Tranexamic Acid for Rotator Cuff Repair: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Autor:	Hurley ET; Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Rodriguez K; Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Karavan MP; Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Levin JM; Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Helmkamp J; Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Anakwenze O; Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Alaia MJ; NYU Langone, New York, New York, USA., Klifto CS; Department of Orthopedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2024 Dec; Vol. 52 (14), pp. 3673-3679. Date of Electronic Publication: 2024 Feb 12.
DOI:	10.1177/03635465231216336
Abstrakt:	Background: Several randomized controlled trials (RCTs) have been conducted to assess the use of tranexamic acid (TXA) in the setting of arthroscopic rotator cuff repair (ARCR). However, these studies have shown mixed results, with some showing improved intraoperative visualization, subsequent operative times, and pain levels, and others finding no difference. Purpose: To perform a systematic review of the RCTs in the literature to evaluate the use of TXA on ARCR. Study Design: Meta-analysis; Level of evidence, 1. Methods: Two independent reviewers performed the literature search based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a third author resolving any discrepancies. RCTs comparing TXA with a control in ARCR were included. Visualization, postoperative pain, operative time, pump pressures, and shoulder swelling were evaluated. A P value < .05 was deemed statistically significant. Results: Six RCTs with 450 patients were included in this review. Overall, 5 studies evaluated intraoperative visualization, with 3 studies finding a significant difference in favor of TXA. With TXA, patients had a lower mean postoperative visual analog scale (VAS) score of 3.3, and with the control, patients had a mean VAS score of 4.1, which was statistically significant ( P = .001). With TXA, the mean weighted operation time was 79.3 minutes, and with the control, the mean operation time was 88.8 minutes, which was statistically significant ( P = .001). No study found any difference in intraoperative pump pressures or swelling. Conclusion: TXA improved visualization, operative time, and subsequent postoperative pain levels in patients undergoing ARCR. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: J.L. has received support for education from TriCoast Surgical Solutions and SouthTech Orthopedics. O.A. has received consulting fees from Exactech Inc, Smith & Nephew, Medical Device Business Services, Biomentus, Lima USA, Responsive Arthroscopy, Encore Medical, and Stryker; support for education from Arthrex and SouthTech Orthopedics; and travel expenses from Wright Medical Technology and Zimmer Biomet Holdings. M.J.A. has received consulting fees from BodyCad, JRF Ortho, and Mitek; research support from Orcosa Inc; support for education from Suvon Surgical, Arthrex, and Gotham Surgical Solutions & Devices; and publishing royalties from Springer. C.K. has received consulting fees from Acumed, restore3d, and Smith & Nephew and holds stock or stock options in GE Healthcare, Johnson & Johnson, Merck, and Pfizer. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Databáze:	MEDLINE
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