Archives of Orthopaedic and Trauma Surgery

, Volume 139, Issue 12, pp 1785–1796 | Cite as

Hemostatic techniques to reduce blood transfusion after primary TKA: a meta-analysis and systematic review

  • Zhenyue Dong
  • Li Han
  • Yifan Song
  • Jianchao Qi
  • Fei WangEmail author
Knee Arthroplasty



To investigate the efficacy of non-tranexamic acid (TXA) on reducing blood loss and requirements of allogeneic blood transfusion (ABT) in total knee arthroplasty (TKA).


The PubMed, EMBASE, and the Cochrane Library databases were researched since incipiency to June 2018. Only randomized controlled trials (RCTs) involved with non-TXA hemostatic techniques in TKA met the inclusion criteria.


A total of 36 RCTs, including 1511 patients, were recruited for analysis. The results of subgroup analysis revealed that hemostatic techniques, which could substantially decrease the rate of ABT, were cell salvage with the transfusion trigger of 9 mg/dl, fibrin sealant with a dosage of 10 ml, and postoperative flexion position.


The available evidence in this meta-analysis suggests that postoperative flexion position, fibrin sealant, and cell salvage can substantially decrease the rate of ABT in TKA. Further studies, including more hemostatic methods and high-quality research, are expected.


Total knee arthroplasty Allogeneic blood transfusion Meta-analysis 



We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled. Department of orthopaedic surgery, Third Hospital of Hebei Medical University


There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryThird Hospital of Hebei Medical UniversityShijiazhuangChina
  2. 2.Hebei Medical UniversityShijiazhuangChina

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