***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: The aim of the present study was to investigate aspects of coagulation and fibrinolysis during knee arthroplasties in order to find out . 1 . whether an increased fibrinolysis is correlated to an increased blood loss 2 . whether there is a difference in markers for coagulation and fibrinolysis in peripheral venous blood compared to those in blood from the wounds 3 . whether the administration of tranexamic acid modifies the fibrinolytic response .  Twenty-four patients were included . Twelve patients were given tranexamic acid intravenously at the end of the operation . The dose was repeated three hours later . The other 12 patients were given an equivalent amount of placebo . The administration was r and omised and double-blind . Levels of prothrombin fragments 1 + 2 , D-dimers , plasminogen , alpha 2-antiplasmin , tissue plasminogen activator ( tPA ) , and plasminogen activator inhibitor ( PAI-1 ) in venous blood were investigated just before the operation , at the end of the operation and three hours later . At the end of the operation blood for analysis was also drawn from the wound . Coagulation and fibrinolysis was activated during and after surgery . The activation was significantly higher in blood from the wounds than in peripheral venous blood . We found no direct correlation between the degree of fibrinolysis and blood loss . The administration of tranexamic acid  reduced fibrinolysis in the wounds but not in peripheral venous blood . The postoperative blood loss was reduced by half Background Hidden blood loss is a major concern for patients undergoing hip surgery for intertrochanteric fracture . The objective of this study was to investigate whether tranexamic acid ( TXA ) could reduce postoperative hidden blood loss in patients undergoing hip surgery for intertrochanteric fracture . Methods A total of 77 patients with intertrochanteric fracture were enrolled in this r and omized controlled study . Patients received either 200 mL ( 1 g ) of TXA ( n = 37 ) or normal-saline ( NS ) ( n = 40 ) i.v . before hip surgery using proximal femoral nail anti-rotation ( PFNA ) . Hemoglobin and hematocrit levels were measured preoperatively and postoperatively at day 1 and 3 . Visible and hidden blood loss volumes were calculated at postoperative day 3 . Results On postoperative day 3 , the transfusion rate was significantly lower in the TXA group compared to the NS group , although mean hemoglobin and hematocrit levels were not significantly different between the two groups . However , the estimated hidden blood loss volume ( 210.09 ± 202.14 mL vs. 359.35 ± 290.12 mL ; P < 0.05 ) and total blood loss volume ( 279.35 ± 209.11 mL vs. 417.89 ± 289.56 mL ; P < 0.05 ) were significantly less in the TXA group compared to the NS group , respectively . Conclusion TXA significantly reduced postoperative hidden blood loss in patients with intertrochanteric fracture who underwent PFNA . ( Registration number : ChiCTR-INR-16008134 ) Objectives : We aim ed to determine whether ( 1 ) tranexamic acid ( TXA ) reduces the incidence of transfusion ( 2 ) TXA reduces the calculated blood loss , and ( 3 ) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture ( FNF ) . Design : Prospect i ve , double-blinded , r and omized controlled trial . Setting : Level 1 Academic Trauma Center . Patients / Participants : One hundred thirty-eight patients who presented with a low-energy , isolated , FNF ( AO 31B ) treated with either hemi- or total hip arthroplasty within 72 hours of injury were r and omized to either the TXA group ( 69 patients ) or placebo group ( 69 patients ) . Intervention : In the TXA group , patients received 2 doses of 15 mg/kg intravenous TXA dissolved in 100 mL of saline , each administered over 10 minutes ; 1 dose just before incision , and the second at wound closure . In the placebo group , 100 mL of saline solution was administered in a similar fashion . Perioperative care was otherwise st and ardized including conservative transfusion criteria . Main Outcome Measurements : Our primary outcome was to determine the proportion of patients who underwent blood transfusion during hospitalization . Secondary outcomes were calculated blood loss , number of units transfused during hospitalization , and incidence of adverse events at 30 and 90 days including thromboembolic event , wound complications , reoperation , hospital readmission , and all-cause mortality . Results : TXA reduced mean incidence of transfusion by 305 mL ( P = 0.0005 ) . There was a trend toward decreased transfusion rate in the TXA group ( 17 % vs. 26 % , P = 0.22 ) . TXA was safe with no differences in adverse events at 30 and 90 days . Conclusions : This r and omized clinical trial found that TXA administration safely reduced blood loss with a tendency for decreased transfusion rate and total blood product consumption for patients undergoing hip arthroplasty for acute FNF . More studies are needed to further ascertain the role of TXA in the management of patients with FNF . Level of Evidence : Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence Introduction : Peritrochanteric fractures are common injuries occurring in elderly patients . Surgeries for these fractures are associated with significant blood loss . Intravenous tranexamic acid has a proven track record in many orthopaedic surgeries including trauma , arthroplasty and spine surgeries . Objective : To study the effect of local subfascial and intramuscular infiltration of tranexamic acid in reducing blood loss and the requirement for blood transfusion in intertrochanteric fracture surgery . Study Design : Single centre prospect i ve analytical study . Material s and Methods : One hundred and thirty seven patients above 65 years of age were included in the study , divided into two groups : the intervention group received subfascial and intramuscular infiltration of 2 g tranexamic acid before wound closure and the control group of alternate patients did not receive any tranexamic acid infiltration . The postoperative drain output was recorded , as well as the haemoglobin level and the patients needing blood transfusion . Results and Conclusions : The preoperative and postoperative haemoglobin values were recorded . The mean preoperative haemoglobin was 10.9 % and 10.8 % ( p=0.79 ) in the trial and control groups respectively . The mean postoperative haemoglobin was 9.5gm% and 9.2gm% ( p=0.36 ) in the two groups . The total postoperative blood loss in the tranexamic acid group and the control group was 190.3ml and 204.3ml respectively ( p=0.25 ) . Ten patients ( 14.9 % ) in the intervention group and 12 patients ( 17.1 % ) in the control group required blood transfusion . We conclude that tranexamic acid does not play a significant role in reducing postoperative blood loss and blood transfusion when used locally in peritochanteric fracture surgery . However a larger double blinded study comparing various modalities of use of tranexamic acid is needed to conclusively establish its role Context : Pharmacological agents are used to reduce postoperative blood loss . Aims : To assess the effects of tranexamic acid on prevention of bleeding and requirement of blood transfusion after major hip and femoral surgeries . Setting s and Design : A prospect i ve , r and omized , double blinded study was conducted in the tertiary care teaching hospital . Methods : Ninety ASA grade I-II patients undergoing hip fracture surgery were included in this prospect i ve study . Forty-five patients received tranexamic acid ( TA ) given in a bolus dose of 500 mg 15 min before surgical incision followed by continuous infusion . The remaining , 45 patients were allocated as a control group . Postoperative bleeding ( volume of blood in the drain ) , percentage fall of hemoglobin , transfusions and complications were recorded . Results : Mean volume of blood in the drain was 39.33±10.09 ml ( mean±SD ) as compared to 91.11±17.61 ml in placebo group showing a P<0.001 . Mean percentage fall in Hb at day 0 was 2.99±3.45 in the study group as compared to 7.70±6.05 in the placebo group ( P<0.001 ) , and fall at day 2 in the study group was 0.35±0.74 , compared to 2.72±2.70 in the placebo group ( P<0.001 ) . The number of patients required blood transfusions were lower in the study group than in the placebo group ( P=0.01 ) . Conclusions : We conclude that tranexamic acid significantly reduces postoperative blood loss and transfusion requirements during major hip and femoral surgeries BACKGROUND the impact of anaemia on the outcome after a hip fracture surgery is controversial , but anaemia can potentially decrease the physical performance and thereby impede post-operative rehabilitation . We therefore conducted a prospect i ve study to establish whether anaemia affected functional mobility in the early post-operative phase after a hip fracture surgery . PATIENTS AND METHODS four hundred and eighty seven consecutive hip fracture patients , treated according to a well-defined multimodal rehabilitation programme with a uniform , liberal transfusion threshold , were studied .  Hb was measured on each of the first three post-operative days , and anaemia defined as Hb < 100 g/l .  Functional mobility was measured with the Cumulated Ambulation Score ( CAS ) . RESULTS the results were obtained from 170 , 132 and 116 patients who were found anaemic on the first , second and third post-operative day , respectively . A significant association between anaemia and the ability to walk independently before the correction of anaemia was present on each of the 3 days separately ( P<0.05 ) . A significant correlation was also found on each day between the functional score and the Hb level . A multivariate analysis integrating the type of surgery , medical complications and prefracture function showed that anaemia at the time of the physiotherapy session was an independent risk factor for not being able to walk on the third post-operative day [ OR 0.41 ( 0.14 - 0.73 ) P = 0.002 ] . CONCLUSION anaemia impedes functional mobility in the early post-operative phase after a hip fracture surgery and is an independent risk factor for patients not being able to walk post-operatively . The potential for a liberal transfusion policy to improve the rehabilitation potential in hip fracture patients with anaemia should be investigated Computer-assisted surgery ( CAS ) in total knee arthroplasty ( TKA ) could be useful in reducing the overall blood loss . A prospect i ve r and omised study was performed with two groups of 50 patients each of whom were treated for knee arthritis . Patients of group A were treated by a conventional st and ard procedure , while for patients of group B a specific CAS procedure was used . We determined the intraoperative blood loss according to the Orthopaedic Surgery Transfusion Haemoglobin European Overview ( OSTHEO ) study . The average blood loss in patients of group A was 1,974 ml ( range : 450–3,930 ml ) compared to 1,677 ml of patients of group B ( range : 500–2,634 ml ) . A statistically significant difference was found between the two groups ( p = 0.0283 ) . Computer-assisted surgery is highly recommended in TKR to save blood . It creates more possibilities to operate on anaemic patients and subjects who can not accept blood products by reducing blood loss risk . RésuméLa chirurgie assistée par ordinateur dans les prothèses totales du genou peut être utile afin de réduire les pertes sanguines . Matériel et méthode : une étude prospect i ve , r and omisée , a été réalisée avec deux groupes de 50 patients , chacun , traités pour une arthrose du genou . Les patients du groupe A ont été opérés sur un mode conventionnel alors que l’autre groupe l’a été avec assistance informatique dans le cadre de la navigation . Nous avons déterminé les perte sanguines per-opératoires selon l’évaluation OSTEO . Résultats : le total des pertes sanguines du groupe A a été de 1974 ml en moyenne ( de 450 à 3930 ) en comparaison des 1677 ml des patients du groupe B ( de 500 à 2634 ml ) . La différence est statistiquement significative entre les deux groupes , p = 0,0283 ) . Conclusion : la navigation avec chirurgie assistée par ordinateur est recomm and ée pour les prothèses de remplacement articulaire afin de réduire les pertes sanguines . Cette technique donne plus de possibilité pour opérer les sujets anémiques qui ne peuvent supporter de grosses pertes sanguines OBJECTIVE To compare the frequency of blood transfusion after surgery for fixation of inter-trochanteric fractures in patients given tranexamic acid versus placebo .  METHODS The r and omised control trial was conducted at the Aga khan university hospital from May 1 to October 31 , 201 
    Output:
    
Conclusions This meta- analysis of the available evidence implies that the intravenous route of TXA shows an ability to reduce transfusion requirements and total blood loss , not increasing the incidence of thromboembolic events in patients undergoing hip surgeries .
The translational potential of this article The result of this meta- analysis shows that the utilization of intravenous TXA in patients with hip fracture undergoing hip surgeries possesses great potential in reducing blood loss and allogeneic blood transfusion safely