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

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 100 mL of povidone-iodine solution (control: group A) or 1.5 (group B) and 3.0 g (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. Level of evidence I – I: high-powered prospective randomized trial.