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The use of tranexamic acid reduces blood loss in osteotomy at knee level: a systematic review

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Aim of this systematic review was to evaluate the literature regarding the effect of tranexamic acid (TXA) on the outcome after knee osteotomy.

Methods

A systematic literature search was carried out in various databases on studies on the use of tranexamic acid in osteotomies around the knee. Primary outcome criterion was the hemoglobin (drop). Secondary outcome criteria were total blood loss, drainage volume, adverse effects such as thromboembolic events, blood transfusions, wound complications and clinical scores. A meta-analysis was performed for quantitative measures. The present study was registered prospectively (www.crd.york.ac.uk/PROSPERO; no.: CRD42021229624).

Results

Seven studies with 584 patients (TXA group: 282 patients, non TXA group: 302 patients) Hemoglobin decrease (1.54 g/dl vs. 2.28 g/dl), blood loss (394.49 ml vs. 595.54 ml) and drainage volume (266.5 ml vs. 359.05 ml) were significantly less in the TXA group compared to the non TXA group. No thromboembolic event was noted in any study. In the non TXA group four blood transfusions were given. Eleven wound complications occurred in the non TXA group in comparison to two wound complications in the TXA group.

Conclusions

The results of the present study show that the application of TXA reduces hemoglobin drop, blood loss and drainage volume. These effects could be responsible for the lesser rate of side effects after administration of TXA during knee osteotomy.

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Funding

The study was not externally funded.

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Author notes

  1. Sebastian Bierke and Martin Häner contributed equally to the present work.

Authors and Affiliations

  1. Klinik für Orthopädie und Unfallchirurgie, Martin Luther Hospital, Caspar-Theyß-Strasse 27-31, 14193, Berlin, Germany

    Sebastian Bierke, Martin Häner, Mats Bentzin, Hi Un Park & Wolf Petersen

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  1. Sebastian Bierke
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  2. Martin Häner
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  3. Mats Bentzin
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Correspondence to Wolf Petersen.

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The present study was registered prospectively (www.crd.york.ac.uk/PROSPERO; no.: CRD42021229624).

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Bierke, S., Häner, M., Bentzin, M. et al. The use of tranexamic acid reduces blood loss in osteotomy at knee level: a systematic review. Knee Surg Sports Traumatol Arthrosc 30, 4104–4114 (2022). https://doi.org/10.1007/s00167-022-06938-z

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