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Table 1 The baseline characteristics of included studies

From: Hemostatic effect of tourniquet combined with tranexamic acid in total knee arthroplasty: a network meta-analysis

Number Author Year Country Language Disease Number Age(years) Interventions Interval, times, dose of TXA Use of drainage tube Outcomes
Total T1 T2 T3 T1 T2 T3 T1 T2 T3 T1 T2 T3
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
  1. Notes: Hb hemoglobin, DVT deep vein thrombosis, PE pulmonary embolism, ROM range of motion, A = placebo; B = IVTXA; C = topical TXA; D = IV combined topical TXA; E = oral TXA; F = placebo + tourniquets; G = IVTXA + tourniquets; H = topical TXA + tourniquets; I = IV-combined topical TXA + tourniquets; T1 = treatment 1; T2 = treatment 2; T3 = treatment 3
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Journal of Orthopaedic Surgery and Research

ISSN: 1749-799X