Tranexamic acid decreases blood loss in shoulder arthroplasty: A meta-analysis

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Abstract

Background:

The objective of this meta-analysis was to evaluate the efficacy and safety of tranexamic acid (TXA) in shoulder arthroplasty (SA).

Methods:

Academic articles were identified from the Cochrane Library, Medline (1966–2017.2), PubMed (1966–2017.2), Embase (1980–2017.2), and ScienceDirect (1966–2017.2). Randomized controlled trials (RCTs) and non-RCTs studying TXA in SA were included. Two independent reviewers conducted independent data abstraction. The I2 statistic was used to assess heterogeneity. Fixed- or random-effects models were used for meta-analysis.

Results:

Two RCTs and 2 non-RCTs met the inclusion criteria. This meta-analysis found significant differences in postoperative hemoglobin reduction (MD = –0.71 g/dL), drainage volume (MD = –133.21 mL), and total blood loss (MD = –226.82 mL) between TXA groups and controls. There were no significant differences in blood transfusion requirements, operation time, or length of hospital stay.

Conclusions:

The use of TXA in SA decreases postoperative hemoglobin reduction, drainage volume, and total blood loss and does not increase the risk of complications. Because of the limited high-quality evidence currently available, additional randomized controlled trials are required.

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