Comparison of Blood Loss After Total Hip Arthroplasty Between Ankylosing Spondylitis and Osteoarthritis

2016 ◽  
Vol 31 (7) ◽  
pp. 1504-1509 ◽  
Author(s):  
Jia Li ◽  
Jinzhu Zhao ◽  
Chongru He ◽  
Wenwen Tong ◽  
Yuming Zou ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Total Hip

scholarly journals Active Ankylosing Spondylitis Increases Blood Loss during Total Hip Arthroplasty for a Stiff Hip Joint

2019 ◽  
Author(s):  
Yong Hu ◽  
Wei-Zhou Jiang
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Disease Activity ◽  
Hip Arthroplasty ◽  
Active Group ◽  
Nutrition Status ◽  
Transfusion Rate ◽  
Stable Group ◽  
Total Hip

Abstract Background: Total hip arthroplasty (THA) has been highlighted as the best treatment option for ankylosing spondylitis (AS) patients with advanced hip involvement. The huge blood loss associated with THA is a common concern of postoperative complications. Disease activity is a specific reflection of systematic inflammation of AS. The purpose of this study was to determine the effect of disease activity on blood loss during THA in patients with AS. Methods: Forty-nine patients with AS who underwent unilateral THAs were retrospectively studied. Ankylosing Spondylitis Disease Activity Score (ASDAS) was employed to evaluate the disease activity. Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) formula was used to assess the surgical blood loss. The patients were divided into active group (ASDAS≥1.3; n=32) and stable groups (ASDAS<1.3; n=17) based on the ASDAS. Peri-operative laboratory values, plain radiographs, intra-operative data, transfusion volume, and use of hemostatic agents were recorded and statistically analyzed. Results: The ASDAS, pre-operative C-reactive protein level, erythrocyte sedimentation rate, and fibrinogen concentration in the active group were higher than the stable group (all P <0.05); however, the pre-operative hemoglobin concentration and albumin level were higher in the stable group (both P <0.05). The total blood loss during THA in stable patients was 1415.31 mL and 2035.04 mL in active patients ( P =0.006). The difference between the two groups was shown to be consistent after excluding the gender difference ( P =0.030). A high transfusion rate existed in both groups (stable group, 76.47% with an average of 1.53 units; active group, 84.37% with an average of 2.31 units), but there was no significant difference between the two groups (both P >0.05). Compensated blood loss, corresponding to transfusion, was noted significantly more often in the active group compared to the stable group ( P =0.027). Conclusion: Active AS patients are at high risk for increased blood loss during THA compared to stable patients. The underlying mechanism includes disorders of the coagulation and fibrinolytic systems, poor nutrition status, osteoporosis, imbalance of oxidative–antioxidative status and local inflammatory reaction. It is strongly recommended to perform THA in AS patients with stable disease.

Perioperative Blood Loss During Total Hip Arthroplasty Among Patients With Ankylosing Spondylitis

Orthopedics ◽  
2017 ◽  
Vol 40 (5) ◽  
pp. e904-e910 ◽  
Author(s):  
Yong Hu ◽  
Wei-Zhou Jiang ◽  
Zhi-Fa Huang ◽  
Tahsin Tarik Torsha ◽  
De-Sheng Yang ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Perioperative Blood Loss

scholarly journals Factors associated with blood loss in ankylosing spondylitis patients with hip involvement undergoing primary total hip arthroplasty: a cross-sectional retrospective study of 243 patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Liangliang Li ◽  
Jun Fu ◽  
Chi Xu ◽  
Haitao Guan ◽  
Ming Ni ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Operating Time ◽  
Ordinal Logistic Regression ◽  
Factors Associated ◽  
Total Hip ◽  
Male Sex

Abstract Background Total hip arthroplasty (THA) can cause considerable blood loss and perioperative transfusion in ankylosing spondylitis (AS) patients. This study aimed to identify the factors related to blood loss in AS patients with hip involvement undergoing THA. Methods We analyzed 243 AS patients with advanced hip involvement undergoing primary THA from 2012 to 2017. Bilateral THA was performed by a one-stage operation during one general anesthesia session. The patients were divided into three groups according to the grade of blood loss, as determined by the Advanced Trauma Life Support hypovolemic shock classification system. Ordinal logistic regression was used to identify factors associated with blood loss in the patients. Results The proportion of patients who were male, underwent bilateral THA, had a hip range of motion (ROM) = 0°, had a BASRI-hip score of 4, underwent iliopsoas and adductor release, and underwent autologous or allogenic transfusion increased significantly with the grade of blood loss, while that of the patients who received tranexamic acid (TXA) decreased significantly (P < 0.05). The preoperative hemoglobin (Hb) level, hematocrit level, and operating time also increased significantly with the grade of blood loss (P < 0.05). The ordinal logistic regression results identified the factors related to blood loss during THA in AS patients with hip involvement to be the male sex (odds ratio [OR] = 3.287; 95% confidence interval [CI] 1.022, 10.567), bilateral THA (OR = 13.896; 95% CI 4.950, 39.011), hip ROM = 0° (OR = 2.513; 95% CI 1.277, 4.946), an elevated erythrocyte sedimentation rate (ESR) level (OR = 3.042; 95% CI 1.320, 7.014), an elevated preoperative Hb level (OR = 1.043; 95% CI 1.017, 1.070), a long operating time (OR = 1.009; 95% CI 1.003, 1.016), and the administration of TXA (OR = 0.252; 95% CI 0.134, 0.472). Conclusions The male sex, bilateral THA, a hip ROM = 0°, an elevated ESR level, a high preoperative Hb level, and a long operating time are risk factors associated with blood loss in AS patients with hip involvement undergoing THA, while the administration of TXA is a protective factor. These results might help determine the risk of bleeding in the perioperative assessment and develop more efficient blood management strategies for THA in AS patients with hip involvement.

scholarly journals Active Ankylosing Spondylitis Increases Blood Loss during Total Hip Arthroplasty for a Stiff Hip Joint

2020 ◽  
Author(s):  
Yong Hu ◽  
Wei-Zhou Jiang ◽  
Cheng-Long Pan ◽  
Tao Wang
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Disease Activity ◽  
Hip Arthroplasty ◽  
Active Group ◽  
Nutrition Status ◽  
Stable Group ◽  
Total Hip ◽  
Significant Difference

Abstract Background: Total hip arthroplasty (THA) has been highlighted as the best treatment option for ankylosing spondylitis (AS) patients with advanced hip involvement. The huge blood loss associated with THA is a common concern of postoperative complications. Disease activity is a specific reflection of systematic inflammation of AS. The purpose of this study was to determine the effect of disease activity on blood loss during THA in patients with AS. Methods: Forty-nine patients with AS who underwent unilateral THAs were retrospectively studied. Ankylosing Spondylitis Disease Activity Score (ASDAS) was employed to evaluate the disease activity. Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) formula was used to assess the surgical blood loss. The patients were divided into active group (ASDAS≥1.3; n=32) and stable groups (ASDAS<1.3; n=17) based on the ASDAS. Peri-operative laboratory values, plain radiographs, intra-operative data, transfusion volume, and use of hemostatic agents were recorded and statistically analyzed. Results: The ASDAS, pre-operative C-reactive protein level, erythrocyte sedimentation rate, and fibrinogen concentration in the active group were higher than the stable group (all P<0.05); however, the pre-operative hemoglobin concentration and albumin level were higher in the stable group (both P<0.05). The total blood loss during THA in stable patients was 1415.31 mL and 2035.04 mL in active patients (P=0.006). The difference between the two groups was shown to be consistent after excluding the gender difference (P=0.030). A high transfusion rate existed in both groups (stable group, 76.47% with an average of 1.53 units; active group, 84.37% with an average of 2.31 units), but there was no significant difference between the two groups (both P >0.05). Compensated blood loss, corresponding to transfusion, was noted significantly more in the active group compared to the stable group (P=0.027). There was no significant difference with regard to functional recovery (P>0.05). Conclusion: Active AS patients are at high risk for increased blood loss during THA compared to stable patients. The underlying mechanism includes disorders of the coagulation and fibrinolytic systems, poor nutrition status, osteoporosis, imbalance of oxidative–antioxidative status and local inflammatory reaction. It is strongly recommended to perform THA in AS patients with stable disease.

scholarly journals Mid-term results of bilateral synchronous total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lei Han ◽  
Renfu Quan ◽  
Zhenle Pei ◽  
Guoping Cao ◽  
Yungen Hu ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Total Hip ◽  
Vas Score ◽  
Mid Term Results ◽  
Bony Ankylosis

Abstract Background Total hip arthroplasty (THA) for bony ankylosis is technically challenging in patients with ankylosing spondylitis (AS). This study aimed to determine the mid-term results of bilateral synchronous THA for bony ankylosis in patients with AS. Methods Nineteen cases of bony ankylosis in patients with AS who received bilateral synchronous THA were included in this study (17 males and 2 females, mean age 49.2 years). Disease duration was 5–38 years (mean 18 years and 6 months). All patients received cementless THA. Intraoperative blood loss, visual analog scale (VAS) score, and complications were assessed. Harris hip scores evaluated the clinical effect. Results Patients were followed up for 62–98 months (mean 82.5 months). VAS score decreased from 7.42 ± 0.92 to 2.42 ± 0.83, Harris hip score improved from 21.8 ± 7.2 to 80.3 ± 6.5, and the flexion-extension range of the hip improved from 0 to 142.3 ± 6.2°. One patient with septum bronchiale had a fracture intraoperatively and was treated with wire strapping. One patient had a traction injury of the femoral nerve postoperatively and recovered 1 year after the operation. Loosening and subsidence were not observed in all patients. Heterotopic bone formation was noted in 3 patients. No complications such as joint dislocation, acute infection, and deep vein thrombosis were found. Conclusion Bilateral synchronous THA was effective for bony ankylosis of the hip in patients with AS because it improved patients’ quality of life and had satisfactory mid-term outcomes.

scholarly journals Less blood loss in supercapsular percutaneously assisted versus posterolateral total hip arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yong Hu ◽  
Min-Cong Wang ◽  
Tao Wang ◽  
Yue Meng ◽  
Xiao-Min Chao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Total Blood Loss ◽  
Transfusion Rate ◽  
Operative Blood Loss ◽  
Total Blood ◽  
Radiographic Findings ◽  
Total Hip ◽  
Affected Side

Abstract Background Although excellent clinical outcomes of supercapsular percutaneously assisted total hip arthroplasty (SuperPath) have been reported, the peri-operative blood loss has rarely been reported. The current study determined the blood loss during SuperPath and compared the blood loss with conventional posterolateral total hip arthroplasty (PLTH). Methods This retrospective study enrolled patients who underwent unilateral primary THA between January 2017 and December 2019. The demographic data, diagnoses, affected side, radiographic findings, hemoglobin concentration, hematocrit, operative time, transfusion requirements, and intra-operative blood loss were recorded. The peri-operative blood loss was calculated using the OSTHEO formula. Blood loss on the 1st, 3rd, and 5th post-operative days was calculated. Hidden blood loss (HBL) was determined by subtracting the intra-operative blood loss from the total blood loss. Results Two hundred sixty-three patients were included in the study, 85 of whom were in the SuperPath group and 178 in the posterolateral total hip arthroplasty (PLTH) group. Patient demographics, diagnoses, affected side, operative times, and pre-operative hemoglobin concentrations did not differ significantly between the two groups (all P > 0.05). Compared to the PLTH group, the SuperPath group had less blood loss, including intra-operative blood loss, 1st, 3rd, and 5th post-operative days blood loss, and HBL (all P < 0.05). Total blood loss and HBL was 790.07 ± 233.37 and 560.67 ± 195.54 mL for the SuperPath group, respectively, and 1141.26 ± 482.52 and 783.45 ± 379.24 mL for the PLTH group. PLTH led to a greater reduction in the post-operative hematocrit than SuperPath (P < 0.001). A much lower transfusion rate (P = 0.028) and transfusion volume (P = 0.019) was also noted in the SuperPath group. Conclusion SuperPath resulted in less perioperative blood loss and a lower transfusion rate than conventional PLTH.

Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty

The Lancet ◽  
1996 ◽  
Vol 347 (8997) ◽  
pp. 289-292 ◽  
Author(s):  
H Schmied ◽  
A Reiter ◽  
A Kurz ◽  
D.I Sessler ◽  
S Kozek
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Mild Hypothermia ◽  
Total Hip ◽  
Transfusion Requirements
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