Evidence map›Paper›PMID 40891906›Full record

SynthesisInternational journal of surgery (London, England)2026

Equivalence of oral and intravenous tranexamic acid in knee arthroplasty: a systematic review and meta-analysis of randomized clinical trials.

Hua Luo, Zhenghua Hong, Liwei Zhang, Wenjun Pan, Cong Chen, Yu Ren

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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.

Hua LuoDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.ORCID 0009-0002-1273-8275
Zhenghua HongDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
Liwei ZhangDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
Wenjun PanDepartment of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
Cong ChenDepartment of Orthopedic, Jiangsu Province (Suqian) Hospital, Suqian, Jiangsu, China.
Yu RenDepartment of Pharmacy, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.ORCID 0000-0002-8306-8312

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranexamic acid (TXA) is widely used to manage blood loss in joint arthroplasty. This study aims to compare the efficacy and safety of oral versus intravenous TXA in knee arthroplasty, focusing on blood loss and related outcomes.

methodsA systematic review and meta-analysis were conducted according to the PRISMA guidelines. Randomized controlled trials (RCTs) comparing oral versus intravenous TXA in knee arthroplasty were included. Studies were assessed for risk of bias using the Cochrane Risk of Bias tool, and data were synthesized using Stata software. Heterogeneity was evaluated using the Q test and I2 statistic. Pooled analyses were performed using random-effects models, with outcomes including hemoglobin (HB) levels, HB drop, hematocrit levels, intraoperative blood loss (IBL), transfusion rates, complications, operation time, and length of hospital stay.

resultsEight RCTs involving 927 patients were included. No significant differences were found between oral and intravenous TXA for postoperative HB (WMD: 0.25, 95% CI: -0.13 to 0.62, P = 0.202), HB drop (WMD: -0.02, 95% CI: -0.11 to 0.07, P = 0.690), hematocrit levels (WMD: 0.01, 95% CI: -0.00 to 0.02, P = 0.187), IBL (WMD: 5.5, 95% CI: -11.84 to 22.84, P = 0.534), transfusion rates (OR: 0.89, 95% CI: 0.49 to 1.63, P = 0.716), complications (OR: 0.67, 95% CI: 0.31 to 1.46, P = 0.314), or length of hospital stay (WMD: -0.03, 95% CI: -0.27 to 0.21, P = 0.813). Operation time was similar overall (WMD: -0.36, 95% CI: -4.07 to 3.34, P = 0.847), but intravenous TXA administered after surgery led to significantly longer operation time than oral TXA (WMD: -8.0, 95% CI: -15.72 to -0.28, P = 0.042).

conclusionCurrent evidence indicates that oral tranexamic acid is equivalent to intravenous administration in knee arthroplasty and can be used as an effective alternative to intravenous administration in clinical practice.

Indexed as

Antifibrinolytic AgentsArthroplasty, Replacement, KneeBlood Loss, SurgicalTranexamic AcidAdministration, IntravenousAdministration, OralBlood TransfusionHumansRandomized Controlled Trials as TopicAntifibrinolytic AgentsTranexamic Acidhemoglobin dropintravenousknee arthroplastyoraltranexamic acid

Identifiers

PMID40891906
PMCPMC12825536

What OpenQuestion holds

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Registered trials

None linked

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.