{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:49:11Z","timestamp":1790603351227,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82302701"],"award-info":[{"award-number":["82302701"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This systematic review and network meta\u2010analysis was performed to explore the optimal dose, efficacy, and safety of tranexamic acid (<jats:styled-content style=\"fixed-case\">TXA<\/jats:styled-content>) treatments versus placebo for high tibial osteotomy (<jats:styled-content style=\"fixed-case\">HTO<\/jats:styled-content>) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content>, Embase, Cochrane Library, Wanfang database, and Chinese National Knowledge Infrastructure (<jats:styled-content style=\"fixed-case\">CNKI<\/jats:styled-content>) databases were searched for the randomized controlled trials (<jats:styled-content style=\"fixed-case\">RCTs<\/jats:styled-content>) meeting prespecified inclusion criteria up to March 2024. Interventions included <jats:styled-content style=\"fixed-case\">TXA<\/jats:styled-content> and placebo treatments. The outcomes included total blood loss, drainage, hemoglobin drop, the occurrence of deep venous thrombosis (<jats:styled-content style=\"fixed-case\">DVT<\/jats:styled-content>) and hematoma. Traditional meta\u2010analysis and network meta\u2010analysis were performed by Stata and R software, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Traditional meta\u2010analysis revealed that <jats:styled-content style=\"fixed-case\">TXA<\/jats:styled-content> was associated with a decrease in the total blood loss, drainage volume, and hemoglobin drop (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). There was no significant difference between <jats:styled-content style=\"fixed-case\">TXA<\/jats:styled-content> and placebo in terms of the occurrence of <jats:styled-content style=\"fixed-case\">DVT<\/jats:styled-content> and hematoma (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Compared with placebo, intravenous (iv) 10\u2009mg\/kg, iv 10\u2009mg\/kg (3 doses), iv 2\u2009g, iv 2\u2009g (2 doses), iv 2\u2009g\u2009+\u2009topical (top) 3\u2009g, iv 50\u2009mg\/kg, and top 10\u2009mg\/kg decreased the total blood loss with statistical significance (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Compared with placebo, iv 10\u2009mg\/kg (<jats:styled-content style=\"fixed-case\">WMD<\/jats:styled-content>\u2009=\u2009\u2212379.91, 95% CI: \u2212378.92, \u221281.22) decreased the drainage volume with statistical significance. Compared with placebo, iv 10\u2009mg\/kg (3 doses), iv 1\u2009g, iv 1\u2009g\u2009+\u2009top 2\u2009g, iv 2\u2009g\u2009+\u2009top 1\u2009g, and iv 50\u2009mg\/kg decreased the hemoglobin drop with statistical significance. No statistically significant difference was found when the two interventions were compared against each other for the occurrence of <jats:styled-content style=\"fixed-case\">DVT<\/jats:styled-content> and hematoma (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). The <jats:styled-content style=\"fixed-case\">SUCRA<\/jats:styled-content> shows that iv 10\u2009mg\/kg ranked first for reducing total blood loss (<jats:styled-content style=\"fixed-case\">SUCRA<\/jats:styled-content>, 90.7%) and drainage volume (<jats:styled-content style=\"fixed-case\">SUCRA<\/jats:styled-content>, 94.3%). The <jats:styled-content style=\"fixed-case\">SUCRA<\/jats:styled-content> shows that iv 1\u2009g\u2009+\u2009top 2\u2009g ranked first (<jats:styled-content style=\"fixed-case\">SUCRA<\/jats:styled-content>, 93.7%) for reducing hemoglobin drop.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Administration with <jats:styled-content style=\"fixed-case\">TXA<\/jats:styled-content> was associated with a decrease in blood loss in <jats:styled-content style=\"fixed-case\">HTO<\/jats:styled-content> patients. The optimal dose of <jats:styled-content style=\"fixed-case\">TXA<\/jats:styled-content> for reducing blood loss was iv 10\u2009mg\/kg. As for reducing hemoglobin drop, iv 1\u2009g\u2009+\u2009top 2\u2009g ranked first. Administration of <jats:styled-content style=\"fixed-case\">TXA<\/jats:styled-content> was not associated with an increase in the occurrence of <jats:styled-content style=\"fixed-case\">DVT<\/jats:styled-content> and hematoma. However, most evidence was graded as low\/very low confidence due to study limitations, imprecision, and heterogeneity. Therefore, these findings should be interpreted as preliminary signals rather than definitive conclusions. Further high\u2010quality randomized trials are required to validate dose\u2010dependent efficacy and long\u2010term safety outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70140","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T03:40:45Z","timestamp":1757648445000},"page":"2784-2808","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Optimal Dose, Efficacy and Safety of Tranexamic Acid on Hemorrhage Control for High Tibial Osteotomy: A Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"17","author":[{"given":"Zhihu","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Tianjin Hospital  Tianjin 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