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BLOOD LOSS FOLLOWING SOFT TISSUE RELEASE IN TOTAL KNEE ARTHROPLASTY OF THE VALGUS KNEE



Abstract

Purpose: The objective of this study was to assess whether a correlation existed between blood loss and soft tissue release carried out during total knee replacement in the valgus knee.

Method: We identified 208 patients with a valgus deformity undergoing primary total knee arthroplasty . These were performed over a 33 month period by a single surgeon. An LCS mobile bearing prosthesis was used in all patients. The valgus deformity range was from 1–38 degrees with a mean of 11.75 degrees. Haemoglobin (Hb) drop was calculated as a measure of blood loss. This was calculated using:

Hb drop = Pre-op Hb – (Day 3 Hb + No. of units of blood received)

(We assumed that one unit of blood equates to one gram increase in circulating haemoglobin).

Results: Osteoarthritis was the major diagnosis (90.3%) followed by rheumatoid disease (5.8%). Forty-four patients (21%) required no soft tissue release, this group having an average deformity of 6 degrees and an average Hb drop of 4.35g/dl. One hundred and forty-six (69%) patients required a posterolateral capsular release, average deformity of 14 degrees with an average Hb drop of 4.63g/dl. Seventeen (8%) patients had a posterolateral and an additional Iliotibial band release, average magnitude of deformity 18 degrees and average Hb drop of 4.97g/dl. One patient had a lateral collateral ligament release, magnitude of deformity 30 degrees and haemoglobin drop of 6.4g/dl.

Conclusion: Soft tissue release in total knee arthroplasties in the valgus knee increases the amount of postoperative bleeding and average length of stay of the patient.

Correspondence should be addressed to Roger Smith, Honorary Secretary, BASK c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN