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Hemostatic techniques to reduce blood transfusion after primary TKA: a meta-analysis and systematic review

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To investigate the efficacy of non-tranexamic acid (TXA) on reducing blood loss and requirements of allogeneic blood transfusion (ABT) in total knee arthroplasty (TKA).

Methods

The PubMed, EMBASE, and the Cochrane Library databases were researched since incipiency to June 2018. Only randomized controlled trials (RCTs) involved with non-TXA hemostatic techniques in TKA met the inclusion criteria.

Results

A total of 36 RCTs, including 1511 patients, were recruited for analysis. The results of subgroup analysis revealed that hemostatic techniques, which could substantially decrease the rate of ABT, were cell salvage with the transfusion trigger of 9 mg/dl, fibrin sealant with a dosage of 10 ml, and postoperative flexion position.

Conclusion

The available evidence in this meta-analysis suggests that postoperative flexion position, fibrin sealant, and cell salvage can substantially decrease the rate of ABT in TKA. Further studies, including more hemostatic methods and high-quality research, are expected.

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Acknowledgements

We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled. Department of orthopaedic surgery, Third Hospital of Hebei Medical University

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  1. Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China

    Zhenyue Dong, Yifan Song, Jianchao Qi & Fei Wang

  2. Hebei Medical University, Shijiazhuang, 050051, Hebei, China

    Li Han

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  1. Zhenyue Dong
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Dong, Z., Han, L., Song, Y. et al. Hemostatic techniques to reduce blood transfusion after primary TKA: a meta-analysis and systematic review. Arch Orthop Trauma Surg 139, 1785–1796 (2019). https://doi.org/10.1007/s00402-019-03271-y

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