![]() Tranexamic acid (TXA) is routinely used to stop heavy bleeding and to reduce the transfusion requirements in patients during peri- and post-operative periods. However, this surgical procedure can cause extensive bleeding due to bone gap and release of blood vessels as well as extensive soft tissues in and around the damaged site, that may lead to soft tissue complications, such as wound hematoma, superficial skin infections, delayed union, and even compartment syndrome. Furthermore, HTO can also be implemented to delay the urgent need for a total or partial knee replacement procedure by preserving the damaged tissue in the knee joint. HTO is intended to shift the misaligned mechanical axis to the midline of the knee to restore normal limb alignment, thereby minimizing the load on the medial compartment to slow down the osteoarthritis progression. High tibial osteotomy (HTO) is a widely used and well-established effective surgical treatment which aims to correct the varus malalignment or deformation with compartmental osteoarthritis or osteonecrosis of the knee in both young and elderly patients. Further studies, including more large-scale and well-designed randomized controlled trials, are warranted to assess the efficacy and safety issues of routine TXA use in HTO patients. But there is no obvious evidence that TXA could reduce blood transfusion rates. This meta-analysis of the available evidence demonstrated that TXA could reduce total blood loss, hemoglobin decrease, drain output, and wound complications without increasing the incidence of thromboembolic events in patients undergoing HTO. Nonsignificant differences were found in the incidence of thromboembolic events (RR = 0.46, 95% CI 0.09 to 2.41, P = 0.36) and blood transfusion rate (RR = 0.25, 95% CI 0.03 to 2.27, P = 0.22). ResultsĪ total of 5 studies were included involving 532 patients. ![]() The meta-analysis was performed using the RevMan 5.3 software. The primary comparison outcome measures were total blood loss, hemoglobin decrease, drain output, wound complications, thrombotic events, and blood transfusion rate of the TXA group versus control. After testing for potential publication bias and/or heterogeneity, we aggregated variables by using the random-effect model. A combined searching strategy of subject words and random words was adopted. PubMed (MEDLINE), EMBASE, and Cochrane Library were systematically searched for relevant literature from inception until 1 February 2021. ![]() The present meta-analysis was conducted to evaluate the efficacy and safety of the application of tranexamic acid (TXA) in patients undergoing high tibial osteotomy (HTO). ![]()
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