Postoperative hemoglobin and recovery of hip muscle strength after total hip arthroplasty

Maezawa, Katsuhiko; Nozawa, Masahiko; Yuasa, Takahito; Gomi, Motosi; Igarashi, Emi; Sato, Hiroki; Sugimoto, Munehiko

doi:10.1016/j.jor.2018.08.016

Cited by 14 publications

(7 citation statements)

References 33 publications

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“…Moreover, there are fewer female smokers than male smokers, which may also explain why women are more likely to develop PONV than men. Perioperative anemia is common in orthopedic patients and is associated with adverse clinical outcome (17). Similarly, in our study, patients with low preoperative Hb levels were more likely to develop PONV from the result in 6-24 hours and 24-72 hours.…”

Section: Discussionsupporting

confidence: 77%

Risk factors of postoperative nausea and vomiting after total hip arthroplasty or total knee arthroplasty: a retrospective study

et al. 2020

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Background: Postoperative nausea and vomiting (PONV) is a common complication after total hip/knee arthroplasty (THA/TKA) that affects patient satisfaction and postoperative recovery. It has been reported that patients undergoing THA/TKA experience PONV at a frequency of 20-83%. This study investigates the occurrence of PONV in patients and analyzes the risk factors.Methods: Patients undergoing primary THA/TKA under general anesthesia from October 1, 2017, to May 1, 2018, were included. Data on patient-related factors were collected before THA/TKA. Anesthesiaand surgery-related factors were recorded postoperatively. Risk factors were analyzed using binary logistic regression.Results: A stronger association of motion sickness and PONV was found at six hours after bilateral THA/ TKA [nausea: odds ratio (OR) =14. 648, vomiting: OR =8.405,]. At 6-24 hours after bilateral THA/TKA, patients who had a history of migraines tended to experience nausea (OR =12.589, 1.978-80.105). Patients with lower body mass index (BMI) were more likely to experience PONV at 24-72 hours (nausea: OR =0.767, 0.616-0.954; vomiting: OR =0.666, 0.450-0.983) after bilateral THA/TKA. Conclusions:The incidence of PONV after primary bilateral THA/TKA was higher than that after unilateral THA/TKA. The risk factors vary at different time points after surgery, and a history of motion sickness is the most critical factor affecting PONV.

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Section: Discussionsupporting

confidence: 77%

Risk factors of postoperative nausea and vomiting after total hip arthroplasty or total knee arthroplasty: a retrospective study

et al. 2020

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“…A similar study on 122 THAs in patients >65 years of age demonstrated a correlation between postoperative Hb and recovery in the 6-minute walking test 51 . Furthermore, a study of 82 THAs showed better recovery of hip muscle strength in patients with a postoperative:preoperative Hb ratio of >0.85 on POD10 52 . In our study, 22.7% of patients in the wax group had a postoperative:preoperative Hb ratio of <0.85 on POD5, compared with 53.2% of those in the control group; this difference was significant and might imply better recovery of hip muscles in the wax group.…”

Section: Discussionmentioning

confidence: 97%

The Efficacy of Bone Wax in Reduction of Perioperative Blood Loss in Total Hip Arthroplasty via Direct Anterior Approach

Mortazavi

Razzaghof

Ghadimi

et al. 2022

Journal of Bone and Joint Surgery

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Background:Perioperative blood management in total hip arthroplasty (THA) has become a prime focus of research. Given the morbidity, delayed recovery, and prolonged hospital stay associated with postoperative anemia, various measures have been proposed to reduce perioperative blood loss (PBL). In this trial, we studied the efficacy of bone wax application on the distal cut surface of the femoral neck in reducing PBL during THA through the direct anterior approach.Methods:In a randomized controlled clinical trial, 152 patients underwent THA through the direct anterior approach with use of bone wax (n = 75) or without bone wax (control) (n = 77). The study was triple-blinded. The primary outcomes were apparent PBL (blood in sponges and suction canister) and total PBL on postoperative days (PODs) 3 and 5 (as calculated with the Good and Nadler methods). Transfusion and complications were the secondary outcomes.Results:No significant difference was found between the 2 groups in terms of age, sex, body mass index, American Society of Anesthesiologists score, etiology, preoperative hematologic/coagulation profile, anesthesia, intraoperative mean arterial pressure, or operative time. Apparent PBL, total PBL on POD3, and total PBL, in milliliters, on POD5 were significantly lower in the wax group, with median values of 200 (interquartile range [IQR]: 115 to 310) versus 370 (IQR: 195 to 513.7), 505.2 (IQR: 409.2 to 637.6) versus 747 (IQR: 494.6 to 955.4), and 536.7 (IQR: 430.9 to 689.3) versus 767.8 (IQR: 537.8 to 1,021.9) in the wax and control groups, respectively (p < 0.001). No significant differences in the rates of transfusion and complications were found.Conclusions:Bone wax on the cut surface of femoral neck can significantly reduce PBL during THA through the direct anterior approach. Bone wax is accessible and inexpensive and can be considered a routine part of the surgical technique in THA through the direct anterior approach. This intervention has no impact on complication or transfusion rates.Level of Evidence:Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

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“…Several studies had indicated that hypoalbuminemia was associated with increased short-term mortality and complications 13 [14,21]. Perioperative anemia was associated with signi cant adverse clinical outcomes, such as decreased physical function [22], increased transfusions [23], complications and mortality [24,25]. These results indicated that the drop of albumin was a predictor for adverse postoperative outcomes in the elderly patients with FNF undergoing hip arthroplasty.…”

Section: Discussionmentioning

confidence: 97%

Perioperative albumin drop is a marker for surgical stress and correlate with clinical outcomes in the elderly patients undergoing hip arthroplasty for femoral neck fractures

Wang,

Liu,

et al. 2024

Preprint

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Background This single-center retrospective study investigated the correlation between the drop of perioperative albumin and clinical outcomes in the elderly patients undergoing hip arthroplasty for femoral neck fractures (FNF). Methods We investigated 278 patients 65 years of age or older who had undergone hip arthroplasty with FNF between January 2021 and March 2023. Albumin, C-reactive protein (CRP) and hemoglobin were monitored on preoperation, postoperative day-0, day-1 and day-7. The decrease of perioperative albumin (ΔAlb) was calculated by subtracting the value on day-0 from preoperation. Then patients were divided into two groups based on the ΔAlb values, with ΔAlb < 0.5 g/dL and ΔAlb ≥ 0.5 g/dL in group 1 and group 2, respectively. Results The albumin declined 0.8 g/dL from preoperation to day-1 and slowly increased by 0.3 g/dL from day-1 to day-7. The patients in group 2 had longer duration of surgery (75 minutes vs 65 minutes, P = 0.028), more intraoperative blood loss (246.7 ± 78.4 mL vs 201.5 ± 59.8 mL, P = 0.031) and changes of CRP (75.2 ± 48.1 mg/L vs 54.9 ± 44.9 mg/L, P = 0.003) comparing with the patients in group 1. Patients in group 2 had higher prevalences of postoperative complications (hypoalbuminemia: 94% vs 15%, moderate-severe anaemia: 60% vs 40%, P < 0.05) and longer postoperative length of stay (14 days vs 13 days, P = 0.045). The ΔAlb value was correlated with the duration of surgery (r= 0.3, P < 0.001), intraoperative blood loss (r = 0.2, P< 0.001), ΔCRP (r = 0.4, P < 0.001) and postoperative LOS (r= 0.2, P = 0.003). Conclusions The levels of albumin decreased significantly after surgery, while the CRP increased. Further, the perioperative albumin drop was a marker for surgical stress and correlated with adverse clinical outcomes.

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Postoperative hemoglobin and recovery of hip muscle strength after total hip arthroplasty

Abstract: We need to consider perioperative strategies to minimize anemia in order to improve patient outcomes.

Cited by 14 publications

References 33 publications

Risk factors of postoperative nausea and vomiting after total hip arthroplasty or total knee arthroplasty: a retrospective study

Risk factors of postoperative nausea and vomiting after total hip arthroplasty or total knee arthroplasty: a retrospective study

The Efficacy of Bone Wax in Reduction of Perioperative Blood Loss in Total Hip Arthroplasty via Direct Anterior Approach

Perioperative albumin drop is a marker for surgical stress and correlate with clinical outcomes in the elderly patients undergoing hip arthroplasty for femoral neck fractures

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