Réduction du saignement par application locale d’acide tranéxamique combinée à de la bétadine dans les prothèses totales de genou : une étude controlée randomisée

Abstract

IntroductionTopical 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 methodsOne hundred and twenty-five patients were randomized to receive 100mL povidone-iodine solution (control: gr.A) or 1.5 (gr.B) and 3.0g (gr.C) of topical TXA in 100mL of povidone-iodine applied into the knee before closure in total knee arthroplasty. ResultsThe 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. DiscussionIn 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 evidenceI – I: High-powered prospective randomized trial.