Bleeding reduction after topical application of tranexamic acid together with Betadine solution in total knee arthroplasty. A randomised controlled study - 23/12/14

Doi : 10.1016/j.otsr.2014.10.013

L.H. Carvalho ^a,^b , E. Frois Temponi ^a,^⁎ , L.F. Machado Soares ^a, M.B.J. Gonçalves ^a, L. Paiva Costa ^a, M.L.A. Tavares de Souza ^a
^a Hospital Madre Teresa, Belo Horizonte, MG, Brazil
^b Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

^⁎Corresponding author. Hospital Madre Teresa, Av Raja Gabaglia 1002, 30441-070 Belo Horizonte, MG, Brazil. Tel.: +55 3 198 185 808.

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Abstract

Introduction

Topical application of tranexamic acid to the knee joint before closure in total knee arthroplasty reduces postoperative bleeding without increase in complication. However, it is unknown the effectiveness of topic TXA performed with other topical medications, like povidone-iodine solution.

Materials and methods

One hundred and twenty-five patients were randomized to receive 100mL of povidone-iodine solution (control: group A) or 1.5 (group B) and 3.0g (group C) of topical TXA in povidone-iodine solution applied into the knee before closure in total knee arthroplasty.

Results

The patients in the TXA groups had higher mean postoperative hemoglobin levels (P=0.01 and P=0.03 in groups B and C, respectively) and a reduced postoperative blood loss in the TXA groups (P=0.07 and P=0.09 in groups B and C, respectively). No significant complications were observed.

Discussion

In this study, topical application of tranexamic acid after total knee arthroplasty together with povidone-iodine solution results in higher postoperative hemoglobin levels and lower blood loss compared with those in the control group without other complications.