Optimizing Blood Management in Total Knee Arthroplasty: An Analytical Study on the Impact of Preoperative and Intraoperative Factors

Abstract

Aim: In surgeries like arthroplasty that involve joint resection, preoperative evaluations of the patient's comorbidities and medications are conducted to reduce blood loss. This study aimed to address factors that can influence the need for blood transfusion due to significant blood loss, in conjunction with preventative measures applied before and after surgery.Materials and Methods: Patients who underwent knee arthroplasty from 2017 to 2022, and for whom necessary follow-up parameters were available, were included in the study. Patients with incomplete data, bleeding diathesis, or preoperative albumin, platelet, prothrombin time, and international normalized ratio levels outside the normal range were excluded. Results: The study included a total of 479 patients. A positive and very weak significant correlation was found between body mass index and intraoperative blood loss. Patients with diabetes showed significantly higher intraoperative blood loss, drainage volume, total blood loss, and the difference in preoperative and postoperative hemoglobin compared to those without diabetes. There were no statistically significant differences in intraoperative blood loss, drainage volume, or total blood loss between patients with and without cardiovascular disease. Patients not receiving tranexamic acid (TXA) had higher intraoperative blood loss compared to those receiving intravenous (IV) TXA and lower compared to those receiving local TXA. The IV group had lower intraoperative blood loss compared to the local group. Conclusion: In conclusion, patient-related factors and pre- and post-operative measures are crucial in managing blood loss in knee arthroplasty. The goal should be to eliminate the need for transfusions and thus prevent possible complications associated with blood transfusions.