Skip to main content

Advertisement

SpringerLink
Log in

Total joint replacement and blood loss: what is the best equation?

  • Review Article
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

With the population aging, total joint replacements which are an effective method to restore patient’s mobility are an increasing necessity. However, such operations are known to entail serious blood loss, which may have dramatic consequences in patients with chronic diseases or when the prosthesis is revised, a situation where the blood loss is even higher. Therefore, formulas to better estimate the blood loss are available. These formulas may also be used for clinical studies to compare blood loss between different joint replacement techniques. The aim of this review is to provide a clear understanding of the formulas and to help physicians to further improve their blood loss estimation. Moreover, surgeons will then be able to choose the most accurate and user-friendly formula for more comparable data between clinical studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89:780–785

    Article  PubMed  Google Scholar 

  2. Orpen NM, Little C, Walker G, Crawfurd EJP (2006) Tranexamic acid reduces early post-operative blood loss after total knee arthroplasty: a prospective randomised controlled trial of 29 patients. Knee 13:106–110

    Article  PubMed  Google Scholar 

  3. Ishii Y, Matsuda Y (2005) Perioperative blood loss in cementless or hybrid total knee arthroplasty without patellar resurfacing: a prospective, randomized study. J Arthroplasty 20:972–976

    Article  PubMed  Google Scholar 

  4. Hinarejos P, Corrales M, Matamalas A, Bisbe E, Cáceres E (2009) Computer-assisted surgery can reduce blood loss after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 17:356–360

    Article  PubMed  Google Scholar 

  5. Wong J, Abrishami A, El Beheiry H, Mahomed NN, Roderick Davey J, Gandhi R, Syed KA, Muhammad Ovais Hasan S, De Silva Y, Chung F (2010) Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial. J Bone Joint Surg Am 92:2503–2513

    Article  PubMed  Google Scholar 

  6. Levy O, Martinowitz U, Oran A, Tauber C, Horoszowski H (1999) The use of fibrin tissue adhesive to reduce blood loss and the need for blood transfusion after total knee arthroplasty. A prospective, randomized, multicenter study. J Bone Joint Surg Am 81:1580–1588

    PubMed  CAS  Google Scholar 

  7. Hays MB, Mayfield JF (1988) Total blood loss in major joint arthroplasty. A comparison of cemented and noncemented hip and knee operations. J Arthroplasty 3 Suppl:S47–S49

    Google Scholar 

  8. Sehat KR, Evans RL, Newman JH (2004) Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br 86:561–565

    PubMed  CAS  Google Scholar 

  9. Billote DB, Glisson SN, Green D, Wixson RL (2002) A prospective, randomized study of preoperative autologous donation for hip replacement surgery. J Bone Joint Surg Am 84-A:1299–1304

    PubMed  Google Scholar 

  10. Charrois O, Kahwaji A, Vastel L, Rosencher N, Courpied JP (2001) Blood loss in total hip arthroplasty for rapidly destructive coxarthrosis. Int Orthop 25:22–24

    Article  PubMed  CAS  Google Scholar 

  11. Lemos MJ, Healy WL (1996) Blood transfusion in orthopaedic operations. J Bone Joint Surg Am 78:1260–1270

    PubMed  CAS  Google Scholar 

  12. Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB (1999) An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am 81:2–10

    PubMed  CAS  Google Scholar 

  13. Mercuriali F, Inghilleri G (1996) Proposal of an algorithm to help the choice of the best transfusion strategy. Curr Med Res Opin 13:465–478

    Article  PubMed  CAS  Google Scholar 

  14. Nadler SB, Hidalgo JH, Bloch T (1962) Prediction of blood volume in normal human adults. Surgery 51:224–232

    PubMed  Google Scholar 

  15. Bourke DL, Smith TC (1974) Estimating allowable hemodilution. Anesthesiology 41:609–612

    Article  PubMed  CAS  Google Scholar 

  16. Ward CF, Meathe EA, Benumof JL, Trousdale F (1980) A computer nomogram for blood loss replacement. Anesthesiology 53:S126

    Article  Google Scholar 

  17. Furman EB, Roman DG, Lemmer LA, Hairabet J, Jasinska M, Laver MB (1975) Specific therapy in water, electrolyte and blood-volume replacement during pediatric surgery. Anesthesiology 42:187–193

    Article  PubMed  CAS  Google Scholar 

  18. Gross JB (1983) Estimating allowable blood loss: corrected for dilution. Anesthesiology 58:277–280

    Article  PubMed  CAS  Google Scholar 

  19. Brecher ME, Monk T, Goodnough LT (1997) A standardized method for calculating blood loss. Transfusion 37:1070–1074

    Article  PubMed  CAS  Google Scholar 

  20. Lisander B, Ivarsson I, Jacobsson SA (1998) Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery. Acta Anaesthesiol Scand 42:707–712

    Article  PubMed  CAS  Google Scholar 

  21. Meunier A, Petersson A, Good L, Berlin G (2008) Validation of a haemoglobin dilution method for estimation of blood loss. Vox Sang 95:120–124

    Article  PubMed  CAS  Google Scholar 

  22. Porteous AJ, Bartlett RJ (2003) Post-operative drainage after cemented, hybrid and uncemented total knee replacement. Knee 10:371–374

    Article  PubMed  CAS  Google Scholar 

  23. Kalairajah Y, Simpson D, Cossey AJ, Verrall GM, Spriggins AJ (2005) Blood loss after total knee replacement: effects of computer-assisted surgery. J Bone Joint Surg Br 87:1480–1482

    Article  PubMed  CAS  Google Scholar 

  24. Iorio R, Robb WJ, Healy WL, Berry DJ, Hozack WJ, Kyle RF, Lewallen DG, Trousdale RT, Jiranek WA, Stamos VP, Parsley BS (2008) Orthopaedic surgeon workforce and volume assessment for total hip and knee replacement in the United States: preparing for an epidemic. J Bone Joint Surg Am 90:1598–1605

    Article  PubMed  Google Scholar 

  25. Demey G, Servien E, Pinaroli A, Lustig S, Ait Si Selmi T, Neyret P (2010) The influence of femoral cementing on perioperative blood loss in total knee arthroplasty: a prospective randomized study. J Bone Joint Surg Am 92:536–541

    Article  PubMed  Google Scholar 

  26. Lotke PA, Faralli VJ, Orenstein EM, Ecker ML (1991) Blood loss after total knee replacement. Effects of tourniquet release and continuous passive motion. J Bone Joint Surg Am 73:1037–1040

    PubMed  CAS  Google Scholar 

  27. Molloy DO, Archbold HAP, Ogonda L, McConway J, Wilson RK, Beverland DE (2007) Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement: a prospective, randomised controlled trial. J Bone Joint Surg Br 89:306–309

    Article  PubMed  CAS  Google Scholar 

  28. Prasad N, Padmanabhan V, Mullaji A (2007) Blood loss in total knee arthroplasty: an analysis of risk factors. Int Orthop 31:39–44

    Article  PubMed  Google Scholar 

  29. Tanaka N, Sakahashi H, Sato E, Hirose K, Ishima T, Ishii S (2001) Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee. J Bone Joint Surg Br 83:702–705

    Article  PubMed  CAS  Google Scholar 

  30. Goodnough LT, Despotis GJ, Merkel K, Monk TG (2000) A randomized trial comparing acute normovolemic hemodilution and preoperative autologous blood donation in total hip arthroplasty. Transfusion 40:1054–1057

    Article  PubMed  CAS  Google Scholar 

  31. Good L, Peterson E, Lisander B (2003) Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement. Br J Anaesth 90:596–599

    Article  PubMed  CAS  Google Scholar 

  32. Ajwani SH, Jones M, Jarratt JW, Shepard GJ, Ryan WG (2012) Computer assisted versus conventional total knee replacement: a comparison of tourniquet time, blood loss and length of stay. Knee 19:606–610

    Article  PubMed  Google Scholar 

  33. Jansen AJ, Andreica S, Claeys M, D’Haese J, Camu F, Jochmans K (1999) Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty. Br J Anaesth 83:596–601

    Article  PubMed  CAS  Google Scholar 

  34. Benoni G, Lethagen S, Fredin H (1997) The effect of tranexamic acid on local and plasma fibrinolysis during total knee arthroplasty. Thromb Res 85:195–206

    Article  PubMed  CAS  Google Scholar 

  35. Cushner FD, Friedman RJ (1991) Blood loss in total knee arthroplasty. Clin Orthop Relat Res 269:98–101

    PubMed  Google Scholar 

  36. Slagis SV, Benjamin JB, Volz RG, Giordano GF (1991) Postoperative blood salvage in total hip and knee arthroplasty. A randomised controlled trial. J Bone Joint Surg Br 73:591–594

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedic and Reconstructive Surgery, Clinical Orthopaedic Research Centre, Service A, Cochin Teaching Hospital, Paris School of Medicine, 27 rue du Faubourg Saint Jacques, 75014, Paris, France

    Emmanuel Gibon, Jean-Pierre Courpied & Moussa Hamadouche

Authors
  1. Emmanuel Gibon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean-Pierre Courpied
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Moussa Hamadouche
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emmanuel Gibon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gibon, E., Courpied, JP. & Hamadouche, M. Total joint replacement and blood loss: what is the best equation?. International Orthopaedics (SICOT) 37, 735–739 (2013). https://doi.org/10.1007/s00264-013-1801-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-013-1801-0

Keywords

Search

Navigation