SynthesisBMC musculoskeletal disorders2025
A comparison of efficacy and safety of oral versus intravenous applications of tranexamic acid in total hip and knee arthroplasty: an updated systematic review meta-analysis of randomized controlled trials.
Synthesis in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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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.
- Intravenous versus oral tranexamic acid in shoulder arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- The Injection of Tranexamic Acid Alone is Not Effective in Reducing Transfusion Requirements Following Total Joint Arthroplasty.Journal of clinical practice and research · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTranexamic acid (TXA) has been extensively used in total hip and total knee arthroplasty (THA and TKA) to reduce blood loss. The commonly investigated routes of TXA administration include oral, intravenous, intra-articular, and topical methods. However, the ideal route of administration remains controversial. The objective of this study was to evaluate and compare the efficacy and safety of oral versus intravenous tranexamic acid in primary total knee and hip arthroplasty.
methodsThe PubMed, Web of Science, Cochrane Library and Embase databases were systematically searched for relevant randomized controlled trials (RCTs) which updated on October 2024. Decline of hemoglobin (DHB), total blood loss (TBL), length of hospital stays (HS), intra-operative blood loss (IBL), operative time, transfusion rate, deep vein thrombosis (DVT) and intramuscular venous thrombosis (IVT) were extracted and analyzed. Sensitivity analyses were conducted for each outcome based on the degree of heterogeneity. Furthermore, we assessed publication bias through funnel plots, Egger tests and the trim-and-fill method. The study adhered to PRISMA and AMSTAR guidelines. All of the analyses were performed using Review Manager (RevMan) 5.4 and Stata 15.0 software.
resultsA total of 2,262 patients from 16 randomized controlled trials (RCTs) were ultimately included in the meta-analysis. No statistically significant differences were observed in terms of decline of hemoglobin (P = 0.95), total blood loss(P = 0.59), length of hospital stays (P = 0.28), intra-operative blood loss (P = 0.64), operative time (P = 0.67), transfusion rate (P = 0.96), deep vein thrombosis (P = 0.14), intramuscular venous thrombosis (P = 0.14) between the oral and intravenous groups. But five studies reported that oral TXA has lower cost than intravenous.
conclusionThis meta-analysis provided updated evidence that suggests oral and intravenous TXA have similar efficacy and safety. However, oral tranexamic acid can reduce financial burden of joint replacement on patients. So more high-quality RCTs are needed to confirm that oral may be the ideal route of administration for TXA.
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