Tranexamic acid in high tibial osteotomy under different procedures: a network Meta-analysis
ZHANG Ke,LIU Bo,CHENG Kai
Department of Joint Surgery, Linfen People's Hospital, Linfen, Shanxi041000，China
Abstract:
Objective To evaluate the differences in the efficacy of tranexamic acid (TXA) applied in high tibial osteotomy (HTO) under different implementation protocols by using network Meta-analysis. Methods All published literature in English and Chinese on the evaluation of the efficacy and safety of TXA for HTO were searched from the Cochrane Library, PubMed, Embase, CNKI, Wanfang database, and the Chinese Biomedical Literature Database system. The observations included: total perioperative blood loss, total postoperative drainage, wound complications, thrombotic events, and blood transfusion rate. A network Meta-analysis was performed using Stata 16.0. Results A total of 13 clinical studies, including 4 randomized controlled trials (RCTs) and 9 retrospective case-control studies (CCTs), with a total of 1 311 patients were included. The results of the network Meta-analysis showed that intravenous TXA reduced total perioperative blood loss and total postoperative drainage, and the use of tourniquets or combined topical and intravenous TXA did not reduce total blood loss. However, the use of tourniquets significantly increased total postoperative drainage. Intravenous TXA alone reduced the rate of postoperative wound complications, but there were no statistical differences in the rates of thrombotic events and blood transfusion rate in patients under each implementation option. Conclusions TXA can reduce total postoperative blood loss and drainage in HTO patients. Intravenous TXA alone is recommended for intraoperative blood management in HTO, and tourniquets are not recommended.
