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Table 2 Overview of the TXA Administration, Transfusion criteria, prothrombin time, activated partial thromboplastin time, and tourniquet time

From: Peri-articular administration of tranexamic acid is an alternative route in total knee arthroplasty: a systematic review and meta-analysis

Author TXA Administration Transfusion criteria PT APTT Tourniquet time
Pinsornsak P PAI: 750 mg TXA into the medial, lateral capsules and the quadriceps tendon prior to capsular closure and tourniquet deflation
IV: 750 mg TXA before tourniquet deflation
Hb < 10 g/dl, anaemia, congestive heart failure, unexplained tachycardia, hypotension unresponsive to fluid replacement NR NR NR
Mao Z PAI: 2 g TXA and 80 mL normal saline into the soft tissues around the joint cavity, 5 to 10 mL at each point, such as posterior joint capsulae synovial membrane and ligaments, especially the sites of soft tissue release and incisal edges in the synovial membrane
IA: 2 g TXA and 80 mL normal saline into the knee joint cavity after wound closure
Hb < 8 g/dl, 8–10 g/dl with hemodynamic instability PAI 11.5 ± 2.5
IA 11.1 ± 0.7
Non-TXA 11.1 ± 0.6
PAI 27.0 ± 4.3
IA 27.0 ± 3.3
Non-TXA 27.0 ± 2.9
NR
Yozawa S PAI: 40 ml of 0.25% ropivacaine with 1: 2000 epinephrine containing 1000 mg TXA(25 mg/ml)into injected into the area around the medial and lateral capsule, the quadriceps muscle tendon, and the infrapatellar fat pad prior to capsular closure
Non-TXA: 40 ml of 0.25% ropivacaine with 1: 2000 epinephrine
Hb < 8 g/dl NR NR NR
Zhang S PAI: TXA solution (1 g TXA, 20 ml saline) comprising 5 ml to the medial capsule, 5 ml to the lateral capsule, and10 ml to the soft tissue around quadriceps femoris
IA: TXA solution of 20 ml (TXA 1 g + 20 ml saline) was injected into the articular cavity after suture incision
Non-TXA: injection of the same amount of saline at the same place
NR PAI 11.60 (11.20,12.15)
IA 11.65 (11.00,12.05)
PAI + IA 11.50 (10.98,12.00)
Non-TXA 11.50 (11.10,12.00)
PAI 25.40 (22.85,27.50)
IA 24.05 (21.63,26.38)
PAI + IA 24.25 (22.35,26.75)
Non-TXA 24.10 (23.00,27.00)
PAI 50.00 (42.00,62.50)
IA 49.50 (40.00,59.75)
PAI + IA 53.00 (37.50,63.25)
Non-TXA 44.00 (36.00,68.00)
Besiris GT PAI: 1.5 g TXA diluted in 50 ml of normal saline. Prior to final prostheses placement 25 ml of the dilution were injection at the posterior knee joint capsule. Following the final prostheses placement, the remaining dilution was injection at the surrounding soft tissues for at least 5 min prior to tourniquet deflation
IA: 1.5 g of TXA diluted in 50 ml of normal saline was injected into the knee joint after knee capsule closure for at least 5 min prior to tourniquet deflation
Hb < 8 mg/dl or < 10.0 mg/dl with concomitant symptoms of anaemia or anaemia-related organ dysfunction NR NR NR
Lin YK PAI: 1 g/10 mL TXA into the rectus femoris, vastus medialis, patella tendon, pes anserinus, and posterior capsule
IA: 1 g/10 mL TXA
Hb < 8 mg/dl, Hb > 3.0 mg/dl with intolerable symptoms or organ dysfunction NR NR NR
Sivasubramanian H PAI: 1 g TXA
IA: 1 g TXA
Hb < 8.5 g/dl, symptomatic, cardiovascular comorbidities NR NR NR
Pinsornsak P PAI: 15 mg/kg TXA was mixed with the anaesthetic cocktail and injected into peri-articular soft tissue without posterior capsular infiltration, including the medial gutter, lateral gutter, and quadriceps muscle before capsular closure
IA: 2 g TXA
Hb < 8 g/dl, Hb 8–10 g/dl with hemodynamic instability NR NR PAI 77.4 ± 4.1
IA 76.5 ± 4.7
Non-TXA 76.1 ± 4.7
Peng HM PAI: 1000 mg/10 ml TXA, 110 ml of saline as a placebo
IV: 1000 mg TXA (110 ml total volume)
Hb < 8 g/dl or < 10 g/dl with symptomatic anaemia, at high risk of cardiac comorbidities NR NR PAI 82.93 ± 3.21
IV 82.36 ± 4.54
Kim KI PAI: 1 g of TXA mixed with PAMC (150 mg ropivacaine, 0.3 mg epinephrine, 45 mg ketorolac, 40 mg triamcinolone, 5 mg morphine, 1 g cefotiam, and 60 ml normal saline) injected into the area around the medial, lateral, anterior and posterior capsule; the quadriceps muscle tendon; and the infrapatellar fat pad just prior to cementation
IV: a dose of 15 mg/kg TXA with 100 ml normal saline twice in the TKA perioperative period
PAI + IV: both IV and PAMC injections
8.0 g/dL with clinical symptoms of anaemia NR NR IV 64.31 ± 6.63
PAI 63.54 ± 5.42
PAI + IV 63.71 ± 5.13
  1. PAI, periarticular injection; PAMC, periarticular multimodal cocktail; IV, intravenous; IA, intra-articular injection; TXA, tranexamic acid; NR, not report; PT, prothrombin time; APTT, activated partial thromboplastin time; TKA, total knee arthroplasty