• Ning Wang, Xiaojiang Xiong, Lixin Xu, Ming Ji, Tao Yang, Jin Tang, Yong Yang, Wangwei Liu, and Hongxia Chen.
• Department of Orthopedics Joint Disease Area.
• Medicine (Baltimore). 2019 Apr 1; 98 (17): e15279e15279.

BackgroundThe purpose of this study was to assess the cost benefit and transfusions of oral and IV tranexamic acid (TXA) in primary total hip arthroplasty (THA).MethodsPubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for randomized controlled trials (RCTs) comparing oral and IV TXA in primary THA. Primary outcomes were total blood loss, maximum hemoglobin drop, transfusion requirements, and cost benefit. Secondary outcomes were length of stay, deep venous thrombosis (DVT) and/or pulmonary embolism (PE).ResultsFour independent RCTs were included involving 391 patients. There was no difference in the total blood loss (P = .99), maximum hemoglobin drop (P = .73), and the length of stay (P = .95) between the 2 groups. Transfusion requirements (P = .97) were similar. The total mean cost was the US $75.41 in oral TXA group and the US $580.83 in IV TXA group. The incidence of DVT (P = .3) did not differ significantly between the 2 groups, and no PE was reported in all studies.ConclusionOral TXA shows similar efficacy and safety as IV TXA in reducing total blood loss, maximum hemoglobin drop and transfusion requirements in primary THA. However, oral TXA may be more cost-benefit than IV TXA.Level Of EvidenceLevel I, therapeutic study.

26 keywords...

hide…