# The Use of Tranexamic Acid in Anterior Cruciate Ligament Reconstruction: A Systematic Review
## 3 Results
### Outcome Results  
Reported outcomes, TXA protocol, surgical protocol, and postoperative protocol were all synthesized in Table 2 for all our included studies. \begin{table}
\begin{tabular}{c c c c c c c c c} \hline \hline \multirow{2}{*}{\begin{tabular}{c} **First** \\ **Author,** \\ **Year** \\ \end{tabular} } & \multirow{2}{*}{\
\begin{tabular}{c} **Sample** \\ **Size** \\ \end{tabular} } & \multicolumn{2}{c}{**Age, Mean \(\pm\) SD, y**} & \multicolumn{2}{c}{**Sex, MF**} & \multicolumn{2}{c}{**Surgery Duration, Min**} & \multirow{2}{*}{
\begin{tabular}{c} **Follow-** \\ **Up** \\ \end{tabular} } \\ \cline{3-3} \cline{5-8}  & & **XAA** & **Control** & **TXA** & **Control** & **TXA** & **Control** & **TXA** & **Control** & **Up** \\ \hline Karasalan, & \multirow{2}{*}{105} & \multirow{2}{*}{28.23 \(\pm\) 6.59} & \multirow{2}{*}{28.31 \(\pm\) 9.01} & \multirow{2}{*}{51/2} & \multirow{2}{*}{49/3} & \multirow{2}{*}{40 \(\pm\) 18} & \multirow{2}{*}{45 \(\pm\) 15} & \multirow{2}{*}{4 weeks} \\
2015 & & & & & & & & \\ \hline Felli, 2019 & 80 & 30.7 \(\pm\) 11.0 & 32.0 \(\pm\) 10.5 & 27/13 & 36/4 & 45 \(\pm\) 6.6 & 40.8 \(\pm\) 12.8 & 12 weeks \\ \hline Chiang, & \multirow{2}{*}{304} & \multirow{2}{*}{25.7 \(\pm\) 8.4} & \multirow{2}{*}{27.6 \(\pm\) 6.9} & \multirow{2}{*}{125/26} & \multirow{2}{*}{119/30} & \multirow{2}{*}{54.5 \(\pm\) 17.2} & \multirow{2}{*}{50.3 \(\pm\) 19.3} & \multirow{2}{*}{4 weeks} \\
2019 & & & & & & & \\ \hline Lee, 2020 & 47 & 30.3 \(\pm\) 9.0 & 25.1 \(\pm\) 8.1 & 20/3 & 21/3 & NR & NR & 6 weeks \\ \hline Banca, & \multirow{2}{*}{43} & \multirow{2}{*}{NR} & \multirow{2}{*}{NR} & \multirow{2}{*}{NR} & \multirow{2}{*}{NR} & \multirow{2}{*}{NR} & \multirow{2}{*}{NR} & \multirow{2}{*}{NR} & \multirow{2}{*}{4 weeks} \\
2021 & & & & & & & & \\ \cline{3-3} \cline{5-8}  & & IV & IA & & IV & IA & & & \\ \cline{3-3} \cline{5-8}  & & \multirow{2}{*}{120} & \multirow{2}{*}{32.7 \(\pm\) 8.5} & \multirow{2}{*}{30.3 \(\pm\) 8.0} & \multirow{2}{*}{30.1 \(\pm\) 7.7} & \multirow{2}{*}{25/15} & \multirow{2}{*}{26/14} & \multirow{2}{*}{23/17} & \multirow{2}{*}{76.5 \(\pm\) 11} & \multirow{2}{*}{71.3 \(\pm\) 10.1} & \multirow{2}{*}{74.4 \(\pm\) 11.8} & \multirow{2}{*}{4 weeks} \\ \cline{3-3} \cline{5-8}  & & \multirow{2}{*}{NR, not reported; IV, intravenous administration; IA, intraarticular administration.} & & & & & \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Baseline characteristics and demographics of all included studies. Figure 3: Summary assessment of bias of the included RCTs. Figure 2: Assessment of risk of bias in the RCTs with the aid of the RoB tool, for individual domains and individual RCTs. Estimated blood loss/drain output was measured in 4 of the 5 studies, resulting in a total pool of 196 patients with TXA administration in one way or another [14; 15; 29; 30]. TXA was administered IV in three of these studies and IA in the remaining one [14; 29; 30]. These authors reported decreases in drain output between the TXA and control group of 90 mL (\(p<0.001\)), 74 mL (\(p<0.001\)), and 41.6 mL/56.8 mL (\(p<0.001\)), all being considered statistically significant data. The only study that did not find statistical significance was the study of [PERSON] et al., which performed IA TXA, but they measured the amount of blood loss, not the drain output. The necessity for knee aspiration was reported by [PERSON] et al. and [PERSON] et al. [30; 31]. The first reported aspiration in three patients from the control group, but with no statistical significance. [PERSON] et al. reported that no knee aspirations were needed. Postoperative pain levels (VAS) were measured as either primary or secondary outcomes in all the included studies. Statistical significance regarding a lower VAS in the intervention groups was mostly reported for the early postoperative period (two weeks) [14; 29; 31; 32]. When cross-checking the analgesic protocol of these studies, there seems to be no correlation with the decrease in VAS.