Objective To evaluate the clinical effectiveness and safety of tranexamic acid (TXA) in arthroscopic rotator cuff repair by meta-analysis. Methods Randomized controlled trials evaluating the clinical effectiveness and safety of TXA use in the perioperative period of arthroscopic rotator cuff repair were identified from the Cochrane Library, PubMed, Embase, VIP Chinese Science and Technology Periodical Database, Chinese National Knowledge Infrastructure, and Wanfang database, with a search time span from the inception of the database to August 2024. Meta-analysis was conducted using RevMan 5.3 software, and mean difference (MD) and risk difference (RD) were used as measures of effect size. Results A total of 7 randomized controlled trials were included. Meta-analysis demonstrated significant differences in good visual clarity [MD=9.10, 95% confidence interval (CI) (4.05, 14.15), P=0.0004] and operative time [MD=?12.07 min, 95%CI (?17.21, ?6.93) min, P<0.00001]. There was no significant difference in mean arterial pressure [MD=?1.08 mm Hg (1 mm Hg=0.133 kPa), 95%CI (?3.13, 0.98) mm Hg, P=0.30] or adverse event rate [RD=0.02, 95%CI (?0.01, 0.06), P=0.22] between the two groups. Conclusion TXA is effective and safe in enhancing visual clarity and significantly reducing operative time in arthroscopic rotator cuff repair, without increasing the incidence of adverse events.
Objective To study the efficacy and safety of bone channeling in arthroscopic rotator cuff repair. Methods China National Knowledge Infrastructure, Cochrane Library, Chongqing VIP, PubMed, Wanfang database and Embase were searched to collect all randomized controlled trials of the application of bone channeling in arthroscopic rotator cuff repair. The search time was from the establishment of databases to October 15, 2025. RevMan 5.3 software was used for meta-analysis to explore the differences in postoperative functional score, pain, complications, reoperation and 2-year postoperative re-tear between the bone channeling group and the control group. Results Nine randomized controlled trial studies were finally included. The results of meta-analysis showed that there were no significant differences in the postoperative Constant Function Score [mean difference (MD)=1.27], American Shoulder and Elbow Surgeons score (MD=1.26), postoperative pain score (MD=0.27), 2-year postoperative incidence of re-tear [relative risk (RR)=1.22], reoperation rate (RR=1.19) and complication rate (RR=1.37) between the bone channeling group and the control group (P>0.05). Conclusions Existing evidence shows that the application of bone channeling in arthroscopic rotator cuff repair failed to improve the postoperative re-tear of patients, but also did not lead to pain and complications.
Objective
To systematically review the clinical efficiency and safety after topical administration of tranexamic acid in total hip arthroplasty.
Methods
Relevant randomized controlled trials were identified from databases such as Cochrane Library, PubMed, Embase and CNKI from the establishment of the database to August, 2017. A systematic review was performed to compare total blood loss, the rate of transfusion and thromboembolism events between the tranexamic acid group and the control group. And the patients in tranexamic acid group were treated with tranexamic acid for hemorrhage after total hip arthroplasty, while the patients in the control group were not treated with tranexamic acid or used isotonic saline. Analysis was carried out using Review Manager version 5.2.0 software.
Results
Eight studies were incorporated into the Meta-analysis. The results of Meta-analysis showed that there was significant difference in total blood loss between two groups [weighted mean difference (WMD)=–360.27 mL, 95% confidence interval (CI) (–412.68, –307.87) mL, P<0.000 01]. There was significant difference in the rate of transfusion between two groups [ (odds ratio,OR)=0.22, 95%CI (0.14, 0.33), P<0.000 01]. There was no significant difference in complications between two groups [OR=1.48, 95%CI (0.41, 5.34), P=0.55].
Conclusion
Topical administration of tranexamic acid could significantly reduce total blood loss and transfusion requirements in primary total hip arthroplasty, and would not increase thromboembolic complications.
