Research Article
Volume 11 Issue 9 - 2020
Intra-Articular Versus Intravenous Tranexamic Acid Application in Total Knee Arthroplasty
Elsiddig Ali Elsiddig Ahmed*
Department of Orthopaedics Surgery, Prince Mutaib Bin Abdulaziz Hospital, Sakaka, Aljouf Area, Saudi Arabia
*Corresponding Author: Elsiddig Ali Elsiddig Ahmed, Department of Orthopaedics Surgery, Prince Mutaib Bin Abdulaziz Hospital, Sakaka, Aljouf Area, Saudi Arabia.
Received: July 25, 2020; Published: August 10, 2020




Abstract

Objectives: Tranexamic acid (TXA) has been reported to decrease bleeding in total knee arthroplasty (TKA) with different administration routes of different efficacies. We aim to review intra-articular (IA) versus intravenous (IV) TXA injection in TKA.

Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses statement (PRISMA). The search strategy included the following databases: (1) PubMed, (2) Google Scholar, (3) Scopus, (4) Web of Science (ISI), (5) Embase, (6) Cochrane central and (7) CINHAL where we searched for relevant randomised controlled trials that compared the effictiveness of IA TXA with IV injection in TKA.

Results: Out of 16 studies that met the inclusion criteria, three reported that IA was better than IV TXA injection, two reported the opposite while the rest reported equal efficacies of both routes. In addition, only four studies reported a significant difference between IA and IV groups in reducing post-operative hemoglobin and five in reducing total blood loss while three in decreasing the need to blood transfusion. Thromboembolic complications and wound infections were reported by four studies each, and for that, throbmboprophylactics (mostly low-molecular-weight-heparin) and antibiotics were prescribed.

Conclusion: It was found that both IA and IV routes are effective. However, the frequency and dosage of injection may affect this efficacy. Moreover, many factors should be considered to increase the quality of the studies that compare these two routes.

Keywords: Intra-Articular; Intravenous; Total Knee Arthroplasty; Tranexamic Acid; Systematic Review

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Citation: Elsiddig Ali Elsiddig Ahmed. “Intra-Articular Versus Intravenous Tranexamic Acid Application in Total Knee Arthroplasty”. EC Orthopaedics 11.9 (2020): 48-62.

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