Abstract:

With the accelerating global population aging, the prevalence of joint diseases such as osteoarthritis has risen markedly, driving an increasing demand for hip and knee arthroplasty. However, surgical outcomes are influenced by multiple factors, including underlying comorbidities of patients (e.g., hypertension and diabetes), surgical techniques, and prosthesis selection. The complexity of comorbidities in elderly patients further amplifies surgical risks and technical challenges. Intraoperative and postoperative hemorrhage remains a pivotal challenge in hip and knee arthroplasty. Elderly patients and those with comorbidities often experience hidden blood loss and elevated transfusion requirements, predisposing them to complications such as infections and transfusion-related adverse events. Although existing guidelines emphasize perioperative blood management, systematic guidance on intraoperative hemostatic strategies remains insufficient. Therefore, there is an urgent need to advance research and standardize intraoperative hemostatic protocols to reduce blood loss,minimize transfusion-associated risks, optimize blood resource utilization, enhance postoperative recovery, and alleviate healthcare system burdens. To address these issues, the consensus expert panel formulated evidencebased recommendations through evidence grading and multidisciplinary discussions, establishing a standardized reference framework for surgical hemostasis. This consensus underscores the necessity of individualized clinical implementation, advocating flexible adaptation based on real-world practice.

Key words: Arthroplasty, replacement, Knee, Hip, Hemostasis, surgical, Postoperative hemorrhage, Consensus