These authors conducted a meta-analysis to evaluate the efficacy and safety of tranexamic acid (TXA) in shoulder arthroplasty. They identified articles from the Cochrane Library, Medline (1966–2017.2), PubMed (1966–2017.2), Embase (1980–2017.2), and ScienceDirect (1966–2017.2). Two RCTs and 2 non-RCTs met their inclusion criteria.
The meta-analysis found significant differences in postoperative hemoglobin reduction (Mean difference (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.
The included studies did not report any postoperative complications or side effects of TXA.
The included studies did not report any postoperative complications or side effects of TXA.
Comment: The results of this study call for additional data to demonstrate the cost effectiveness of tranexamic acid. Other means of blood loss control, such as good surgical technique, attention to hemostasis and short operating time may obviate much of the apparent benefit of TSA.
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