Vol. 13 No. 2 (2021): Arch Pub Health
Clinical Science

Comparative analysis of hidden blood loss in total knee arthroplasty

Antonio Gavrilovski
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Ilir Shabani
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Vilijam Velkovski
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Teodora Todorova
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Shaban Memeti
University Clinic for children’s surgery; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia

Published 2021-09-27

Keywords

  • total knee arthroplasty,
  • hidden blood loss,
  • tourniquet

How to Cite

1.
Gavrilovski A, Shabani I, Velkovski V, Todorova T, Memeti S. Comparative analysis of hidden blood loss in total knee arthroplasty. Arch Pub Health [Internet]. 2021 Sep. 27 [cited 2021 Oct. 16];13(2). Available from: https://id-press.eu/aph/article/view/6013

Abstract

The aim of the study was to investigate the influential factors for hidden blood loss after a total knee arthroplasty and their relationship with the total blood loss. Total knee arthroplasty (TKA) is a crucial treatment of late-stage knee osteoarthritis. Measured blood loss is significantly inconsistent with the hemoglobin (HB) drop postoperatively. Fifty-four patients, 20 males and 34 females, were retrospectively analyzed. The preoperative blood loss and therefore the hidden blood loss following TKA were calculated by the Gross formula. The typical perioperative blood loss was found to be 780±220 ml and therefore the average hidden blood loss was 280±180 ml. No significant differences were found in hidden blood loss for males compared to females. Hidden blood loss may not be reduced by hemostasis during operation with a deflated tourniquet.

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References

  1. Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical scoring system. Clin Orthop Relat Res 1989;248:13–4.
  2. Font-Rodriguez DE, Scuderi GR, Insall JN. Survivorship of cemented total knee arthroplasty. ClinOrthopRelat Res 1997;345:79–86.
  3. Ranawat CS, Padgett DE, Ohashi Y. Total knee arthroplasty for patients younger than 55 years. ClinOrthopRelat Res 1989;248:27–33.
  4. Walker RH. Transfusion risks. Am J ClinPathol1987;88:374
  5. Lotke PA, Faralli VJ, Orenstein EM, Ecker ML. Blood loss after total knee replacement: effect of tourniquet release and continuous passive motion. J Bone Joint Surg [Am] 1991;73-A:1037-40.
  6. Fiebig E. Safety of the blood supply. ClinOrthopRelat Res 1998;357:6–18
  7. Cushner FD, Friedman RJ. Blood loss in total knee arthroplasty. ClinOrthopRelat Res1991; 269:98–101
  8. Sehat KR, Evans R, Newman JH. What proportion blood is basically lost in total knee arthroplasty Correct blood loss management should take hidden loss under consideration. Knee 2000;7:151–5
  9. Pattison E, Protheroe K, Pringle RM, Kennedy AC, Dick WC. Reduction in haemoglobin after knee surgery. Ann Rheum Dis 1973;32:582–4.
  10. Faris PM, Ritter MA, Keating EM, Valeri CR. Unwashed filtered bleed collected after knee and hip arthroplasties. A source of autologous red blood cells. J Bone Joint Surg Am 1991;73:1169–78.
  11. Erskine JG, Fraser C, Simpson R, Protheroe K, Walker ID. Blood loss with knee replacement. J R CollSurgEdinb 1981;26:295–7.
  12. Bao N, Zhou L, Cong Y, Guo T, Fan W, Chang Z, et al. Free fatty acids are liable for the hidden blood loss in total hip and knee arthroplasty. Med Hypotheses 2013;81:104–7.
  13. Good L, Peterson E, Lisander B. Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement. Br J Anaesth 2003;90:596–9.
  14. Zhou XD, Wu LD. Can we actually need tranexamic acid in total hip arthroplasty? A meta-analysis of 19 randomized controlled trials. Arch Orthop Trauma Surg. 2013;133:1017–27.
  15. Zhou XD, Li J, Xiong Y, Jiang LF, Li WJ, Wu LD. Can we actually need closed-suction drainage in total hip arthroplasty? A meta-analysis. IntOrthop. 2013;37:2109–18.
  16. Zhao J, Li J, Zheng W, Liu D. Low body mass index and blood loss in primary total hip arthroplasty: results from 236 consecutive Marie-Strumpell disease patients. BioMed Res Int 2014;2014:742393.
  17. Cushner FD, Friedman RJ. Blood loss in total knee arthroplasty. ClinOrthopRelat Res 1991;269:98–101.
  18. Shen HL, Li Z, Feng ML, Cao GL. Analysis on hidden blood loss of total knee replacement in end stage knee osteoarthritis. Chin Med J (Engl) 2011;124:1653–6.
  19. Li J, Zhou Y, Jing J, Zhan J. Results on hidden blood loss after total hip replacement with two different anticoagulants.Chin J Reparative ReconstrSurg 2013;27:432–5.
  20. Bell TH, Berta D, Ralley F, Macdonald SJ, McCalden RW, Bourne RB, et al. Factors affecting perioperative blood loss and transfusion rates in primary total joint arthroplasty: a prospective analysis of 1642 patients. Can J Surg 2009;52:295–301.
  21. Ward CF, Meathe EA, Benumof JL, Trousdale F. A computer nomogram for blood loss replacement. Anaesthesiology 1980;53:S126
  22. Gross JB. Estimating allowable blood loss: corrected for dilution. Anaesthesiology 1983;58:277-80.
  23. Prasad N, Padmanabhan V, Mullaji A. Blood loss in total knee arthroplasty: An analysis of risk factors. IntOrthop. 2007;31:39–44.