fourteen studies encompassing 2594 patients met the inclusion criteria for our meta-analysis. Our meta-analysis indicated that when compared with the placebo group, topical use of TXA significantly reduced total blood loss (MD = −297.65 ml, 95 % CI −371.68 ml, 116.08 ml; P < 0.01), drainage loss (MD = −164.68 ml, 95 % CI −236.63 ml, −92.73 ml; P < 0.01), transfusion rate (RR = 0.26, 95 % CI 0.17, 0.40; P < 0.01) and with less of a drop in haemoglobin level (SMD = −0.66, 95 % CI −0.91, −0.41; P < 0.01) after primary THA. No significant difference in length of hospital stay (MD = −0.40, 95 % CI −0.91, 0.11; P = 0.14), deep vein thrombosis (RR = 1.19, 95 % CI 0.40, 3.57; P = 0.16) and pulmonary embolism (RR = 1.11, 95 % CI 0.11, 10.81; P = 0.21) among the study groups. CONCLUSIONS: Topical TXA could significantly reduce total blood loss, drainage loss, transfusion rates and decrease haemoglobin level following THA, without increasing risk of venous thromboembolisms. BioMed Central 2016-02-16 /pmc/articles/PMC4754977/ /pubmed/26878845 http://dx.doi.org/10.1186/s12891-016-0923-0 Text en © Chen et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Chen, Shubiao
Wu, Kezhou
Kong, Gengbin
Feng, Weili
Deng, Zhihua
Wang, Hu
The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis
title The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis
title_full The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis
title_fullStr The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis
title_full_unstemmed The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis
title_short The efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis
title_sort efficacy of topical tranexamic acid in total hip arthroplasty: a meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754977/
https://www.ncbi.nlm.nih.gov/pubmed/26878845
http://dx.doi.org/10.1186/s12891-016-0923-0
work_keys_str_mv AT chenshubiao theefficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT wukezhou theefficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT konggengbin theefficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT fengweili theefficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT dengzhihua theefficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT wanghu theefficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT chenshubiao efficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT wukezhou efficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT konggengbin efficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT fengweili efficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT dengzhihua efficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis
AT wanghu efficacyoftopicaltranexamicacidintotalhiparthroplastyametaanalysis