Effect of Bone Cement Sealing of Intramedullary Femoral Canal on Coagulation Status and Blood Loss after Total Knee Arthroplasty
Objective To explore the effect of bone cement sealing of intramedullary femoral canal on coagulation status and blood loss after total knee arthroplasty(TKA).Methods Patients with primary knee osteoarthritis who underwent unilateral TKA for the first time from January 2022 to April 2024 were selected as the research subjects.According to the different methods of sealing intramedullary femoral canal during surgery,the patients were divided into experimental group(43 cases)and control group(40 cases),and were given bone cement or autogenous bone sealing of the intramedullary femoral canal,respectively.Thrombelastography(TEG)indexes(R,K,α,MA and CI),blood loss(total blood loss,intraoperative blood loss,drain blood volume,hidden blood loss),transfusion rate and DVT incidence on postoperative day 1 and postoperative day 7 were compared.Results The α on the 1st day after operation and the CI on the 1st and 7th day after operation in the experimental group was significantly higher than in the control group(P＜0.05).The rest of the TEG indexes showed no statistically significant difference between the experimental group and the control group(P＞0.05).The total postoperative blood loss and hidden blood loss in the experimental group were significantly less than in the control group(P＜0.05).The intraoperative blood loss and drain blood volume showed no significant difference between the experimental group and the control group(P＞0.05).The transfusion rate and the rate of DVT formation had no significant difference between the experimental group and the control group(P＞0.05).Conclusion Sealing the intramedullary femoral canal with bone cement during TKA produces a relative postoperative hypercoagulable state and reduces total and hidden blood loss,but has no effect on the amount of drainage,the rate of transfusion,or the incidence of DVT.
Bone cementIntramedullary femoral canalThrombelastographyArthroplasty,replacement,knee
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