Blood management of staged bilateral total knee arthroplasty in a single hospitalization period

Journal of Orthopaedic Surgery and Research

FuXing Pei¹  Bin Shen¹  ZeYu Huang¹  Jun Ma¹ 

[1] Department of Orthopaedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People¿s Republic of China

关键词: Blood loss;    Transfusion;    Bilateral;    Multimodal blood management;    Tranexamic acid;   

Others  :  1144401
DOI  :  10.1186/s13018-014-0116-1

 received in 2014-09-08, accepted in 2014-11-03,  发布年份 2014

【 摘 要 】

Introduction

Few literatures have studied the blood management in patients treated with staged bilateral primary total knee arthroplasty (TKA) in a single hospitalization period. Therefore, this study aims to evaluate the effectiveness and safety of the newly introduced multimodal blood management (MBM) in these patients.

Materials and methods

We retrospectively compared the perioperative parameters in 70 cases undergoing staged bilateral primary TKA in a single hospitalization period from 2012¿2013 in a single center with two different groups of patients, allocating cases to the group with the newly introduced MBM (Group A, n =33) and controls to the group without the newly introduced MBM (Group B, n =37). The newly introduced MBM protocols include preoperative hemoglobin (Hb) evaluation, high protein diet, tourniquet release after skin closure, preoperative oral iron treatment and femoral canal obturation, and one dose of tranexamic acid (TXA) IV with another one if necessary. While in the control group, only routine blood-saving techniques were used.

Results

Group A had a transfusion rate of 9% (3/33), whereas 32.4% of patients (12/37) in Group B received allogenic blood transfusion. Significant benefits were also found in Group A in terms of postoperative Hb and hematocrit (Hct), reduction of postoperative pain, swelling, postoperative pain, length of stays, and hospital costs. No deep vein thrombosis (DVT) events were found in all these patients.

Conclusions

The newly introduced MBM in staged bilateral TKA in a single hospitalization period can reduce blood loss effectively as well as pain and knee joint swelling instead of leading to increased complications and result in significant cost savings.

【 授权许可】

   
2014 Ma et al.; licensee BioMed Central Ltd.

【 图 表 】

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