Clinics (Sao Paulo). 2019;74:e1186.

Comparison of Floseal^® and Tranexamic Acid for Bleeding Control after Total Knee Arthroplasty: a Prospective Randomized Study

Camilo Partezani Helito , Marcelo Batista Bonadio , Marcel Faraco Sobrado , Pedro Nogueira Giglio , José Ricardo Pécora , Gilberto Luis Camanho , Marco Kawamura Demange

DOI: 10.6061/clinics/2019/e1186

OBJECTIVE:

Tranexamic acid (TXA) and the hemostatic agent Floseal^® have already been used to minimize bleeding during total knee arthroplasty (TKA).

METHODS:

We conducted a prospective, randomized study of 90 patients with indications for TKA. Following inclusion, the participants were randomly allocated in blocks to the following 3 groups: control, Floseal^® and TXA. Bleeding parameters, including decreases in hemoglobin (Hb), drain output, number of blood transfusions and complications, were assessed. ClinicalTrials.gov: NCT02152917.

RESULTS:

The mean decrease in Hb was highest in the control group (4.81±1.09 g/dL), followed by the Floseal^® (3.5±1.03 g/dL) and TXA (3.03±1.2 g/dL) groups. The Floseal^® and TXA groups did not differ, and both performed better than the control group. The mean total drain output was 901.3±695.7 mL in the control group, 546.5±543.5 mL in the TXA group and 331.2±278.7 mL in the Floseal^® group. Both TXA and Floseal^® had significantly less output than the control group, and Floseal^® had significantly less output than TXA. The number of blood transfusions was very small in all 3 groups.

CONCLUSION:

The use of TXA or Floseal^® was associated with less blood loss than that of the control group among patients undergoing primary TKA, as measured both directly (intraoperative bleeding + drainage) and on the basis of a decrease in Hb, without differences in the rate of complications. TXA and Floseal^® showed similar decreases in Hb and total measured blood loss, but the drain output was smaller in the Floseal^® group.