The Effect Of Hidden Blood Loss On Limb Swelling After Primary Total Knee Arthroplasty

BackgroundWith the improvement of people’s living standards and the intensification of aging population in China,the incidence of knee osteoarthritis(KOA)is getting higher and higher.Currently,total knee arthroplasty(TKA)is used to treat elderly people.The most effective method of KOA in the end-stage of the crowd.However,the operative limb of TKA is often accompanied by different degrees of swelling,resulting in increased pain,extended bed time,slow recovery of walking function,and ultimately affecting the surgical outcome of TKA.There are many reasons reported in the literature that cause swelling after TKA,and hidden blood loss(HBL)may be one of the important reasons.At present,there are few literatures at home and abroad about the effect of hidden blood loss on limb swelling after TKA.ObjectiveObserving and analyzing the influence of hidden blood loss on the degree of swelling of the limbs after primary total knee arthroplasty,and providing a theoretical basis for the prevention and treatment of postoperative swelling of TKA.Methods123 Patients with KOA who underwent unilateral total knee arthroplasty from the First Affiliated Hospital of Xinxiang Medical University between January 2016 and March 2017 were screened retrospectively.According to whether or not deep venous thrombosis of lower extremities occurred after TKA,it was divided into group A(20 cases of deep vein thrombosis group)and group B(103 cases of deep vein thrombosis without lower limb).The amount of hidden blood loss was calculated by the preoperative and postoperative hemoglobin changes.By measuring the circumference of the upper and lower 10 cm of the knee from 1 to 7 days after knee surgery,the average changes in the 10cm circumference of the upper and lower knees D-up and D-down were calculated.Results1.There was no statistically significant difference in age,gender,BMI,cases of blood transfusion,operation time and other general data between the two groups(P>0.05);2.Analysis of the changes in hidden blood loss,supracondylar and infraorbital weeks within 1 week after surgery revealed that the first time after the first 3 to 5 days after operation,the amount of hidden blood loss in patients with TKA peaked,3 to 5 days after the operation last 10 cm weeks Changes in diameter and axillary diameter at 10 cm also reached the maximum,and the amount of hidden blood loss was roughly consistent with the trend of the 10 cm diameter of the upper and lower armpits;3.The Pearson correlation analysis between the two groups of hidden blood loss and limb circumference showed that there was a correlation between the hidden blood loss and the 10 cm value of the patellar and infra patellar diameter in the non thrombus group(P < 0.05);4.There was no significant difference between the two groups of the hidden blood loss,the 10 cm circumference on the patellar and the 10 cm circumference of the patellar(P > 0.05);5.In the non-thrombotic group,regression analysis showed that the amount of hidden blood loss in patients with TKA had a certain influence on the circumference of the limb,and the data was statistically significant(P<0.05).Conclusions1.The changes of hemoglobin in patients should be continuously observed within 3 to 5 days after the initial TKA;2.The degree of swelling in the lower extremities of patients is positively correlated with the amount of hidden blood loss.HBL can aggravate swelling of the lower extremities.