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Table 2 Dose and method for topical and intravenous administration of TXA

From: Comparison of the effectiveness and safety of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled trials

Author/s Intervention Methods of administration the tranexamic acid Transfusion criteria Thromboprophylaxis
Topical IV Topical IV
Gomez-Barrenna 2014 [27] 3 g/100 mL 15 mg/kg. 2 doses One dose irrigated before joint closure, and the other half was administered intra-articularly after skin closure Fifteen to 20 min before tourniquet release and 100 mL 3 h Hb <80 g/L NS
Patel JN 2014 [31] 2 g TXA/ 100 mL NS 10 mg/kg 1 dose 2 min TA before tourniquet release, with drain One dose as IO Hb b 8.0 g/dL + symptom LMWH
Maniar RN 2012 [30] 3 g TXA/100 mL NS 10 mg/kg 1 dose
10 mg/kg 2 doses
10 mg/kg 2 doses
10 mg/kg 3 doses
5 min TXA before tourniquet release, clamp drain 2 h then fully open One dose as IO
Two doses as IOPO
Two doses as POIO
Three doses at POIOPO
Hb b 8.5 g/dL
Hb b 10.0 g/dL + symptom
LMWH
Seo JG 2013 [33] 1.5 g TXA/100 mL 1.5 g TXA/100 mL, NS IXA while suturing, with no clamp drain One dose at post-operative Hb b 8.0 g/dL
Hb b 10.0 g/dL + symptoms
NS
Sarzaeem MM 2014 [32] 1.5 gTXA/100 mL NS
3.0 gTXA/100 mL NS
1.5 g TXA/100 mL, NS 1.5 g TXA: IXA injected through the drain after wound closure 3 g TXA: 5 min TXA before suturing, clamp drain 1 h then fully open One dose at post-operative Hb b 7.0 g/dL
Hb b 10.0 g/dL + symptom
NS
Soni A 2014 [34] 3 g TXA/100 mL 10 mg/kg 3 doses 5 min TXA before tourniquet release, clamp drain 2 h then fully open Three doses as POIOPO Hb b 8.0 g/dl LMWH
Tang Lian 2014 [29] 500 mg/5 mL 10 mg/5 mL Intra-articular injection after suction without drain Intravenous 15 min before tourniquet release Hb <90 g/L LMWH
Han Wenfeng 2014 [26] 1 g/50 mL 15 mg/kg, maximum 1.2 g Spray the TXA before suction and clamp drain for 30 min then fully open Induction of general anesthesia Hb <70 g/L LMWH
Aguilera X 2015 [24] 1 g/10 mL 1 g * 2 doses The TXA was applied by syringe spray and drain was kept closed during the first hour and removed 24 h after surgery Patients in the control group received a slow IV infusion Hb <80 g/L
Hb <80 g/L + symptoms between 8.5 and 9 g/dL + symptoms
LMWH
Digas G 2015 [25] 2 g 15 mg/kg 1 dose Intra-articular Before deflation of the tourniquet Hb <85 g/L
Hb <95 g/L + symptoms
3.500 IU of tinzaparin
Jiang Hua 2015 [28] 2 g/100 mL 10 mg/kg 1 dose Intra-articular Before closing the wound NS Enoxaparin and Rivaroxaban
Hou zhenyang 2015 [36] 500 mg/10 mL 10 mg/kg 1 dose Intra-articular Before insert the prosthesis Hb <70 g/L Rivaroxaban
  1. NS not stated, Hb hemoglobin, LMWH low molecular weight heparin, IO intra-operative, IOPO intra-operative and postoperative, POIO postoperative and intra-operative, POIOPO postoperative, intra-operative, and postoperative, TXA tranexamic acid