Department of Orthopedics, Tianjin University Tianjin Hospital, 300211 Tianjin, China.
Jt Dis Relat Surg. 2022;33(3):686-694. doi: 10.52312/jdrs.2022.732. Epub 2022 Oct 6.
In this meta-analysis, we aimed to compare the efficacy and safety of peri-articular injection (PAI) and intraarticular injection (IAI) of tranexamic acid (TXA) in total knee arthroplasty (TKA).
We performed a comprehensive literature search from electronic databases such as Springer, Web of Science, PubMed, Cochrane Library databases, and ScienceDirect up to October 2021. The language of identified articles was not restricted. The keywords used for the search strategy included: "tranexamic acid", "total knee arthroplasty", "peri-articular injection" and "intra-articular injection".
Two randomized-controlled trials (RCTs) and four non-RCTs with a total of 491 patients met the inclusion criteria. Of the patients, 242 patients were in the PAI group and 249 patients were in the IAI group. No significant difference was observed between the two groups in hemoglobin drop, postoperative drainage volume, total blood loss, blood transfusion requirements, or units of blood transfused. There was no significant difference between the two groups regarding postoperative infection or deep venous thrombosis.
The PAI of TXA is comparable to IAI of TXA in decreasing postoperative blood loss during TKA.
在这项荟萃分析中，我们旨在比较膝关节置换术中关节周围注射（PAI）和关节内注射（IAI）氨甲环酸（TXA）的疗效和安全性。
我们从 Springer、Web of Science、PubMed、Cochrane Library 数据库和 ScienceDirect 等电子数据库中进行了全面的文献检索，检索时间截至 2021 年 10 月。未对文章的语言进行限制。搜索策略中使用的关键词包括：“氨甲环酸”、“全膝关节置换术”、“关节周围注射”和“关节内注射”。
符合纳入标准的有 2 项随机对照试验（RCT）和 4 项非随机对照试验，共 491 例患者。其中，242 例患者接受 PAI，249 例患者接受 IAI。两组间血红蛋白下降量、术后引流量、总失血量、输血需求或输血量均无显著差异。两组术后感染或深静脉血栓形成也无显著差异。
在 TKA 中，TXA 的 PAI 在减少术后失血方面与 IAI 相当。
