Efficacy and Safety of XXXX in Bilateral Total Knee Replacement: A Meta-Analysis and Systematic Review.

@entity1 @entity190 @entity928 @entity1151 @entity1150 @entity927
BACKGROUND @entity927 ( @entity928 ) has been well documented to reduce @entity190 and transfusion requirements in @entity1 undergoing unilateral total knee arthroplasty (TKA). However, the efficacy and safety of @entity928 in simultaneous bilateral TKA have not been clearly defined. The aim of our study was to systematically review the existing evidence regarding the role of @entity928 in @entity1 undergoing simultaneous bilateral TKA. MATERIAL AND METHODS A systematic search of all studies published through June 2014 was performed using Medline, EMBASE, OVID, and other databases. All studies that compared the efficacy and safety of @entity928 administration in simultaneous bilateral TKA @entity1 were identified. The data from the included trials were extracted and analyzed regarding @entity190 and transfusion rates. The evidence quality levels of the selected articles were evaluated using a grading system. RESULTS Six studies were included, in which a total of 245 @entity1 received @entity928 and 271 @entity1 were controls. Overall, the results demonstrated that the use of @entity928 significantly reduced total @entity190 by a mean of 371.1 ml (95% confidence interval (CI)=-412.12 to -330.09; p<0.001) and reduced the number of @entity1 requiring blood transfusion (risk ratio (RR)=0.16; 95% CI=0.10 to 0.28; p<0.001). No significant differences in adverse effects such as @entity1150 ( @entity1150 ) or @entity1151 ( @entity1151 ) were noted in any group. CONCLUSIONS The intravenous use of @entity928 in @entity1 undergoing simultaneous bilateral TKA is effective and safe and results in significantly reduced estimated @entity190 and transfusion rates. No significant difference was observed in the incidence of side effects. Due to the limitations in the evidence quality of current meta-analyses, well-conducted, larger, high-quality randomized controlled trials (RCTs) are required.
