1484 Tranexamic Acid Use to Decrease Blood Loss in Primary Shoulder and Elbow Replacement: A Systematic Review and Meta-Analysis

Abstract Tranexamic acid (TXA) is an inexpensive, commonly used antifibrinolytic agent that has been shown to significantly reduce perioperative blood loss and transfusion requirements after total hip knee replacement. We conducted a systematic review meta-analysis synthesise the latest evidence regarding effects of TXA on in shoulder replacement (TSR) elbow (TER). systematically searched MEDLINE, EMBASE CENTRAL from inception 03 September 2020 for randomised controlled trial (RCTs) observational studies. Our primary outcome was loss, secondary outcomes included need venous thromboembolic (VTE) complications. Four RCTs five retrospective cohort studies (RCS) met eligibility criteria TSRs, but none TERs. RCT data determined administration decreased estimated postoperative change haemoglobin (Hb) Hb when compared placebo. RCS demonstrated significant association between Hb, Hct length stay. This demonstrates TSR decreases with placebo associated lower shorter stay no treatment increase VTE should be part wider management strategy minimise patients undergoing TSR. Further research needed demonstrate if similar benefit exists TER.