Yu Tao, Chen Yiqi, Yang Ziye, Chen Hao, Shen Zhenyu, Xue Enxing, Wu Dengying
The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Department of Orthopaedics, The Second Affiliated Hospital, Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
BMC Musculoskelet Disord. 2025 Apr 22;26(1):399. doi: 10.1186/s12891-025-08587-y.
The aim of our study was to compare the hidden blood loss (HBL) between patients treated with unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) and to identify predictors of HBL in this cohort.
We conducted a retrospective study including 91 patients who had knee osteoarthritis, of which 31 cases (male/female: 12/19) received HTO and 60 cases (male/female: 24/36) received UKA, from January 2021 to January 2023. Demographics, clinical information and laboratory values were collected and compared. Recording preoperative and postoperative hematocrit and estimating intraoperative blood loss by surgeon to calculate HBL according to Nadler, Gross and Sehat formula. Effect sizes were determined using Cohen's d and Glass rank biserial correlation coefficient to assess clinical difference in the data. The Spearman correlation analysis was used to investigate an association between patient's characteristics and HBL. Multiple linear regression analysis was used to confirm independent risk factors of HBL.
The HBL and TBL of the HTO group (534.49 ± 336.05 ml, 639.65 ± 337.81 ml, respectively) are significantly higher than that in the UKA group (359.42 ± 263.51 ml, 408.76 ± 283.50 ml, respectively; P = 0.008, P = 0.001). Effect size analysis indicated moderate clinical significance (Cohen's d [95% CI] = 0.604 [0.160, 1.045] for HBL, 0.762 [0.312, 1.208] for TBL). The multiple linear regression analysis suggested post-operative hemoglobin values and hemoglobin loss were independent risk factors for HBL in the UKA and HTO groups.
This study provides new insights into the comparative blood loss between HTO and UKA procedures, highlighting that HBL and TBL are significantly higher in HTO than in UKA. The moderate clinical significance of this difference emphasize the need for careful management of post-operative anemia, particularly in patients undergoing HTO, where blood loss may be more pronounced. Its risk factors should be paid more attention during the perioperative period.
Not applicable.
本研究旨在比较单髁膝关节置换术（UKA）和高位胫骨截骨术（HTO）患者的隐性失血（HBL）情况，并确定该队列中HBL的预测因素。
我们进行了一项回顾性研究，纳入了91例膝骨关节炎患者，其中31例（男/女：12/19）接受了HTO，60例（男/女：24/36）接受了UKA，时间跨度为2021年1月至2023年1月。收集并比较了人口统计学、临床信息和实验室值。记录术前和术后的血细胞比容，并由外科医生估计术中失血量，根据Nadler、Gross和Sehat公式计算HBL。使用Cohen's d和Glass等级双列相关系数确定效应量，以评估数据中的临床差异。采用Spearman相关分析研究患者特征与HBL之间的关联。使用多元线性回归分析确定HBL的独立危险因素。
HTO组的HBL和总失血量（TBL）（分别为534.49±336.05 ml、639.65±337.81 ml）显著高于UKA组（分别为359.42±263.51 ml、408.76±283.50 ml；P = 0.008，P = 0.001）。效应量分析表明具有中等临床意义（HBL的Cohen's d [95% CI] = 0.604 [0.160, 1.045]，TBL的Cohen's d [95% CI] = 0.762 [0.312, 1.208]）。多元线性回归分析表明，术后血红蛋白值和血红蛋白损失是UKA组和HTO组HBL的独立危险因素。
本研究为HTO和UKA手术的失血比较提供了新的见解，突出表明HTO的HBL和TBL显著高于UKA。这种差异的中等临床意义强调了术后贫血需要仔细管理，特别是在HTO患者中，其失血可能更明显。围手术期应更加关注其危险因素。
不适用。
