Hemostatic powder can reduce blood loss in primary total knee arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2024.05.004

Abstract

Abstract:

Objective

To investigate the efficacy and safety of hemostatic powder used in total knee arthroplasty （TKA）.

Methods

A prospective randomized cohort study was used in this study.A total of 213 patients （213 knees） with knee osteoarthritis who underwent TKA for the first time in the joint surgery Department of Xuzhou Renci Hospital from January 2023 to November 2023 were included. Patients with coagulation dysfunction and anemia ［hemoglobin（Hb）＜90 g/L］were excluded. The enrolled patients were randomly divided into two groups by envelope method： the experimental group （98 patients received hemostatic powder） and the control group （115 patients did not receive hemostatic powder）. Hb was detected before surgery，one day and three days after surgery， and the total blood loss， intraoperative blood loss and hidden blood loss were compared between the two groups. Blood transfusion rate， incidence of DVT， occurrence of superficial skin infection， and gender were compared by chi square test. T test was used to compare operative time，intraoperative blood loss， occult blood loss， total blood loss， Hb， age， and body mass index （BMI）.

Results

The Gross and Nadler equations were used to calculate blood loss in both groups. The total blood loss of the experimental group was （627.0±92.9） ml， which was less than （815.5±142.4） ml of the control group （t=11.224，P＜0.001）. The hidden blood loss of the experimental group was （530.5±78.6） ml， which was less than （693.4±120.8）ml of the control group （t=11.450， P＜0.001）. The hemoglobin in the experimental group was higher than that in the control group at one day and three days after operation （t=4.771，7.070， both P＜0.05）.There was no statistically significant difference in intraoperative blood loss， operation time， blood transfusion rate， postoperative LHS，superficial skin infection rate or incidence of DVT between the two groups （all P＞0.05）.

Conclusion

Hemostatic powder can reduce perioperative blood loss without increasing complications during total knee arthroplasty.

Key words: Arthroplasty, Knee, Hemostatics, Powders, Hemorrhage, Postoperative complications

Qiaoqiao Ma, Chuankai Zhang, Kaijin Guo, Tao Jiang, Zihao Wang, Yong Liu, Liang Hao. Hemostatic powder can reduce blood loss in primary total knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(05): 585-589.

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URL: https://zhgjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-134X.2024.05.004

https://zhgjwkzz.cma-cmc.com.cn/EN/Y2024/V18/I05/585

Figures/Tables 2

Table 1 Comparison of baseline data between experimental group and control group

组别Groups	例数Number of cases	性别［例，（%）］Gender		年龄［岁，（ $\bar{x}$ ±s）］Age（year）	BMI［kg/m²，（ $\bar{x}$ ±s）］	术前Hb［g/L，（ $\bar{x}$ ±s）］Hb level before surgery
组别Groups	例数Number of cases	男Male	女Female	年龄［岁，（ $\bar{x}$ ±s）］Age（year）	BMI［kg/m²，（ $\bar{x}$ ±s）］	术前Hb［g/L，（ $\bar{x}$ ±s）］Hb level before surgery
实验组Experimental group	98	42	56	63.3±12.5	22.1±2.5	129.2±10.3
对照组Control group	115	49	66	64.6±11.8	21.8±2.1	131.8±11.5
统计值Statistical value		χ ²=0.001		t=0.847	t=0.936	t=1.718
P值		＞0.05		＞0.05	＞0.05	＞0.05

Table 1 Comparison of baseline data between experimental group and control group

组别Groups	例数Number of cases	性别［例，（%）］Gender		年龄［岁，（ $\bar{x}$ ±s）］Age（year）	BMI［kg/m²，（ $\bar{x}$ ±s）］	术前Hb［g/L，（ $\bar{x}$ ±s）］Hb level before surgery
组别Groups	例数Number of cases	男Male	女Female	年龄［岁，（ $\bar{x}$ ±s）］Age（year）	BMI［kg/m²，（ $\bar{x}$ ±s）］	术前Hb［g/L，（ $\bar{x}$ ±s）］Hb level before surgery
实验组Experimental group	98	42	56	63.3±12.5	22.1±2.5	129.2±10.3
对照组Control group	115	49	66	64.6±11.8	21.8±2.1	131.8±11.5
统计值Statistical value		χ ²=0.001		t=0.847	t=0.936	t=1.718
P值		＞0.05		＞0.05	＞0.05	＞0.05

Table 2 Comparison of clinical data between experimental group and control group

组别Groups	例数Number of cases	手术时间［min，（ $\bar{x}$ ±s）］Operation time	术中出血量［ml，（ $\bar{x}$ ±s）］Intraoperative blood loss	隐形失血量［ml，（ $\bar{x}$ ±s）］Hidden blood loss	总失血量［ml，（ $\bar{x}$ ±s）］Total blood loss	术后1 d Hb［g/L，（ $\bar{x}$ ±s）］Hb level one day after surgery
实验组Experimental group	98	87.4±10.8	109.5±36.1	530.5±78.6	627.0±92.9	110.9±15.3
对照组Control group	115	86.9±11.7	112.0±32.6	693.4±120.8	815.5±142.4	101.2±14.6
统计值Statistical value		t=0.322	t=0.584	t=11.450	t=11.224	t=4.771
P值		＞0.05	＞0.05	＜0.001	＜0.001	＜0.001
组别Groups	例数Number of cases	术后3 d Hb［g/L，（ $\bar{x}$ ±s）］Hb level three days after surgery	输血率［例（%）］Blood transfusion rate	术后LHS［d，（ $\bar{x}$ ±s）］LHS after surgery	DVT［例（%）］	浅表皮肤感染［例（%）］Superfacial infection in skin
实验组Experimental	98	98.4±12.3	2（2.0）	5.3±0.8	3（3.1）	4（4.1）
对照组Control group	115	84.8±15.9	4（3.5）	5.5±0.8	4（3.5）	7（6.1）
统计值Statistical value		t=7.070	χ ²=0.047	t=0.924	χ ²=0.046	χ ²=0.434
P值		＜0.001	＞0.05	＞0.05	＞0.05	＞0.05

Table 2 Comparison of clinical data between experimental group and control group

组别Groups	例数Number of cases	手术时间［min，（ $\bar{x}$ ±s）］Operation time	术中出血量［ml，（ $\bar{x}$ ±s）］Intraoperative blood loss	隐形失血量［ml，（ $\bar{x}$ ±s）］Hidden blood loss	总失血量［ml，（ $\bar{x}$ ±s）］Total blood loss	术后1 d Hb［g/L，（ $\bar{x}$ ±s）］Hb level one day after surgery
实验组Experimental group	98	87.4±10.8	109.5±36.1	530.5±78.6	627.0±92.9	110.9±15.3
对照组Control group	115	86.9±11.7	112.0±32.6	693.4±120.8	815.5±142.4	101.2±14.6
统计值Statistical value		t=0.322	t=0.584	t=11.450	t=11.224	t=4.771
P值		＞0.05	＞0.05	＜0.001	＜0.001	＜0.001
组别Groups	例数Number of cases	术后3 d Hb［g/L，（ $\bar{x}$ ±s）］Hb level three days after surgery	输血率［例（%）］Blood transfusion rate	术后LHS［d，（ $\bar{x}$ ±s）］LHS after surgery	DVT［例（%）］	浅表皮肤感染［例（%）］Superfacial infection in skin
实验组Experimental	98	98.4±12.3	2（2.0）	5.3±0.8	3（3.1）	4（4.1）
对照组Control group	115	84.8±15.9	4（3.5）	5.5±0.8	4（3.5）	7（6.1）
统计值Statistical value		t=7.070	χ ²=0.047	t=0.924	χ ²=0.046	χ ²=0.434
P值		＜0.001	＞0.05	＞0.05	＞0.05	＞0.05

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