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This high-quality systematic review and meta-analysis of published randomized controlled trials evaluating the efficacy of tranexamic acid (TXA) in reducing blood loss and transfusions in total hip replacement (THR) is sound and may be useful for the reader. The authors used the Cochrane methodology for conducting systematic reviews and meta-analyses. The quality of included studies was assessed with a powerful tool, the total quality assessment score. Tranexamic acid is indeed effective in reducing both bleeding and transfusions in these patients. No major side effects, with a particular focus on thrombotic events, are reported. However, the global efficacy, as already demonstrated in the past, is weak (only a 20% reduction in bleeding and transfusions), far from the efficacy of aprotinin!

– Charles-Marc Samama