Blood Loss-Related Functional Outcome in Post-Operative Total Knee Arthroplasty: Prospective Cohort Study
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Abstract
Objective: Current blood management programs for knee arthroplasty recommend avoiding blood transfusions and setting criteria for hemoglobin (Hb) < 7 g/dl or < 8 g/dl inpatients who have cardiac diseases or specific situations that do not concern the pre-operative HB level. This cutoff is safe for hemodynamically stable patients and those without cardiovascular complications. However, no study has shown the result of functional outcome, which is the primary objective of total knee arthroplasty (TKA).
Methods: We conduct an 18-month prospective cohort study on patients diagnosed with primary OA knee and indicated for surgical treatment with total knee arthroplasty at a single medical school hospital. Patients were divided into two groups of HB loss <20% or ≥20%. Timed up and go information was collected and compared at pre-operative period and post operative day 1, 2, 3 and 14.
Results: A total of 154 patients were analyzed. No significant different in patient characteristics was found between the Hb loss <20% group (group 1, n=120) and HB loss ≥20% group (group 2, n=34). Comparison of mean TUG between the two groups found no significant difference on post-operative day 1 (81.34 ± 20.09 and 84.99 ± 25.59 (P=0.45)), 2 (56.85 ± 11.12 and 59.06 ± 13.67 (P=0.39)), 3 (44.14 ± 8.20 and 45.66 ± 9.19 (P=0.35)) and 14 (31.92 ± 6.02 and 34.04 ± 5.99 (P=0.07)).
Conclusion: No significant difference in physical outcomes was found between the two groups. Current blood transfusion criteria after total knee arthroplasty can be used without concern about the physical outcome at the early post-operative period.
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