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Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong Wu J Bone Joint Surg Am Volume 94(13):1153-1159 July 3, 2012 ©2012 by The Journal of Bone and Joint Surgery, Inc.

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Page 1: Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong

Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis

by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong Wu

J Bone Joint Surg AmVolume 94(13):1153-1159

July 3, 2012

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong

The amount of blood loss per patient was significantly less in the tranexamic acid group compared with the placebo group (weighted mean difference, −504.90 mL [95% CI, −620.89 to

−388.92 mL]; p < 0.00001).

Zhi-Gao Yang et al. J Bone Joint Surg Am 2012;94:1153-1159

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong

The number of blood transfusions per patient was significantly less in the tranexamic acid group compared with the placebo group (weighted mean difference, −1.43 units [95% CI, −1.69 to −1.17

units]; p < 0.00001).

Zhi-Gao Yang et al. J Bone Joint Surg Am 2012;94:1153-1159

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong

The rate of patients requiring transfusion was significantly less in the tranexamic acid group compared with the placebo group (OR, 0.16 [95% CI, 0.10 to 0.25]; p < 0.00001).

Zhi-Gao Yang et al. J Bone Joint Surg Am 2012;94:1153-1159

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong

The rate of deep-vein thrombosis was not affected for the tranexamic acid group as compared with the placebo group (OR, 0.75 [95% CI, 0.34 to 1.67]; p = 0.48).

Zhi-Gao Yang et al. J Bone Joint Surg Am 2012;94:1153-1159

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong

The rate of pulmonary embolism was not affected for the tranexamic acid group as compared with the placebo group (OR, 0.65 [95% CI, 0.18 to 2.33]; p = 0.50).

Zhi-Gao Yang et al. J Bone Joint Surg Am 2012;94:1153-1159

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong

Prothrombin time was not affected for the tranexamic acid group as compared with the placebo group (weighted mean difference, −0.04 second [95% CI, −0.33 to 0.24 second]; p = 0.77).

Zhi-Gao Yang et al. J Bone Joint Surg Am 2012;94:1153-1159

©2012 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty: A Meta-Analysis by Zhi-Gao Yang, Wei-Ping Chen, and Li-Dong

Activated partial thromboplastin time was not affected for the tranexamic acid group as compared with the placebo group (weighted mean difference, 0.37 second [95% CI, −0.56 to 1.29

seconds]; p = 0.44).

Zhi-Gao Yang et al. J Bone Joint Surg Am 2012;94:1153-1159

©2012 by The Journal of Bone and Joint Surgery, Inc.