Blood loss after revision knee arthroplasty is 1.38- to 2.17-fold higher than after primary knee arthroplasty: A retrospective analysis of 898 cases - 27/04/21
, Florian Gerber b, Arne Schermuksnies b, Sven Edward Putnis c, Thomas Neri d, e, Thomas Jan Heyse f
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Abstract |
Background |
There are a number of factors that influence blood loss during and after primary total knee arthroplasty (TKA) and revision TKA (rTKA). The purpose of this study was to provide a factorial assessment that would aid surgeons in managing expected blood loss in rTKA, when compared to TKA. The first question asked was the blood loss and transfusions between TKA and rTKA and the second question was risk factors for blood loss after rTKA.
Hypothesis |
Blood loss in any rTKA is higher than in TKA by a factor of 2.
Patients and methods |
A retrospective single-centre consecutive series of rTKA between 2006 and 2018 was performed. Based on the rTKA types identified in joint registries, 4 rTKA cohorts were created: aseptic minor rTKA, aseptic major rTKA, 1st stage, and 2nd stage septic rTKA. A consecutive TKA cohort from the same study period was used to create a propensity score matched cohort with the aseptic major rTKA cohort.
Result |
A total of 622 rTKA were identified. Aseptic major rTKA had double the median blood loss than TKA. The lowest blood loss was observed in the TKA group followed by aseptic minor rTKA, and the highest in 2nd stage septic rTKA. The median total blood loss was higher in all rTKA by a factor ranging between 1.38 and 2.17. Higher age, female gender, lower preoperative hemoglobin, chronic heart disease and history of myocardial infarction were risk factors for increased blood loss. The type of rTKA performed was not predictive of blood loss in the linear regression analysis.
Discussion |
Blood loss after rTKA is 1.38 to 2.17-fold higher than after TKA. The blood loss observed in 2nd stage septic rTKA and aseptic major rTKA was the highest. Older female patients, with a low preoperative hemoglobin, were identified to be at the highest risk of blood loss after rTKA. Strategies for further blood loss reductions need to be utilised to the fullest extent for these procedures.
Level of evidence |
III; retrospective prognostic study.
Le texte complet de cet article est disponible en PDF.Keywords : Total knee arthroplasty, Revision knee arthroplasty, Blood loss, Septic TKA revision, Tranexamic acid
Plan
| ☆ | This work was performed at the University Hospital Marburg, Centre for Orthopedics and Traumatology, Marburg, Germany. |
Vol 107 - N° 3
Article 102856- mai 2021 Retour au numéro
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