Efficacy of tranexamic acid in improving visual clarity and operative time of arthroscopic rotator cuff repair: A systematic review and meta-analysis

Objective: The aim of this study was to examine if tranexamic acid (TXA) can assist in improving outcomes of arthroscopic rotator cuff repair (RCR). Methods: The databases of PubMed, Embase, Web of Science, CENTRAL, and Scopus were searched for all types of studies examining the efficacy of TXA for arthroscopic RCR. Twelve studies, 10 randomized controlled trials (RCTs), and 2 retrospective studies were considered eligible. Results: Meta-analysis of only 2 studies using a visual clarity grading system showed better visualization with the use of TXA. A similar difference was noted for studies using the visual analog scale. Operating time was not significantly different between the groups, but subgroup analysis of RCTs demonstrated reduced operating time with TXA. Meta-analysis showed no difference in 24-hour pain scores between TXA and control groups. Qualitative assessment of studies for blood loss showed no significant effect of TXA. No major complications were reported in any of the studies. Conclusion: This study has pooled evidence suggesting that TXA can improve visual clarity in arthroscopic RCR and may also result in a reduction in operating time. TXA does not seem to reduce blood loss or 24-hour postoperative pain scores. Level of Evidence: Level II, Therapeutic Study.