Hip Pelvis.  2015 Sep;27(3):141-145. 10.5371/hp.2015.27.3.141.

Comparison of Perioperative Blood Loss in Primary Non-cemented Total Hip Arthroplasty for Rapidly Destructive Coxarthrosis and Osteonecrosis of the Femoral Head

• Song JH
• Han SK
• Lee KH
• Lee JM
• Lee KH

• KMID: 2069143
• DOI: http://doi.org/10.5371/hp.2015.27.3.141

Abstract

PURPOSE
The purpose of this study is to compare the perioperative blood loss in primary non-cemented total hip arthroplasty (THA) performed for rapidly destructive coxarthrosis (RDC) with the perioperative blood loss in primary non-cemented THA for typical osteonecrosis of the femoral head (ONFH).
MATERIALS AND METHODS
From January 2000 to December 2013, 19 patients were diagnosed with RDC (group 1) and 40 patients were diagnosed typical Ficat stage IV ONFH (group 2), comparison of perioperative blood loss between group 1 and group 2 in primary noncemented THA was done. Patients with preoperative usage of steroid or anticoagulants medication and with hemodynamic abnormal blood test results were excluded. The blood loss was measured up to the fifth post operation day and calculated with formula proposed by Mercuriali, Inghilleri and Nadler.
RESULTS
Non-compensated blood loss calculated in milliliters of red blood cells was 362 mL (standard deviation [SD], 187; range, 77-675) in group 1 and 180 mL (SD, 145; range, 53-519) in group 2. Compensated blood loss was 630 mL (SD, 180; range, 380-760) in group 1 and 503 mL (SD, 260; range, 190-1, 505) in group 2. The total blood loss after primary non-cemented THA is greater when surgery is performed for RDC than for ONFH, with the volume of 992 mL (SD, 300; range, 457-1, 434) in group 1 and 683 mL (SD, 360; range, 226-1, 975) in group 2 respectively.
CONCLUSION
Total perioperative blood loss was significantly greater in RDC than in ONFH in primary non-cemented THA.

Keyword

Femur head; Rapidly destructive coxarthrosis; Osteonecrosis; Primary non-cemented total hip arthroplasty; Blood loss

MeSH Terms

Anticoagulants
Arthroplasty, Replacement, Hip*
Erythrocytes
Femur Head
Head*
Hematologic Tests
Hemodynamics
Humans
Osteoarthritis, Hip*
Osteonecrosis*
Anticoagulants

Figure

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  Fig. 1 X-ray findings of rapidly destructive coxarthrosis. (A) Anteroposterior radiograph shows sclerosis of right femoral head. (B) After 4 months, rapid destruction of the right femoral head is noticeable.

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  Fig. 2 Magnetic resonance imaging (MRI) findings of rapidly destructive coxarthrosis. (A) Coronal T2-weighted MRI shows severely collapsed femoral head and destroyed acetabulum with extensive bone marrow edema. Intermediate signal intensities within the joint effusion, synovial proliferation, inflammation. (B) Gadolinium-enhanced MRI with fat suppression shows a heterogeneously enhanced synovium, surrounding soft tissue, and bone marrow lesions.

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