Evidence map›Paper›PMID 33183324›Full record

ArticleJournal of orthopaedic surgery and research2020

Hemostatic effect of tourniquet combined with tranexamic acid in total knee arthroplasty: a network meta-analysis.

Yimin Zhang, Bao Lang, Guifeng Zhao, Fengming Wang

Abstract readNetwork Meta-Analysis
In one paragraph

Article in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Yimin ZhangJoint Surgery Department, Weifang People's Hospital, Weifang, 261000, People's Republic of China.
Bao LangAnesthesiology Department, Weifang People's Hospital, Weifang, 261000, People's Republic of China.
Guifeng ZhaoMedical Department, Weifang People's Hospital, No. 151, Guangwen Road, Kuiwen District, Weifang, 261000, Shandong Province, People's Republic of China. zhaoguifeng69@126.com.
Fengming WangOrthopaedics Department, People's Hospital of Xiashan Ecological and Economic Development Zone, No. 1, Xiashou Road, Xiashan District, Weifang, 261325, Shandong Province, People's Republic of China. wangfengming0331@163.com.

Funding

the Natural Science Foundation of Shandong Province Project No. ZR2019PH026Weifang Health Committee Project No.2017WSJS002
6 · The paper itself

Abstract

backgroundThere are various techniques to reduce blood loss in total knee arthroplasty (TKA), including the use of a tourniquet and tranexamic acid (TXA). In this study, we studied the combined effect of TXA with a tourniquet on blood loss in the setting of primary TKA.

methodsRandomized controlled trials (RCTs) of nine treatment methods were included (placebo, intravenous [i.v.] TXA, topical TXA, i.v.-combined topical TXA, oral TXA, placebo + tourniquet, i.v. TXA +tourniquet, topical TXA + tourniquet, and i.v.-combined topical TXA + tourniquet). The patients were divided into eight groups according to the different treatment strategies, with 30 cases per group. The differences in the total blood volume, the number of patients transfused, the hemoglobin before and after the operation, and complications after the operation were compared.

resultsTotally 15 RCTs meeting our inclusion criteria were collected in this study. Compared with the placebo + tourniquet group, the i.v. TXA + tourniquet group displayed lower hemoglobin reduction value, pulmonary embolism (PE) incidence, total blood loss, and blood transfusion risk; the topical TXA + tourniquet group showed reduced PE incidence, total blood loss, and blood transfusion risk, and the i.v.-combined topical TXA and i.v.-combined topical TXA + tourniquet groups showed decreased total blood loss and lower blood transfusion risk. Retrospective clinical study results also demonstrated that the efficacy of i.v.-combined topical TXA was the best.

conclusionsOur meta-analysis indicates that i.v.-combined topical TXA provides a low total blood loss without increasing the blood transfusion risk in patients undergoing total knee replacement surgery.

Indexed as

Hemostatic TechniquesTourniquetsAdministration, TopicalAgedArthroplasty, Replacement, KneeBlood Loss, SurgicalCase-Control StudiesCombined Modality TherapyFemaleFollow-Up StudiesHumansInfusions, IntravenousMaleMiddle AgedRandomized Controlled Trials as TopicRetrospective StudiesTranexamic AcidHemostasisRandomized controlled trialTotal knee replacementTourniquetsTranexamic acid

Identifiers

PMID33183324
PMCPMC7663901

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.