Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
Clin Orthop Surg. 2024 Oct;16(5):711-717. doi: 10.4055/cios24082. Epub 2024 Jun 26.
Thrombocytopenia is a condition where platelet counts are below the normal range (< 150 × 10/µL), resulting in a higher risk of bleeding and affecting the results of hip arthroplasty. We assessed the impact of preoperative platelet counts on the clinical results of patients who underwent hip arthroplasty.
Between April 2003 and March 2023, 437 patients (451 hips), who had preoperative thrombocytopenia of less than 150 × 10/µL platelets, underwent hip arthroplasty. Preoperative platelet levels were categorized into severe thrombocytopenia (< 50 × 10/µL) and non-severe thrombocytopenia (50-149 × 10/µL). Total blood loss, operation time, requirement of transfusion, amount of transfusion, duration of surgical wound oozing, length of hospital stay, mortality rate at 1 year after surgery, and any complication were compared between the 2 groups.
No notable differences were observed in the surgery time or the total amount of blood loss between the groups. The requirement of transfusion and the amount of transfused blood were higher in the severe thrombocytopenia group. Prolonged oozing was found in around 18% in both groups, while periprosthetic joint infections occurred in 3 of the non-severe thrombocytopenia group. No significant difference was noted in the duration of hospital stay (25.6 ± 18.3 days vs. 19.4 ± 16.6 days, = 0.067) and 1-year mortality (22.2% vs. 11.8%, = 0.110).
Hip arthroplasties are safe for patients with low platelet counts and do not lead to prolonged hospital stays. On the other hand, patients with severe thrombocytopenia tend to need blood transfusions more frequently than those with less severe thrombocytopenia.
血小板减少症是指血小板计数低于正常范围（<150×10/µL）的一种病症，会增加出血风险，并影响髋关节置换术的结果。我们评估了术前血小板计数对接受髋关节置换术患者临床结果的影响。
2003 年 4 月至 2023 年 3 月期间，437 例（451 髋）术前血小板计数<150×10/µL 的患者接受髋关节置换术。术前血小板水平分为严重血小板减少症（<50×10/µL）和非严重血小板减少症（50-149×10/µL）。比较两组间总失血量、手术时间、输血需求、输血量、手术切口渗血持续时间、住院时间、术后 1 年死亡率和任何并发症。
两组手术时间或总失血量无显著差异。严重血小板减少症组输血需求和输血量较高。两组约有 18%的患者出现切口渗血时间延长，非严重血小板减少症组有 3 例发生假体周围关节感染。两组住院时间（25.6±18.3 天 vs. 19.4±16.6 天，=0.067）和 1 年死亡率（22.2% vs. 11.8%，=0.110）无显著差异。
对于血小板计数较低的患者，髋关节置换术是安全的，不会导致住院时间延长。另一方面，严重血小板减少症患者比血小板减少症较轻的患者更倾向于需要输血。
