ArticleJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2025
Weight-based tranexamic acid lowers the risk of postoperative blood loss and transfusion requirements compared with fixed-dose regimen in revision knee arthroplasty: a comparative study.
Article in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07450794 (Association Between Weight-Based Equivalent of Fixed 1 g Tranexamic Acid and Intraoperative Remifentanil Titration Frequency and Anesthesiologist Workload in Septorhinoplasty), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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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.
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.
Association Between Weight-Based Equivalent of Fixed 1 g Tranexamic Acid and Intraoperative Remifentanil Titration Frequency and Anesthesiologist Workload in Septorhinoplasty: A Prospective Observational Cohort Study
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk prediction models for blood transfusion in patients undergoing total hip and knee arthroplasty: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Patellar resurfacing in primary total knee arthroplasty is associated with fewer reoperations but comparable clinical and functional outcomes: an umbrella review of meta-analyses.Arthroplasty (London, England) · 2026Review
- Effect of tranexamic acid on planktonic and biofilm susceptibility of Candida albicans.BMC microbiology · 2026Article
- Learning curve for robotic-assisted total knee arthroplasty.Journal of orthopaedic surgery and research · 2026Article
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Authors and funding
7 authors.
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Abstract
backgroundIntravenous tranexamic acid (TXA) dosing regimens differ substantially across studies, varying from fixed doses (e.g., 1-2 g) to weight-based protocols (e.g., 10-20 mg/kg). This study aimed to compare postoperative blood loss, transfusion rates, in-hospital mortality, and complications between fixed-dose and weight-based TXA regimens in revision total knee arthroplasty (rTKA). MATERIALS AND
methodsThis retrospective comparative study included 298 patients who underwent rTKA between June 2004 and May 2024. Patients were divided into three groups: (1) the no TXA group; (2) the fixed-dose TXA group, in which patients received an intravenous infusion of 1 g TXA before skin incision and a topical application of 1 g; and (3) the weight-based TXA group, in which patients received a weight-adjusted dose of 20 mg/kg/h TXA intravenously and a topical application of 1 g. We analyzed the maximum decrease in hemoglobin (Hb) levels, postoperative transfusion rate, and the incidence of in-hospital mortality and complications.
resultsThe weight-based TXA group demonstrated a lower maximal decrease in Hb compared with both the no TXA (18.22 g/L versus 26.09 g/L, p < 0.001) and fixed-dose TXA (18.22 g/L versus 24.69 g/L, p < 0.001) groups. Both the fixed-dose TXA and weight-based TXA groups exhibited lower postoperative transfusion rates compared with the no TXA group (p < 0.001). The weight-based TXA group showed a lower postoperative transfusion rate compared with the fixed-dose TXA group (p = 0.022). Although the incidence of deep vein thrombosis (DVT) among the three groups was statistically significant (p = 0.038), pairwise comparisons between groups did not reveal statistically significant differences (all p > 0.05).
conclusionsWeight-based dosage of TXA significantly reduced postoperative blood loss and transfusion requirements in rTKA compared with fixed-dose TXA regimen. A weight-based TXA regimen should be considered to effectively minimize postoperative blood loss and decrease transfusion requirements. LEVEL OF EVIDENCE: Level 3, non-randomized observational study.
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