Assessment of blood loss in total knee arthroplasty depending on the type of the endoprosthesis

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Abstract


Introduction. In the modern conditions arthroplasty of joints has become one of the main methods of treatment that enables to restore joint movements, weight bearing ability and quickly return the patient to an active lifestyle. Total knee arthroplasty (TKA) is accompanied by a significant blood loss resulting in a decrease of hemoglobin level and higher requirements in postoperative blood transfusion. Purpose of the study: to estimate the volume of blood loss in patients after total knee arthroplasty depending on the design of the endoprosthesis. Patients and methods. Retrospective study included 73 patients with stage 3 gonarthrosis by Kosinskaya. All patients were divided into groups: in group 1 (n=50) the standard total cemented knee joint endoprosthesis; in group 2 (n=23) - the associated rotational constructions were used. Hemoglobin and hematocrit tests were performed prior to and in 24 hours after operation. The volume of intra- and postoperative (in 24 hours) blood loss was calculated by the of hemoglobin balance formula. Results. In 24 hours after operation the hemoglobin level was 122.5 ± 9.6 g/l in patients from group 1 and 105.1±8.2 g/l (p=0.001) in patients from group 2. The difference in hemoglobin levels in patients within group 1 was 10.5±6.6 g/l, within group 2 - 28.5±7.5 g/l (p=0.006). The volume of intra- and postoperative (in 24 hours) blood loss for the 1st and 2nd patient groups of made up 420.5±276.7 ml, in group 2 it was 1163.0±302.5 ml (p<0.05), respectively. Fresh frozen plasma transfusion in intra- and postoperative period was performed to 23 (57.5%) patients from group 1 and 21 (91.3%) patients from group 2. Conclusion. The revealed features of blood loss after knee arthroplasty, depending on the type of implant construction, require appropriate organizational measures to ensure effective transfusion therapy in surgical interventions on the knee joint.

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About the authors

A. I Abelevich

Mogilev Regional Hospital

Mogilev, Belarus

O. M Abelevich

Mogilev Regional Hospital

Mogilev, Belarus

A. V Marochkov

Mogilev Regional Hospital

Mogilev, Belarus

References

  1. Белецкий А.В., Ломать Л.Н., Борисов А.В. и др. Состояние проблемы и перспективы развития эндопротезирования суставов в республике Беларусь. Журнал Гродненского государственного медицинского университета. 2010; 2 (30): 94-6.
  2. Lu Q., Peng H., Zhou G., Yin D. Perioperative blood management strategies for total knee arthroplasty. Orthop. Surg. 2018; 10 (1): 8-16. https://doi.org/10.1111/os.12361.
  3. Tavares Cardozo R., Fidelisde Souza Junior E., Campoli Alves W., Barbi Filho F. Total knee arthroplasty: indication of blood transfusion according to hematimetric variation and clinical symptoms of hypoperfusion. Rev. Bras. Ortop. 2014; 49 (5): 507-12. https://doi.org/10.1016/j.rboe.2013.09.002.
  4. Healy W.L., Della Valle C.J., Iorio R. et al. Complications of total knee arthroplasty: standardized list and definitions of the Knee Society. Clin. Orthop. Relat. Res. 2013; 471 (1): 215-20. https://doi.org/10.1007/s11999-012-2489-y.
  5. Vasconcelos J.W., Vasconcelos G.A. Blood loss in total knee arthroplasty with and with out tourniquet release. Acta Ortop. Bras. [online]. 2011; 19 (1): 32-6. https://doi.org/10.1590/S1413-78522011000100007.
  6. Barros M.F., Ribeiro E.C., Dias R.G. Blood level changes in total knee arthroplasty with and without a tourniquet. Acta Ortop. Bras. 2017; 52 (6): 725-30. https://doi.org/10.1016/j.rboe.2017.10.001.
  7. Корнилов Н.Н. Гонартроз и сходные с ним клинические состояния (клинические рекомендации). СПб; 2013: 4.
  8. Gao F.Q., Li Z.J., Zhang K. et al. Four methods for calculating blood-loss after total knee arthroplasty. Chin. Med. J. (Engl). 2015; 128 (21): 2856-60. https://doi.org/10.4103/0366-6999.168041.
  9. Gehan E.A., George S.L. Estimation of human body surface area from height and weight. Cancer Chemother. Rep. 1970; 54 (4): 225-35.
  10. Lisander B., Ivarsson I., Jacobsson S.A. Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery. Acta Anaesthesiol. Scand. 1998; 42 (6): 707-12.
  11. McConnell J., Dillon J., Kinninmonth A. et al. Blood loss following total knee replacement is reduced when using computer-assisted versus standard methods. Acta Orthop. Belg. 2012; 78 (1): 75-9.
  12. Shen H.L., Li Z., Feng M.L., Cao G.L. Analysis on hidden blood loss of total knee arthroplasty in treating knee osteoarthritis. Chin. Med. J. (Engl). 2011; 124 (11): 1653-6.
  13. Prasad N., Padmanabhan V., Mullaji A. Blood loss in total knee arthroplasty: an analysis of risk factors. Int. Orthop. 2007; 31 (1): 39-44. https://doi.org/10.1007/s00264-006-0096-9.
  14. Накопия В.Б., Корнилов Н.Н., Божкова С.А. и др. Скрытая кровопотеря после тотального эндопротезирования коленного сустава на фоне комплексной антикоагулянтной тромбопрофилактики. Современные проблемы науки и образования. 2017; 6.
  15. Hopewell S., Omar O., Hyde C. et al. A systematic review of the effect of red blood cell transfusion on mortality: evidence from large-scale observational studies published between 2006 and 2010. BMJ Open. 2013; 3 (5): pii: e002154. https://doi.org/10.1136/bmjopen-2012-002154.
  16. Smith T.O., Hing C.B. Is a tourniquet beneficial in total knee replacement surgery? A meta-analysis and systematic review. Knee. 2010; 17 (2): 141-7. https://doi.org/10.1016/j.knee.2009.06.007.

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