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

Abstract

I - I: high-powered prospective randomized trial.

Topical versus intravenous tranexamic acid in total knee arthroplasty

“…39 The topical application combined with povidoneiodine solution or epinephrine has also shown promising results in terms of lower blood loss and higher postoperative haemoglobin levels. 40,41,42 The main strength of our meta-analysis is that it included only RCTs. However, there are several limitations.…”

Efectividad y eficiencia de la vía clínica rápida (fast-track) en prótesis total de rodilla y cadera (PTR y PTC): 11 años de experiencia. Validación de la vía clínica. Análisis de la estancia hospitalaria, tasa de revisiones y coste en un hospital público español

“…Husted afirma que la estancia media en PTC oscila entre los 5 y los 9,4 días 25 . Los factores que influyen en la estancia hospitalaria son múlti-ples, pueden ser pre, intra y postoperatorios, e incluyen la morbilidad de los pacientes y factores económicos, sociales y culturales 25 .…”

Use of tranexamic acid in total knee arthroplasty

“…For topical administration, doses of tXA range from 250 mg to 3 g, diluted in 75 to 250 ml of saline solution. tXA has also been shown to be effective administered with other topical medications, like povidone-iodine solution (3 g of topical tXA in povidoneiodine solution) (24). the aim of the present study was to compare the efficacy of systemic, local and combined administration of tXA in reducing blood loss after tKA.…”

“…tranexamic acid in tKa confirmed the efficacy of iA administration, albeit proposing different doses and different methods of topical administration (washing or through the drain) (24,(38)(39)(40)(41)(42). in particular, Georgiadis et al randomized patients to two groups receiving either 2 g of tXA in 75 ml of saline or a placebo solution intraoperatively.…”

“…similarly, various recent studies have demonstrated the efficacy of iA tXA administration in reducing blood loss after tKA (Tabs. 2, 3) (24,29,(40)(41)(42)(43)(44)(45)(46)(47). Furthermore, recent meta-analyses showed no difference between topical and iV tXA administration (44,(48)(49)(50)(51)(52)(53)(54)(55), even though some Authors reported conflicting results (43,46,47,56).…”