Effect Of Osteoporosis On Hidden Hemorrhage After Total Knee Replacement

Objective:To investigate the relationship between the degree of osteoporosis and total blood loss,dominant blood loss and hidden blood loss during perioperative in elderly patients after total knee arthroplasty(TKA).Methods:From October 2015 to December 2017,patients undergoing unilateral total knee arthroplasty in the orthopedics department of Dalian Central Hospital were enrolled in this study.After strict screening,70 patients were enrolled into the study,including 18 males,Female 52 cases,the average age of 70.94 ± 6.30 years.The general information of patients(age,height,weight,BMI,BMD,etc.)was recorded and the hemorrhage volume as well as the hematocrit on the first day,the third day and the fifth day after operation were recorded.Application formula to calculate the total blood loss per patient,dominant blood loss,hidden blood loss.All patients were divided into 3groups according to the WHO classification of osteoporosis: normobaric group(n = 12),osteopenia group(n = 21),osteoporosis group(n = 37).The latest statistical software SPSS22.0 was used for data analysis.For the measurement data,one-way ANOVA was used to analyze the differences among different groups,and the independent sample t-test was used to analyze the difference between the two groups.For the count data,the differences between different groups using chi-square test,P <0.05 that the difference was statistically significant.Results:The study was eventually included in the exclusion criteria of 70 patients after rigorous screening,and all patients were performed by a team of experienced physicians in the same group.The three groups of patients with general information such as gender,age,BMI,operation time were no significant difference(P> 0.05).The total amount of blood loss in the three groups were(787.88 ± 173.48)m L 、(856.09 ±213.54)m L 、(1046.78±207.36)m L,respectively.The mean blood loss were(262.04±37.14)m L、(260.55±29.99)m L、(264.48±35.09)m L,and the latent blood loss were(529.84±113.15)m L、(595.54±128.11)m L、(782.30±123.53)m L,respectively.Among them,the total amount of blood loss and the amount of hidden blood loss,the osteoporosis group were significantly higher than those in the osteopenia group and the normal bone mass group,the difference was statistically significant(P <0.05);while in the amount of dominant blood loss In comparison,there was no significant difference between the three groups(P> 0.05).Conclusion:Osteoporosis can significantly increase perioperative blood loss in patients with knee joint replacement,especially increase the total blood loss and hidden blood loss,but have no obvious effect on the amount of dominant blood loss.