Lower blood loss after unicompartmental than total

Authors: PierreEmmanuel Schwab Patricia Lavand’homme Jean Cyr Yombi Emmanuel Thienpont

Publish Date: 2014/07/26

Volume: 23, Issue: 12, Pages: 3494-3500

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Abstract

It is intuitive that blood loss is lower after unicompartmental knee arthroplasty UKA but the difference in potential blood loss between UKA and total knee arthroplasty TKA has not yet been studied extensively The hypothesis of this study was that blood loss is less important in UKA and that it can be performed without transfusion risk even in preoperative anaemic patientsA comparative matched retrospective study on 105 57F/48M UKA patients with a mean SD age of 64 10 years a mean SD BMI of 295 5 kg/m2 and a mean SD preoperative haemoglobin Hb level of 137 15 g/dl was matched with 105 TKA patients for age BMI gender ASA score and preoperative alignment Blood loss was measured peroperatively and as a substitute for blood loss by mean Hb and haematocrit drop at day 2 and 4 postoperativelyMean SD visible blood loss was lower for UKA 20 10 cc vs 110 10 cc P  00001 Mean SD Hb levels were higher for UKA compared to TKA at day 2 129 14 vs 121 14 g/dl P  00001 day 4 127 14 vs 115 16 g/dl P  00001 and day 21 132 14 vs 127 13 g/dl P = 00185 Hidden blood loss was more important for TKA 02 vs 06 g/dl Transfusion rates were 0  for UKA and 2  for TKA Transfused patients were all female with moderate preoperative anaemia Hb  11 g/dl undergoing TKAHaemoglobin drop is higher with more hidden blood loss in TKA Patients with preoperative anaemia can undergo UKA without a risk for transfusion however women with moderate anaemia planned for TKA are at risk The transfusion rate for TKA is however very low and so expected survival of the implant versus risk of comorbidity should be discussed with the patient

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