To explore the effect of using bone cement sealing femoral medullary cavity on the perioperative blood loss of total knee arthroplasty (TKA) surgery.

A total of 173 cases of osteoarthritis patients, whom undergone unilateral primary TKA surgery were retrospectively analyzed from January, 2014 to December, 2016. Among them, 116 cases of patients who had complete imaging data and hematological test reports without coagulation or hemodynamics affecting diseases were included. There were 53 cases of males and 63 cases of females, with an average age of (64±5) years. Sixty-five cases received the intervention of autologous cutting bone plug filling the femoral marrow cavity (group A) and 51 cases accepted management of combined autologous cutting bone plug filling the femoral marrow cavity and bone cement sealing the residual femoral marrow cavity(group B). Chi-square test was used to compare the difference of gender, anesthesia method, rate of allogeneic transfusion and deep venous thrombosis(DVT) of lower extremity between the two groups. Independent-samples t test was used for comparison of operation time, intraoperative blood loss, osteotomy thickness, and volume of wound drainage, dominant hemorrhage and hidden hemorrhage between the two groups.

All the operations were completed successfully. There was no significant difference with regard to the preoperative basic information such as gender ratio (χ²=0.161, P>0.05), age (t=-8.38, P>0.05) and body mass index (BMI) (t=1.837, P>0.05) in the two groups. No significant difference was found about the anesthesia way (χ²=0.91, P >0.05), operation time (t=1.714, P>0.05), and osteotomy thickness (t=0.448, P>0.05) in the two groups. The average volume of dominant hemorrhage in group A was (237.7±58.7) ml, mean volume of dominant hemorrhage in group B was (225.5±68.1) ml, there was no statistical difference between the two groups (P>0.05). The average volume of hidden hemorrhage in group A was (624.6±77.1)ml, mean volume of hidden hemorrhage in group B was (543.1±63.3 ) ml with statistical difference (t =6.104, P<0.05). The rate of allogeneic transfusion in group A was 35% and group B was 21%, a statistical difference was observed between the two groups (χ²=4.861, P<0.05). The incidence of DVT in group A and group B were respectively 6.1% and 3.9%, with no statistical difference (P>0.05).

Using the bone cement sealing the residual femoral marrow cavity can effectively reduce the perioperative volume of hidden blood loss in TKA surgery.