Table 1 The baseline characteristics of included studies

1

Wang

2018

China

English

Osteoarthritis

147

74

73

65 ± 13.1

63.6 ± 11.5

E

C

2 g of TXA (4 tablets of 500 mg) by oral bolus appropriately 2 h before incision as a preoperative dose, a postoperative dose of 1 g was repeated 6 and 12 h after surgery, respectively

Received an intraarticular administration of 100 mL of saline solution containing a 3 g dose of TXA

No

Duration of surgery, the total blood loss, transfusion risk, Hb, ROM, DVT, PE

2

Huang

2017

China

English

Osteoarthritis

150

50

50

50

66.2 ± 8.3

65.1 ± 6.8

65.8 ± 6.3

I

D

F

Treated with a tourniquet multiple doses of intravenous TXA (20 mg/kg 5 to 10 min before the skin incision and 10 mg/kg 3, 6, 12, and 24 h later) along with 1 g of topical TXA

Multiple doses of intravenous TXA (20 mg/kg5 to 10 min before the skin incision and 10 mg/kg 3, 6, 12, and 24 h later) along with 1 g of topical TXA

Treated with the tourniquet only

Yes

ROM, Flexion contracture, Hb, the total blood loss, duration of surgery, transfusion risk, DVT, PE

3

Tzatzairis

2016

Greece

English

OSTEOARTHRITIS

120

40

40

40

68.58 ± 7.50

69.55 ± 6.61

69.10 ± 8.68

A

B

C

Did not receive TXA.

1 g (100 mg/mL) of TXA, in 100 mL normal saline, intravenously 10 min before incision

1 g (100 mg/mL) of TXA, in 100 mL normal saline was administered intra-articularly after joint capsule closure.

Yes

Blood loss, transfusion risk, Hb, duration of surgery

4

Nielsen

2016

Denmark

English

Osteoarthritis

60

30

30

65.5 ± 7.8

63.2 ± 8.6

B

D

Received 1 g of TXA administered intravenously only and 100 mL of saline solution administered intra-articularly

1 g of TXA administered intravenously during the induction of anesthesia and 3 g diluted in 100 mL of saline solution (0.9%) administered intra-articularly after closure of the capsule

No

Duration of surgery, the total blood loss, transfusion risk, Hb1d

5

Jain

2016

India

English

Osteoarthritis

119

60

59

70.0 ± 6.56

68.27 ± 8.66

B

D

Given IVTXA as a preoperative and postoperative dose given 3 and 6 h after surgery

topical TXA solution was applied intra-articularly about 5 min before closure of arthrotomyin addition IV doses

No

Duration of surgery, transfusion risk, the total blood loss, DVT, Hb

6

May

2016

USA

English

Osteoarthritis

131

69

62

65.0 ± 9.6

63.0 ± 10.6

G

H

1 g of TXA in 100 mL of normal saline (after anesthetic induction and before tourniquet inflation) and 1 dose of 50 mL of normal saline without TXA (administered after capsular closure)

2 g of TXA was prepared for the topical dose in 50 mL of saline, and 100 mL of normal saline without TXA

No

Duration of surgery, 0/1d Hb,3d total blood loss, PE, DVT

7

Drosos

2016

Greece

English

Osteoarthritis

90

30

30

30

71.77 ± 6.5

69.27 ± 7.21

71.1 ± 6.32

F

G

H

No TXA

Received 1 g TXA intravenously

1 g TXA in 30 ml normal saline (a solution of 40 ml) was applied topically

yes

Hb4d, the total blood loss, transfusion risk

8

Yang

2015

China

English

Osteoarthritis, traumatic arthritis or rheumatoid arthritis

80

40

40

69 ± 5

67 ± 6

F

H

20 mL of normal saline solution

Receive 500 mg of TXA in 20 mL of normal saline solution

No

Duration of surgery, Transfusion risk, Hb, DVT, PE

9

Keyhani

2015

Iran

English

Osteoarthritis

120

40

40

40

68.4 ± 10.4

67 ± 11.9

63.9 ± 9

G

H

F

Received 500 mg of TXA in 100 cc saline at the end of the surgery

Received an intra-articular dose of 3 g of TXA in 100 mL normal saline. Half of the solution was used to irrigate the joint before joint closure.

Did not receive TXA

Yes

Hb4d, the total blood loss, transfusion risk, DVT, PE

10

Patel

2014

USA

English

Osteoarthritis

89

42

47

64.9 ± 7.8

64.8 ± 9.7

G

H

Versus IV administration of 10 mg/kg, 10 min prior to tourniquet deflation.

Administered2.0gTXAin100mlofnormal saline directly into the surgical site and bathed in the solution, undisturbed for 2 min prior to tourniquet release

Yes

Hb, transfusion risk, DVT

11

Good

2003

Sweden

English

Osteoarthritis

51

24

27

72(50–84)

72(46–83)

F

G

Placebo 10 mg/kg i.v. just before tourniquet release and 3 h later

TXA 10 mg/kg i.v. just before tourniquet release and 3 h later

Yes

Blood loss, DVT, transfusion risk

12

Tanaka

2001

Japan

English

Osteoarthritis, rheumatoid arthritis

53

26

27

65(58–70)

65(59–69)

F

G

Saline twice, 10 min before surgery and on deflation of the tourniquet

10 mg/kg of TNA 10 min before surgery and again 10 min before deflation of the tourniquet

Saline 10 min before surgery and 20 mg/kg of TNA 10 min before deflation of the tourniquet

Yes

Hb1/2/4/7d, duration of surgery, transfusion risk, the total blood loss

13

Jansen

1999

Belgium

English

Osteoarthritis, rheumatoid arthritis

42

21

21

71.0(64–84)

70.7(62–80)

F

G

Normal saline of 15mgkg-1 was administered 30 min before surgery + every 8 h 3 days after surgery

TXA (15mgkg-1) was administered 30 min before surgery + every 8 h 3 days after surgery

Yes

Duration of surgery, the total blood loss, transfusion risk, DVT

14

BENON

1996

Sweden

English

Osteoarthritis, aseptic bone necrosis

86

43

43

76 ± 7

74 ± 7

G

F

IV 10 mg/kg TXA

A median time of 12 min (1 to 40) before deflation of the tourniquet, repeated after 3 h, 10 mg/kg placebo

Yes

Duration of surgery, the total blood loss, DVT, PE, ROM