Systemic iodine levels increase with povidone-iodine irrigation, but does this affect thyroid functions? A...

Area of Science:

• Orthopedic Surgery
• Endocrinology
• Clinical Trials

Background:

• Povidone iodine (PI) irrigation is used in arthroplasty to prevent infections.
• Systemic effects of PI, particularly from intraoperative irrigation, require investigation.
• This study evaluates PI's systemic impact via urine iodine and thyroid function tests.

Purpose of the Study:

• To assess the systemic absorption of iodine from intraoperative povidone iodine irrigation.
• To determine the effect of absorbed iodine on thyroid function after arthroplasty.
• To compare urine iodine and thyroid hormone levels between patients receiving PI irrigation and a control group.

Main Methods:

• A case-control study included 96 patients undergoing knee or hip arthroplasty.
• Patients were divided into two groups: standard irrigation with PI versus standard irrigation alone.
• Urine iodine, TSH, free T3, and free T4 levels were measured preoperatively and postoperatively.

Main Results:

• Urinary iodine levels peaked in the early postoperative period in the PI group (450 µg/L).
• A significant difference in urinary iodine levels persisted between groups for 14 days post-surgery.
• No statistically significant differences in thyroid function tests were observed between the groups.

Conclusions:

• Diluted povidone iodine can be considered for irrigation in total joint arthroplasty to reduce infection risk.
• PI irrigation at the tested concentration and duration did not significantly alter thyroid function.
• Larger, long-term studies are recommended to further evaluate the systemic effects of PI irrigation.