Effect of Tranexamic Acid on Shoulder Surgery: An Updated Meta-Analysis of Randomised Studies

The effect of Tranexamic acid (TXA) has been proven to be effective in reducing blood loss in lower limb arthroplasty. The aim of this study is to investigate the effect of TXA in shoulder surgery with the updated studies.A systematic review and meta-analysis of all the randomized controlled trials (RCTs) was conducted. We compared the outcomes of patients with and without TXA. The PUBMED, MEDLINE, EMBASE and CENTRAL databases were systematic searched for relevant studies.A total of 14 studies, enrolling 1131 patients were included for qualitative and quantitative analysis. Our results revealed that TXA was associated with significant reduction in total volume blood loss (MD:-112.97, p=0.0006), drain output (MD:-81.90, p<0.00001), hemoglobin changes (MD:-0.55, p=0.02), shorter operative time (MD:-6.19, p=0.01) and lower risk of hematoma formation (OR:-0.20, p=0.01). The postoperative VAS pain score was also significantly better in the TXA group (MD:-0.78, p<0.00001). No significant difference was detected in length of hospital stay and incidence of thromboembolization.The usage of TXA in shoulder surgery appeared to be safe and effective in reducing blood loss without any significant complication.