Oral tranexamic acid reduces blood loss in total-knee arthroplasty: A meta-analysis

BACKGROUND: Postoperative hemorrhage following total-knee arthroplasty (TKA) remains an important topic. The objective of the meta-analysis is to assess the effectiveness of oral antifibrinolytics for blood management in patients undergoing TKA. METHODS: We searched Medline (1966 to August 2018), PubMed (1966 to August 2018), Embase (1980 to August 2018), ScienceDirect (1985 to August 2018), and the Web of Science (1995 to August 2018) for randomized control trials (RCTs). To assess the heterogeneity of study trial and determine the model for analysis (random-effect model or fixed-effect model), I(2) tests and Chi-squared were conducted. We utilized the STATA 12.0 (StataCorp, College Station, TX) to perform all statistical analyses. RESULTS: A total of 5 RCTs met our inclusion criteria. This meta-analysis shows that there are significant differences between the 2 groups regarding total blood loss, hemoglobin reduction, and transfusion rates. In addition, no adverse effects were identified in treatment groups. CONCLUSION: The oral form of antifibrinolytics in TKA is able to significantly decrease blood loss, postoperative hemoglobin reduction, as well as transfusion requirements. No increased risk of postoperative complications was observed. Higher quality RCTs is necessary to confirm our finding.