Evidence map›Paper›PMID 34703327›Full record

ReviewOrthopedic research and reviews2021

Utilization of Tranexamic Acid in Surgical Orthopaedic Practice: Indications and Current Considerations.

Aryan Haratian, Tara Shelby, Laith K Hasan, Ioanna K Bolia, Alexander E Weber, Frank A Petrigliano

Registry-linked trialOpen access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Orthopedic research and reviews, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06781021 (The Effect of Tranexamic Acid Vs Torniquet on Visual Clarity in Knee Arthroscopic Anterior Cruciate Ligament), which is not on this map. Cited by 23 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 3 pooled it
1.7field-weighted citation impact, top 16% of its field
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.

NCT06781021 naenrolling by invitationnot on this mapstarted 2024, after this paper: background citation

The Effect of Tranexamic Acid Vs Torniquet on Visual Clarity in Knee Arthroscopic Anterior Cruciate Ligament (ACL) Reconstruction

TypeinterventionalSponsorThe University of The West IndiesRan2024 to 2026Enrolled60ConditionsACL TearsArmsTourniquet, TXA
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Meta-Analysis of the Efficacy and Safety of Tranexamic Acid in Spinal Surgery.Computational and mathematical methods in medicine · 2022
    Pooled it
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Reducing Surgery for Pediatric Posttonsillectomy Hemorrhage Using Tranexamic Acid: A Quality Improvement Initiative.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025
    Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Review
  18. Article
  19. Review
  20. Article
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

6 authors at 1 institution in 1 country.

Aryan HaratianUSC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA.
Tara ShelbyUSC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA.
Laith K HasanUSC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA.
Ioanna K BoliaUSC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA.ORCID 0000-0002-9410-1421
Alexander E WeberUSC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA.
Frank A PetriglianoUSC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA.ORCID 0000-0001-8816-6256
Keck Hospital of USC · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Tranexamic acid (TXA) is a lysine analog that exhibits an anti-fibrinolytic effect by directly preventing the activation of plasminogen as well as inhibiting activated plasmin from degrading fibrin clots, thereby promoting hemostasis and reducing the duration and quantity of blood loss. The aims of this study were to summarize the indications, routes of administration, safety, and clinical outcomes of TXA use throughout the different subspecialities in orthopedic surgery. Given that orthopedic procedures such as TKA, THA, fracture fixation, and various spine surgeries involve significant intraoperative blood loss, TXA is indicated in providing effective perioperative hemostasis. Additionally, use of TXA in orthopedic trauma has been indicated as a measure to reduce blood loss especially in a group with potential for hemodynamic compromise. TXA has been implicated in reducing the risk of blood transfusions in orthopedic trauma, joint surgery, and spine surgery, although this effect is not seen as prominently in sports medicine procedures. There remains disagreement in literature as to whether TXA via any route of administration can improve other clinically significant outcomes such as hospital length of stay and total operative time. Procedures that rely extensively on clarity on visualization of the surgical field such as knee and shoulder arthroscopies can greatly benefit from the use of TXA, thereby leading to less intraoperative bleeding, with better visual clarity of the surgical field. While most studies agree thrombosis due to TXA is unlikely, new research in cells and animal models are evaluating whether TXA can negatively impact other aspects of musculoskeletal physiology, however with conflicting results thus far. As of now, TXA remains a safe and effective means of promoting hemostasis and reducing intraoperative blood loss in orthopedic surgery.

Indexed as

operative blood lossorthopaedic surgeryoutcomestranexamic acidtransfusion rateTXA

Identifiers

PMID34703327
PMCPMC8541761
OpenAlexW3206076158

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.