| Total hip arthroplasty is one of the most effective treatment for the end-stage diseases of the hip, which can greatly improve hip function, correct gait, relieve pain, has a positive long term outcome. In recent years, young non-menopausal women suffering from end-stage hip disease increased year by year. With the improvement of people's economic condition, the change of social concept, the progress of medical technology and the update of prosthetic design, more and more young women choose to accept total hip arthroplasty to solve pain, correct gait and restore hip function to be competent at a better job and gain a better social status. Menstrual cycle is a unique physiological cycle changes for non-menopausal women, with the menstrual cycle changes, women's hormone levels also showed a cyclical change. In the past, the traditional concept that menstrual women often suffer from coagulation abnormalities, that easy to produce too much bleeding. The excessive bleeding that contributed anemia, hypotension, coagulation disorders, infection and other complications makes surgeons worry. Objective To analysis the effect of females who performed total hip arthroplasty (THA) at different menstrual phases on intraoperative blood loss (IBL) and total blood loss (TBL). Methods Two hundred and fifty no-menopause females diagnosed as osteonecrosis of the femoral head (ONFH),osteoarthritis of hip, congenital dysplasia of acetabulum (Crowe ?-?) were retrospectively enrolled in this study. They all underwent unilateral THA between August, 2010 and February, 2017 in our Hospital. Age, height, weight, body weight index (BMI),preoperative hemoglobin and coagulation test results (PT,APTT, TT and PLT) were collected and analyzed. The average age of these patients was (31.28±5.72) years (mean±SD) with a range of 19 to 40 years. To minimize the effect of different length of menstrual cycle of these patients, day in menstruation (t) to length of menstrual cycle ratio (T, t/T ratio, range: 0.00-1.00) was calculated for each individual. Patients were subclassified into groups according to different phases of the menstrual cycle: 1)menstrual group(t/T in 0.00 to 0.20, n=36), 2) follicle group (t/T in 0.21 to 0.59, n=129), 3) ovulatory group(t/T in 0.60 to 0.79, n=51) and 4) luteal group(t/T in 0.80 to 0.99, n=34). The clinical information and difference of IBL and TBL among the four groups were analyzed by one-way ANOVA (for normal distribution data). Results There was no significant difference in demographics(age, height, weight and BMI). Although TT and FIB were different among the four groups(p=0.018 and p=0.036, respectively), they were still in normal range. The IBL was(318.60±186.25)ml in follicle group, (296.67±230.45)ml in ovulatory group,(341.18±260.67)ml in luteal group, (297.22±187.44)ml in menstrual group. The difference of IBL of four groups was not statistically significant (P=0.743). The TBL was(843.40±514.98)ml in follicle group,(741.71±420.83)ml in ovulatory group,(898.44±422.68)ml in luteal group, (760.53±360.27)ml in menstrual group. The difference of TBL of four groups was not statistically significant (P =0.347). Conclusion Females would not suffer more IBL and TBL when underwent THA in the menstrual phase. |
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