SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Safety and efficacy of tranexamic acid in pelvi-acetabular trauma surgery: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Role of Tranexamic Acid in Orthopedic Trauma: Current Evidence, Clinical Applications, and Ongoing Controversies.Journal of orthopaedic case reports · 2026Article
- Intraoperative tranexamic acid use in elderly patients with intertrochanteric fractures: impact on early postoperative inflammation and clinical outcomes.Frontiers in physiology · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPelvic and acetabular fractures, often resulting from high-impact trauma, pose significant challenges due to extensive blood loss and complex surgical procedures. Tranexamic acid (TXA), widely used in elective orthopedic surgeries, offers a potential strategy for managing blood loss. However, its efficacy and safety in pelvic-acetabular trauma surgeries have shown inconsistent results in prior studies.
objectiveTo systematically evaluate the safety and efficacy of intravenous TXA in reducing perioperative blood loss, transfusion requirements, and complications in pelvic and acetabular trauma surgeries.
methodsA systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. Literature searches of PubMed, Embase, and Cochrane databases identified relevant studies. Data on blood loss, transfusion rates, thromboembolic events, surgical time, and complications were extracted and analyzed using RevMan 5.4 software. A random-effects model was applied to account for heterogeneity.
resultsAfter screening, a total of 6 RCTs with 511 patients were included in this meta-analysis. TXA did not significantly reduce estimated blood loss (mean difference: 117.54 ml; 95% CI - 286.48-51.40; p = 0.17) or transfusion rates (risk ratio: 0.88; 95% CI 0.48-1.60; p = 0.67). No significant differences were observed in the number of transfused blood units, surgical duration, or complication rates, including thromboembolic events (risk ratio: 1.36; 95% CI 0.57-3.22; p = 0.48). TXA demonstrated a favorable safety profile with no increased risk of systemic or local complications.
conclusionWhile TXA appears safe in pelvi-acetabular trauma surgery, current evidence from six RCTs does not support a significant reduction in blood loss or transfusion needs. Further high-quality RCTs with standardized protocols are needed to refine TXA's role in this context. LEVEL OF EVIDENCE I:
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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.