title: Bleeding reduction after topical application of tranexamic acid together with Betadine solution in total knee arthroplasty. A randomised controlled study.
abstract: BACKGROUND
  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.
  
  
  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 3.0 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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  I - I: high-powered prospective randomized trial.
authors.affiliation: Hospital Madre Teresa, Belo Horizonte, MG, Brazil; Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: luciohcj@gmail.com.
authors.forename: L H
authors.initials: LH
authors.lastname: Carvalho
authors.affiliation: Hospital Madre Teresa, Belo Horizonte, MG, Brazil. Electronic address: dufrois@hotmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Frois Temponi
authors.affiliation: Hospital Madre Teresa, Belo Horizonte, MG, Brazil.
authors.forename: L F
authors.initials: LF
authors.lastname: Machado Soares
authors.affiliation: Hospital Madre Teresa, Belo Horizonte, MG, Brazil.
authors.forename: M B J
authors.initials: MB
authors.lastname: Gonçalves
authors.affiliation: Hospital Madre Teresa, Belo Horizonte, MG, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Paiva Costa
authors.affiliation: Hospital Madre Teresa, Belo Horizonte, MG, Brazil.
authors.forename: M L A
authors.initials: ML
authors.lastname: Tavares de Souza
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D000933:Antifibrinolytic Agents / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage*
chemical_list: D000891:Anti-Infective Agents, Local; D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid; D011206:Povidone-Iodine
keywords: Blood loss; Povidone-iodine solution; Total knee arthroplasty; Tranexamic acid