Sangrado perioperatorio en el reemplazo total de rodilla

Abstract

Introduction

Total knee arthroplasty (TKA) is the treatment of choice for knee osteoarthritis in advanced stages. The number of procedures has increased exponentially in recent years, but because it is a surgery, complications are inherent, with perioperative bleeding being one of those that generates the most interest in the profession due to its high associated morbidity and mortality. The objective of this research was to describe the clinical factors involved in major perioperative bleeding and the need for blood transfusion in TKA.

Material and methods

Descriptive observational study based on retrospective data in patients undergoing TKA. An analysis of the variables was made, taking into account perioperative blood loss and the need for allogeneic red blood cell transfusion.

Results

777 patients were recruited, with a mean age of 69 years (SD: 9.7). Four patients were transfused with cumulative incidence of 0.5% (95% CI: 0.14 - 1.3), 3 of them were revision surgeries. The blood loss of the patients who required transfusion was on average 1590 ml vs 730 ml of those who did not require it, the surgical time was 115 minutes vs 74 minutes and the preoperative hemoglobin 14.8 g/dl vs 12.7 g/dl respectively.

Conclusions

Allogeneic transfusions in TKA occurred more frequently in surgeries with prolonged surgical time and in revision surgeries. No statistically significant differences were found between age, gender and body mass index (BMI).

Level of evidence

Level III; Retrospective study.