Tranexamic acid use in arthroscopic rotator cuff repair : a systematic review and meta-analysis of randomized controlled trials

© 2024 The Authors.

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 8(2024), 5 vom: 28. Sept., Seite 995-1003
1. Verfasser: Alzobi, Osama Z (VerfasserIn)
Weitere Verfasser: Derbas, Jawad, Toubasi, Ahmad, Hantouly, Ashraf, Abdullah, Abdullah, Zikria, Bashir, Alkhatib, Nedal
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2024
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Review Arthroscopy Meta-analysis Rotator cuff Systematic review TXA Tranexamic acid
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520 |a Background: Rotator cuff disease, a prevalent cause of shoulder disability and pain among middle-aged and older adults, has seen an uptick in arthroscopic repairs in the last 2 decades. These repairs necessitate optimal visualization and controlled hemostasis to prevent complications. This study aimed to assess the efficacy of tranexamic acid (TXA) in arthroscopic rotator cuff repairs by evaluating all available randomized controlled trials (RCTs) in the literature 
520 |a Methods: A systematic search was conducted in PubMed, Cochrane Library, Embase, Science Direct, Web of Science, Google Scholar, and CINAHL databases from inception through November 2022 for RCTs investigating the use of TXA in arthroscopic rotator cuff repair. The studies selected reported on the primary outcomes, which include visual clarity during surgery, postoperative pain, and operative time. The quality of the studies was evaluated using the RoB 2 (Risk of Bias) tool 
520 |a Results: A total of 7 studies, with level I and II of evidence, comprising 510 randomized patients (253 females, 257 males) were included, with mean ages of 59 and 58 years for the TXA and control groups, respectively. Bias was graded "Low" in 2 RCTs and "Some concerns" in 5 RCTs. Visual analog scale for pain was significantly different with TXA use at postoperative day 1 (weighted mean difference (WMD) = -0.55; 95% confidence interval (CI): -1.07 to -0.04, P = .04). Operative time was significantly higher for the control group with a mean difference of 7.97 minutes (WMD = -7.97; 95% CI: -15.19 to -0.74, P = .04). The impact of TXA on visual clarity during shoulder arthroscopy remains uncertain. However, postoperative shoulder swelling results were comparable in both groups (WMD = -1.71; 95% CI: -3.72 to 0.29, I2 = 99% (where I2 = heterogeneity statistic), P = .69). Considerable heterogeneity was seen in some results 
520 |a Conclusion: Pooled data suggest that the use of TXA in shoulder arthroscopy does reduce postoperative shoulder pain and has a positive effect on decreasing operative time. However, the reduction in pain may not be clinically significant, and there is no effect on reducing shoulder swelling. The impact of TXA on visual clarity remains inconclusive, and further research is needed using methodologically rigorous articles that incorporate objective measures and controlled factors to eliminate subjective bias 
650 4 |a Journal Article 
650 4 |a Review 
650 4 |a Arthroscopy 
650 4 |a Meta-analysis 
650 4 |a Rotator cuff 
650 4 |a Systematic review 
650 4 |a TXA 
650 4 |a Tranexamic acid 
700 1 |a Derbas, Jawad  |e verfasserin  |4 aut 
700 1 |a Toubasi, Ahmad  |e verfasserin  |4 aut 
700 1 |a Hantouly, Ashraf  |e verfasserin  |4 aut 
700 1 |a Abdullah, Abdullah  |e verfasserin  |4 aut 
700 1 |a Zikria, Bashir  |e verfasserin  |4 aut 
700 1 |a Alkhatib, Nedal  |e verfasserin  |4 aut 
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