Table 8 Articles included in the review analyzing the use of tranexamic acid in periarticular infiltrations

Peng et al. [91]

RCT

93

1. IV administration of 1 g TXA (n = 47)

2. Periarticular administration of 1 g TXA (n = 46)

1 g

Complications were monitored day 3 and day 14

TXA administration via PAI significantly decreased total blood loss and hidden blood loss compared to IV TXA. There was no difference in drainage volume

No venous thromboembolism. No severe complications reported

Hishimura et al. [92]

RCT

109

1. (L) Local injection of TXA (n = 57)

2. (D) Drain Clamping (n = 52)

10 mg/kg

Assessment period 14 days, VTE evaluated at 7 days, Hgb levels evaluated at postoperative day 3

Total blood loss showed non-inferiority in the PAI group vs. drainage clamping, however, TXA was superior for suppressing bleeding

Not reported

Kim et al. [88]

RCT

240

1. Intravenous TXA (n = 80)

2. TXA administered in a periarticular injection (n = 80)

3. Combination of Intravenous and periarticular injection of TXA (n = 80)

1 g

Evaluation period 1–5 days postoperatively

Intravenous and periarticular administration of TXA showed comparable effects. Combination of IV and periarticular TXA showed added effect

No differences in complications between groups. No differences in needs for transfusion

Zhang et al. [90]

RCT

218

1. Intra-articular injection of TXA, periarticular injection of placebo (n = 52)

2. Intra-articular injection of TXA and periarticular injection of TXA (n = 53)

3. Intra-articular injection of placebo, periarticular injection of TXA (n = 50)

4. Intra-articular injection of placebo and periarticular injection of placebo (n = 55)

1 g

Range of motion, and hemoglobin explored on postoperative day 1. VAS assessed on postoperative day 2. DVT assessed 7 days postoperative

Combined use of periarticular and intra-articular injection of TXA significantly reduced total blood loss. Combined method also shows improved visual analogue scales and range of motion in the early postoperative period (48 h), but not in the late postoperative periods (6 months)

No thromboembolic events. No differences in wound-related complications between groups

Pinsornsak et al. [89]

RCT

108

1. Patients receiving 15 mg/kg Periarticular infiltration of TXA (n = 36)

2. Patients receiving 2 g intra-articular TXA (n = 36)

3. Patients receiving no TXA (n = 36)

15 mg/kg

No significant difference in total blood loss between periarticular and intra-articular groups at 48 h. Serum TXA elevated at 2 h and 24 h postoperative

Total blood loss, hemoglobin decreases, and blood transfusion rates were decreased in the periarticular and intra-articular groups compared to control. Serum TXA levels were significantly higher in the intraarticular group vs. the periarticular group

No differences in complications of periarticular and intra-articular groups. 14% of control group showed subcutaneous ecchymoses

No venous thromboembolism