Research Of Hidden Blood Loss After THA And TKA

Objectives1.To investigate the presence of hidden blood loss after THA and TKA;2.To investigate the correlated mechanisms of hidden blood loss after THA and TKA;3.To investigate the prognostic significance of hidden blood loss after THA.Methods1.From September 2008 to march 2010, 54 patients were treated with THA and 32 patients were treated with TKA. Using Gross formula, the total blood loss was calculated according to height, weight and pre- and post-operation Hct, and the hidden hemorrhage was got by subtracting the visible blood loss from total loss.2.To calculate the value of blood loss after the TKA group,the THA group,the cemented grpup and uncemented group,to detect the value of FFA,oxygen concentration,albumin pre-and post-arthroplasty and analyze statistically.3.From May 2008 to July 2009, Harris hip score was employed to evaluate the function of 71 patients with uni-total hip arthroplasty(included 47 males and 24 females,the mean age is 68.3 years old). Combined with hidden blood loss, we analyzed the correlation between hidden blood loss and the functional rehabilitation.Results1. In patients with TKA and THA, the mean total blood loss was 1455 ml and 1442 ml respectively, and the hidden hemorrhage was 694 ml (48%) and 463 ml (32%) respectively. The hidden hemorrhage in those with TKA was significantly higher than those with THA.2.The average concentration of free fatty acids (FFA) is 2365 umol/L in TKA and 1626 umol/L in THA. The hidden blood loss was positively correlated with the level of free fatty acids(FFA).3. Hidden blood loss significantly correlated with functional rehabilitation (P =.004), but no correlation was found with age, gender and location (P>0.05). Conclusions1.Hidden blood loss was found in patients post TKA and THA,and hidden blood loss with cemented are higher than those wih uncemented.2.Hidden blood loss is associated with the level of FFA,and we can confer the fat embolism may be an factor of hidden blood loss post TKA and THA.3.Hidden blood loss has some clinical implications to the patients after THA,and it can be used as a reference for functional recovery after arthroplasty.