Evidence map›Paper›PMID 40319268›Full record

ArticleBMC musculoskeletal disorders2025

Factors associated with high hidden blood loss in patients undergoing primary total knee arthroplasty for osteoarthritis: a cross-sectional retrospective study of 1444 patients.

Tao Deng, Yongjian Liang, Chi Xu, Libo Hao, Jun Fu, Jiying Chen

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Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
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6citing papers in PubMed, 2 pooled it
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Tao DengMedical School of Chinese PLA, Beijing, People's Republic of China.
Yongjian LiangMedical School of Chinese PLA, Beijing, People's Republic of China.
Chi XuDepartment of Orthopedic Surgery, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
Libo HaoDepartment of Orthopedic Surgery, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
Jun Fu *Department of Orthopedic Surgery, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China. fujun301gk@163.com.
Jiying Chen *Department of Orthopedic Surgery, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China. chenjiyingpla@sina.com.

Funding

National Key Research and Development Program of China No.2023YFB4705600
6 · The paper itself

Abstract

purposeTotal knee arthroplasty (TKA) can cause significant hidden blood loss after surgery, and transfusion or erythropoietin (EPO) treatment may be required. This study aimed to identify the factors associated with blood loss in patients undergoing TKA for osteoarthritis (OA).

methodsWe retrospectively enrolled 1444 OA patients undergoing primary TKA from January 2022 to June 2024. The patients were divided into two groups according to the grade of hidden blood loss. To identify the key influencing factors, we conducted a logistic regression analysis.

resultsThis study analyzed 1,444 primary arthroplasty cases, identifying 236 patients with high hidden blood loss (HHBL). Coronary artery disease (CAD) was significantly more prevalent in the HHBL group (15.3% vs. 9.4%, p = 0.006). Preoperative EPO use was higher in the low hidden blood loss (LHBL) group (21.9% vs. 9.3%, p < 0.001). Significant preoperative lab differences included hemoglobin, hematocrit, and platelet count. Surgical factors associated with HHBL included left knee TKA, conventional mechanical TKA (CMTKA), longer operation times, and intraoperative blood loss (IBL) > 20%. Postoperatively, the HHBL group had significantly more transfusions and longer hospital stays. Logistic regression identified CAD, platelet count, left knee surgery, CMTKA, operation time, and preoperative EPO use as significant factors influencing HHBL. These findings highlight the need for targeted strategies to manage blood loss in knee arthroplasty patients.

conclusionsThis study identifies several factors associated with high hidden blood loss in patients undergoing TKA for osteoarthritis. CAD, CMTKA, prolonged operation time, left-sided surgery, lower preoperative platelet count, and lack of preoperative erythropoietin (EPO) use were significantly linked to HHBL. While these associations highlight potential targets for intervention, further prospective studies are needed to confirm causality.

Indexed as

Arthroplasty, Replacement, KneeBlood Loss, SurgicalOsteoarthritis, KneePostoperative HemorrhageAgedBlood TransfusionCross-Sectional StudiesErythropoietinFemaleHumansMaleMiddle AgedOperative TimeRetrospective StudiesRisk FactorsErythropoietinFactorsHidden blood lossOsteoarthritisTotal knee arthroplasty

Identifiers

PMID40319268
PMCPMC12048921

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.