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Chondrotoxic effects of tranexamic acid and povidone-iodine on the articular cartilage of rabbits

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Abstract

Purpose

To evaluate the chondrotoxic effects of intra-articular use of TXA 20 mg/kg and/or 0.35% PVPI on knee joint cartilage in an experimental model of rabbits.

Methods

Forty-four male New Zealand adult rabbits were randomly assigned to four groups (control, tranexamic acid (TXA), povidone-iodine (PVPI), and PVPI + TXA). The knee joint cartilage was accessed through an arthrotomy and exposed to physiological saline SF 0.9% (control group), TXA, PVPI, and PVPI followed by TXA. Sixty days after surgical procedure, the animals were sacrificed and osteochondral specimens of the distal femur were obtained. Histological sections of cartilage from this area were stained with hematoxylin/eosin and toluidine blue. The following cartilage parameters were evaluated by the Mankin histological/histochemical grading system: structure, cellularity, glycosaminoglycan content in the extracellular matrix, and integrity of the tidemark.

Results

The isolated use of PVPI causes statistically significant changes in cartilage cellularity (p-value = 0.005) and decrease glycosaminoglycan content (p = 0.001), whereas the isolated use of TXA decreased significantly the glycosaminoglycan content (p = 0.031). The sequential use of PVPI + TXA causes more pronounced alterations in the structure (p = 0.039) and cellularity (p = 0.002) and decreased content of glycosaminoglycans (p < 0.001) all with statistical significance.

Conclusion

Data suggest that intra-articular use of tranexamic acid 20 mg/kg and intraoperative lavage with 0.35% povidone-iodine solution for three min are toxic to the articular cartilage of the knee in an experimental in vivo study in rabbits.

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Authors and Affiliations

  1. Orthopaedic Department, Universidade Federal de Minas Gerais, Ave Prof. Alfredo Balena 190, Belo Horizonte, Minas Gerais, 30130100, Brazil

    Frederico Silva Pimenta, Túlio Vinícius de Oliveira Campos, Guilherme Moreira de Abreu e Silva & Marco Antônio Percope de Andrade

  2. Institute of Education and Research Santa Casa, Ave dos Andradas 2688, Belo Horizonte, Minas Gerais, 30130100, Brazil

    Marcelo Araújo Buzelin

  3. Pathologic Anatomy Department, Universidade Federal de Minas Gerais, Ave Prof. Alfredo Balena 190, Belo Horizonte, Minas Gerais, 30130100, Brazil

    Cristiana Buzelin Nunes

Authors
  1. Frederico Silva Pimenta
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  2. Túlio Vinícius de Oliveira Campos
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  3. Guilherme Moreira de Abreu e Silva
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  6. Marco Antônio Percope de Andrade
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Frederico Silva Pimenta, Marco Antônio Percope de Andrade, Cristiana Buzelin Nunes, Tulio Vinicius de Oliveira Campos, Guilherme Moreira de Abreu e Silva and Marcelo Araújo Buzelin. The first draft of the manuscript was written by Frederico Silva Pimenta and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Frederico Silva Pimenta.

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Pimenta, F.S., de Oliveira Campos, T.V., de Abreu e Silva, G.M. et al. Chondrotoxic effects of tranexamic acid and povidone-iodine on the articular cartilage of rabbits. International Orthopaedics (SICOT) 47, 2429–2437 (2023). https://doi.org/10.1007/s00264-023-05820-y

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