ArticleEFORT open reviews2025
Evidence on oral tranexamic acid versus intravenous tranexamic acid for perioperative blood management in total knee arthroplasty: a systematic review and meta-analysis.
Article in EFORT open reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- Intravenous versus oral tranexamic acid in shoulder arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Effect of controlled hypotension combined with low-pressure tourniquet on hemoglobin reduction after total knee arthroplasty.BMC surgery · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: This study aimed to systematically evaluate the efficacy and safety of oral versus intravenous tranexamic acid (TXA) in total knee arthroplasty (TKA). Methods: The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched. Data extraction and quality assessment were performed independently by two investigators. The primary outcomes were hemoglobin (Hb) decrease and blood loss, while secondary outcomes included transfusion rate, operation time, hospital stay, and complications. The analysis used random-effects models and assessed heterogeneity with I 2 values. Results: Nine studies were included in the meta-analysis, comprising a total of 1,227 participants. Across the included studies, oral TXA was most commonly administered as 1.95-2 g given 1-2 h before surgery, with some regimens including postoperative doses. Intravenous TXA was typically given as 1 g before surgery, sometimes with additional doses before wound closure or after surgery. The results showed no significant difference between oral and intravenous TXA in terms of Hb decrease and transfusion rates. Similarly, there was no significant difference in complications, operation time, and length of hospital stay. Comparable findings were observed in both RCTs and non-RCTs. Sensitivity analysis demonstrated that the overall results remained robust, with no single study exerting a substantial influence on the pooled estimates. Conclusions: Based on available evidence, there is no significant difference observed between oral and intravenous TXA in patients undergoing TKA. However, the wide confidence intervals for several outcomes indicate important uncertainty, and further high-quality studies are needed to confirm the comparative effectiveness and safety.
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Registered trials
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