Tranexamic acid administration for the prevention of periprosthetic joint infection and surgical site infection: a systematic review and meta-analysis

Introduction Tranexamic acid (TXA) has been widely utilized to reduce blood loss and allogeneic transfusions in patients who undergo lower limb arthroplasty. In recent years, there have been several articles reporting the incidence of periprosthetic joint infection (PJI) as a primary outcome of TXA...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2023-11, Vol.143 (11), p.6883-6899
Main Authors: Imanishi, Keiji, Kobayashi, Naomi, Kamono, Emi, Yukizawa, Yohei, Takagawa, Shu, Choe, Hyonmin, Kumagai, Ken, Inaba, Yutaka
Format: Article
Language:English
Subjects:
Administration, Topical
Antifibrinolytic agents
Antifibrinolytic Agents - therapeutic use
Arthritis, Infectious
Arthroplasty, Replacement, Hip - adverse effects
Blood Loss, Surgical - prevention & control
Hip Arthroplasty
Humans
Joint surgery
Medicine
Medicine & Public Health
Meta-analysis
Orthopedics
Prosthesis-Related Infections - drug therapy
Prosthesis-Related Infections - etiology
Prosthesis-Related Infections - prevention & control
Randomized Controlled Trials as Topic
Surgical site infections
Surgical Wound Infection - prevention & control
Systematic review
Tranexamic Acid - therapeutic use
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Summary:Introduction Tranexamic acid (TXA) has been widely utilized to reduce blood loss and allogeneic transfusions in patients who undergo lower limb arthroplasty. In recent years, there have been several articles reporting the incidence of periprosthetic joint infection (PJI) as a primary outcome of TXA administration, but no meta-analysis has been conducted to date. The present systematic review and meta-analysis evaluated the efficacy of TXA administration in preventing PJI and surgical site infection (SSI). Materials and methods Pubmed, CINAHL, and the Cochrane Library bibliographic databases were searched for studies published by May 24, 2022, that evaluated the effects of TXA on PJI and SSI. Two researchers screened the identified studies based on the PRISMA flow diagram. The quality of each randomized clinical trial was assessed using Version 2 of the Cochrane risk-of-bias tool for randomized trials (ROB2.0), and the quality of cohort and case–control studies was assessed by risk of bias for nonrandomized studies (ROBANS-I). Results Of the 2259 articles identified from the database search, 31 were screened and selected. Treatment with TXA significantly reduced the incidence of overall infection, including PJI, SSI, and other infections (OR 0.55; 95% CI 0.49–0.62) ( P  
ISSN:1434-3916
0936-8051
1434-3916
DOI:10.1007/s00402-023-04914-x