Perioperative blood loss in lower-extremity total joint arthroplasty  

Dmitry D. Sadchikov, Assistant of the sub-department of traumatology and orthopedics, postgraduate student, Saratov State Medical University named after V.I. Razumovsky (112 Bolshaya Kazachya street, Saratov, Russia), disadchikov@yandex.ru
Igor A. Norkin, Doctor of medical sciences, professor, head of the sub-department of traumatology and orthopedics, Saratov State Medical University named after V.I. Razumovsky (112 Bolshaya Kazachya street, Saratov, Russia), sarniito504@gmail.com
Daniil M. Puchinyan, Doctor of medical sciences, professor, chief researcher of the department of fundamental and clinical experimental research, Saratov State Medical University named after V.I. Razumovsky (112 Bolshaya Kazachya street, Saratov, Russia), puchinyan@mail.ru

Background. Perioperative blood loss in lower-extremity total joint arthroplasty is one of the causes of thromboembolic and infectious complications. The purpose of the research is to assess perioperative blood loss in patients who have undergone knee or hip arthroplasty for deforming osteoarthritis using a modified method for determining blood loss with Moore principle. Materials and methods. A single-center prospective study in volved 106 patients with III-IV stage osteoarthritis who underwent knee (64) or hip (42) joint replacement with intravenous tranexamic acid. Low molecular heparins are used for anticoagulant prophylaxis: 12 hours before surgery, 6 hours after it and then daily in doses as prescribed by the instructions. The number of red blood cells, platelets, hemoglobin con centration in the blood and hematocrit level were determined using an automatic hematolo gy analyzer. The volume of perioperative blood loss was calculated by Sh.V. Timerbulatov, et al.’s method and its modification. Results. One day after knee replacements, there was a statistically significant decrease in the number of red blood cells (p = 0.00000...), platelets (p = 0.02), hemoglobin (p = 0.00000...) and hematocrit value (p = 0.00000...). Similar changes were observed after hip replacement (p = 0.00000...; p = 0.039; p = 0.00000... and p = 0.00000..., respectively). According to the prototype, the perioperative blood loss dur ing knee replacement was 1322 [1008; 1718] ml, according to the original method – 1195 [973; 1591] ml (r = +0,9, p = 0.00000...); for hip replacement 871 [707; 1079] ml and 892 [638; 1238] ml (r = +0,86, p = 0.00000...), respectively. Conclusion. The suggested method for determining perioperative blood loss can be recommended for evaluating blood loss during scheduled trauma and orthopedics surgeries.

total arthroplasty, knee joint, hip joint, perioperative anemia, blood loss estimation

Sadchikov D.D., Norkin I.A., Puchinyan D.M. Perioperative blood loss in lower-extremity total joint arthroplasty. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2025;(2):29–40. (In Russ.). doi: 10.21685/2072-3032-2025-2-3