ArticleJB & JS open access
Efficacy and Safety of Intraosseous Regional Versus Intravenous Tranexamic Acid in Total Knee Arthroplasty: A Randomized Controlled Trial.
Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Tranexamic acid (TXA) reduces perioperative blood loss in total knee arthroplasty (TKA); however, evidence for intraosseous regional administration (IORA) remains limited. We evaluated the efficacy and safety of IORA-TXA versus intravenous TXA (IV-TXA) in TKA. Methods: In this prospective, randomized, single-center trial, 98 patients undergoing primary TKA were randomized 1:1 to IORA-TXA or IV-TXA (49 per group) at a uniform dose of 20 mg/kg. The primary outcome was calculated perioperative blood loss. Secondary efficacy outcomes included calculated hidden blood loss, postoperative hemoglobin (Hb) levels, and transfusion rate. Safety outcomes included deep vein thrombosis (DVT), muscular calf vein thrombosis, pulmonary embolism (PE), and wound-related complications. Results: Compared with IV-TXA, IORA-TXA reduced calculated perioperative blood loss (674.8 ± 335.0 vs. 817.5 ± 357.2 mL; mean difference, 142.6 mL; 95% CI, 7.4-277.8; p = 0.038) and calculated hidden blood loss (644.8 ± 335.5 vs. 790.9 ± 339.0 mL; mean difference, 146.1 mL; 95% CI, 10.9-281.3; p = 0.035). Postoperative Hb was similar on POD1 (134.0 ± 9.8 vs. 130.1 ± 11.1 g/L; p = 0.067) but was higher with IORA-TXA on POD2 (119.8 ± 8.3 vs. 113.8 ± 11.5 g/L; mean difference 6.0 g/L; 95% CI 2.0-10.0; p = 0.005) and POD3 (114.8 ± 7.9 vs. 109.8 ± 12.6 g/L; mean difference 5.0 g/L; 95% CI 0.8-9.2; p = 0.020). No patient required blood transfusion. DVT detected by routine postoperative Doppler occurred numerically more often with IORA-TXA than with IV-TXA: 10.2% (95% CI, 3.4%-22.2%) versus 0.0% (95% CI, 0.0%-7.3%); p = 0.056. Conclusions: IORA-TXA reduced calculated perioperative and hidden blood loss and improved early postoperative Hb preservation compared with IV-TXA. However, DVT incidence was numerically higher with IORA-TXA, indicating a potential thromboembolic safety signal that warrants confirmation in larger, adequately powered trials. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Identifiers
What OpenQuestion holds
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.