The Efficacy and Safety of Tranexamic Acid Combined with Rivaroxaban in Prevention of Clinical Events in Patients after Total Knee/ Hip Arthroplasty: A Meta-analysis

Aims To evaluate the efficacy and safety of tranexamic acid combined with rivaroxaban in prevention of clinical events in patients after TKA/THA through meta-analysis of randomized controlled trials. Materials and Methods Randomized Controlled Trials (RCTs) were retrieved from medical literature databases. Risk ratios (RR) Standard mean difference (SMD) and 95% confidence intervals (CI) were calculated to compare the primary and safety endpoints. Results In total, 21 articles (32 trial comparisons) were retrieved which contained 2909 patients. In general, 1718 patients (59.06%) were randomized to experimental group whereas 1191 patients (40.94%) were randomized to control group. The result showed that TXA combined with rivaroxaban significantly reduce TBL, BTV, BTR and the incidence of MB compared to the control group; there were no significant differences in NMB between experimental group and control group. Conclusion This meta-analysis reveals that TXA combined with rivaroxaban can significantly reduce TBL, BTV, the incidence of blood transfusion and the incidence of MB compared to the control group, which proved that its efficacy and safety are trustworthy.