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International Orthopaedics

, Volume 31, Issue 1, pp 39–44 | Cite as

Blood loss in total knee arthroplasty: an analysis of risk factors

  • Narayana PrasadEmail author
  • Vinod Padmanabhan
  • Arun Mullaji
Original Paper

Abstract

The amount of blood loss in a primary cemented total knee arthroplasty (TKA) seems to vary in different reported studies. We carried out a prospective study to determine the factors affecting the peri-operative blood loss, hidden blood loss and blood transfusion requirements in a primary cemented total knee arthroplasty. The factors analysed were gender, diagnosis, tourniquet time and body mass index (BMI). We included a total of 66 consecutive patients who underwent primary TKA by a single surgeon (A.M). There was significantly more peri-operative blood loss in male patients than in females (p=0.001, Student’s t test). The patients with rheumatoid arthritis did not show any statistical difference in peri-operative blood loss compared with that in patients with osteoarthritis. The tourniquet time and the surgical time showed a positive correlation with peri-operative blood loss. The BMI did not show any correlation with peri-operative blood loss. The incidence of blood transfusion was significantly higher in patients with rheumatoid knees as their pre-operative haemoglobin value was low. The amount of hidden blood loss in our series was 38%. We concluded that gender and tourniquet time plays a role in blood loss in TKA, but diagnosis (advanced osteoarthritis [OA] or rheumatoid arthritis (RA) does not. The blood transfusion depends on both pre-operative haemoglobin value and intra-operative blood loss. The post-operative transfusion trigger can be brought to 8.0 g% in a haemodynamically stable patient.

Keywords

Blood Loss Total Knee Arthroplasty Estimate Blood Loss Primary Total Knee Arthroplasty Rheumatoid Arthritis Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

La quantité de perte de sang dans une prothèse totale du genou de première intention cimentée est variable suivant les différentes études. Nous avons réalisé une étude prospective pour déterminer quels étaient les facteurs de la perte sanguine péri-opératoire et quels étaient les facteurs qui entraient dans la nécessité d’une transfusion, après une prothèse totale du genou de première intention. Les facteurs analysés ont été le sexe, le diagnostic, l’utilisation d’un garrot, le BMI. Nous avons inclus dans cette étude, 66 patients consécutifs, opérés par le même chirurgien (A.M.). Il y a eu une de façon significative une augmentation des pertes sanguines péri-opératoires chez les patients de sexe masculin (p=0.001, Student’s t test). Les patients présentant une arthrite rhumatoïde n’ont pas montré de différences significatives dans la perte de sang, comparés aux patients opérés pour gonarthrose. Le temps de garrot et le temps opératoire sont en corrélation avec les pertes de sang péri-opératoires, l’augmentation du BMI ne semble pas avoir de corrélation avec la perte sanguine. L’incidence des transfusions est de façon significative plus élevée chez les patients opérés pour arthrite rhumatoïde du genou et dont l’hémoglobine préopératoire était basse. Nous pouvons en conclure que le sexe et le temps de garrot ont une responsabilité dans la perte de sang dans la prothèse totale du genou mais, certainement pas l’étiologie. La nécessité de transfusion dépend du taux d’hémoglobine pré-opératoire et des pertes sanguines per-opératoires. Une transfusion peut être pratiquée pour 8.0 g% chez un patient haemodynamiquement stable.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Narayana Prasad
    • 1
    Email author
  • Vinod Padmanabhan
    • 1
  • Arun Mullaji
    • 1
  1. 1.Trauma and OrthopaedicsBombay Hospital and Postgraduate InstituteMumbaiIndia

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