scholarly journals Association between preoperative hemoglobin and postoperative moderate and severe anemia among patients undergoing primary total knee arthroplasty: a single-center retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Guorui Cao ◽  
Xiuli Yang ◽  
Hong Xu ◽  
Chen Yue ◽  
Zeyu Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Severe Anemia ◽  
Intraoperative Blood Loss ◽  
Preoperative Hemoglobin ◽  
Total Knee ◽  
Primary Total Knee

Abstract Background Postoperative moderate and severe anemia (PMSA) has been a serious perioperative complication in primary total knee arthroplasty (TKA). However, the ideal cutoff values to predict PMSA is still undetermined. The aim of this study was (1) to identify the risk factors associated with PMSA and (2) to establish the cutoff values of preoperative hemoglobin (HB) associated with increased PMSA in primary TKA. Methods We identified 474 patients undergoing primary TKA and separated those in which PMSA (HB was less than 110 g/L on postoperative day 1 and 3) was developed from those without PMSA. Multivariate logistic regression model was used to identify independent risk factors for PMSA. Area under the receiver-operator curve (AUC) was used to determine the best-supported preoperative HB cutoff across all the patients. Results The PMSA rate in primary TKA was 53.2%. Significant risk factors were lower preoperative HB (OR [odds ratio] = 1.138, 95% CI [confidence interval] = 1.107–1.170, p < 0.001) and more intraoperative blood loss (OR = 1.022, 95% CI 1.484–4.598, p < 0.001). A preoperative HB cutoff value that maximized the AUC was 138.5 g/L for men (sensitivity: 79.4%, specificity: 75.0%) and 131.5 g/L for women (sensitivity: 74.7%, specificity: 80.5%), respectively. Conclusion We should recognize and consider the related risk factors to establish specific, personalized risk assessment for PMSA, including preoperative HB and intraoperative blood loss. Of these, preoperative HB was a referable tool to predict PMSA in primary TKA.

A Randomized Controlled Study on the Use of Tourniquet in Primary Total Knee Arthroplasty

2022 ◽  
Author(s):  
Chaofan Zhang ◽  
Chun Hoi Yan ◽  
Ping Keung Chan ◽  
Henry Fu ◽  
Kwong Yuen Chiu
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Skin Incision ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Total Knee ◽  
Primary Total Knee

Abstract Background The use and the optimal timing of tourniquet during primary total knee arthroplasty (TKA) is controversial. Most previous studies failed to show clinically significant differences in different strategies. The aim of this study was to determine how three strategies of tourniquet application affect the outcome in TKA patients. Methods This was a prospective randomized controlled study. Patients who undergo TKA were randomized into one of the three groups (1:1:1 ratio): tourniquet inflated from skin incision to cement hardening, tourniquet from cement application to hardening, and tourniquet from skin incision to skin closure. The perioperative blood loss, limb swelling, and complications were recorded. The level of hemoglobin, hematocrit, C-reactive protein (CRP), interleukin (IL)-6, creatine kinase (CK), and lactate dehydrogenase (LDH) were determined. Patients' thigh and TKA wound pain, Knee Society knee score (KSKS) and Knee Society functional assessment (KSFA) scores, and rehabilitation parameters were evaluated. Results A total of 90 patients were enrolled. The baseline characteristics were comparable. We only found significant difference in the intraoperative blood loss (skin to cement: 58.7 ± 36.1 mL, cement-only: 147.8 ± 107.9 mL, skin to skin: 16.3 ± 13.1 mL, p < 0.0001). There were no statistical differences in postoperative drainage, thigh/knee circumference, change of hemoglobin/hematocrit, CRP, IL-6, CK, and LDH on day 1 to day 4 after surgery. The thigh/TKA wound Visual Analogue Scale scores, KSKS score, KSFA score, and rehabilitation parameters were not significantly different at up to 6-month follow-up. No thromboembolic events were noted. Conclusion Our results revealed that there was no best tourniquet strategy in TKA. Different tourniquet methods can be utilized based on surgeon preference without affecting outcomes.

Incidence and risk factors for neuropathy following primary total knee arthroplasty

2017 ◽  
Vol 27 ◽  
pp. S27
Author(s):  
J. Nguyen ◽  
E. Su ◽  
S. Lyman ◽  
E. Manning ◽  
K. Cummings ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Total Knee ◽  
Primary Total Knee

scholarly journals Blood transfusion after primary total knee arthroplasty can be significantly minimised through a multimodal blood-loss prevention approach

2013 ◽  
Vol 38 (2) ◽  
pp. 347-354 ◽  
Author(s):  
Sara Moráis ◽  
Miguel Ortega-Andreu ◽  
Emerito Carlos Rodríguez-Merchán ◽  
Norma G. Padilla-Eguiluz ◽  
Hanna Pérez-Chrzanowska ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Loss Prevention ◽  
Total Knee ◽  
Prevention Approach ◽  
Primary Total Knee
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