Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (48): 8963-8967.doi: 10.3969/j.issn.2095-4344.2012.48.007

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Effect of low molecular weight heparin on blood loss after primary total hip arthroplasty and total knee arthroplasty

Xu Jie, Ma Ruo-fan, Li Liang-ping, Cai Zhi-qing, Dong Wen-wu   

  1. Department of Orthopedics, Sun Yat-sen Memoral Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
  • Received:2012-04-12 Revised:2012-05-18 Online:2012-11-25 Published:2013-03-14
  • About author:Xu Jie☆，Doctor, Associate professor, Associate chief physician, Department of Orthopedics, Sun Yat-sen Memoral Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China lplllpfe@163.com

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Abstract:

BACKGROUND: Deep vein thrombosis of lower limb is a common complication after total hip arthroplasty and total knee arthroplasty, and the application of low molecular weight heparin has become the general guiding principles after arthroplasty.
OBJECTIVE: To explore the clinical impact of low molecular weight heparin on blood loss after total knee arthroplasty and total hip arthroplasty.
METHODS: Between January 2006 and June 2011, the clinical data from 529 patients undergoing primary total knee arthroplasty and total hip arthroplasty were retrospectively analyzed. In accordance with using low molecular weight heparin or not, the cases were divided into two groups, the trial group and the control group. In the trial group, the patients received subcutaneous injection of low molecular weight heparin (4 000-6 000 U/day) from 8-12 hours after arthroplasty and lasted for 10-15 days. In the control group, the patients received no anticoagulation drug. The total blood loss, dominant blood loss and hidden blood loss of two groups were compared.
RESULTS AND CONCLUSION: There was significant difference of total blood loss between two groups (t =-23.42, P < 0.01). The dominant blood loss was the major part of blood loss for the total knee arthroplasty cases and the hidden blood loss was the major part of blood loss for the total hip arthroplasty cases, there was significant difference of dominant blood loss and hidden blood loss between two groups (t=-23.3, P < 0.01). Application of low molecular weight heparin after arthroplasty can increase the patients’ bleeding volume; the percentage of dominant and hidden blood loss in total hip arthroplasty is different from that in total knee arthroplasty. Calculation of the dominant blood loss, including operating bleeding and postoperative draining was not enough to estimate perioperative blood loss. We should pay more attention on the changes of hemoglobin during anticoagulant therapy. Fully consider the hidden blood loss according to the surgery characteristics and thus result in better preparation of blood during operation.

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