An Evaluation of Intra‑ and Post‑operative Blood Loss in Total Hip Arthroplasty at the National Orthopaedic Hospital, Lagos

Abstract

Background: Severe hip pain with associated significant functional limitation is the major indication for total hip replacement, a  rewarding and gratifying procedure. However, significant blood loss can occur in the intra‑ and post‑operative periods, posing a major challenge and necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this study was to evaluate blood loss after primary total hip replacement, and to determine the effect of surgical time on blood loss.

Patients and Methods: A prospective study of blood loss after total hip arthroplasty in 41 patients. All cases were primary total hip arthroplasty done by one surgeon. Intra‑ and post‑operative blood losses were recorded in two groups of patients (surgical time <2 h and surgical time >2 h), and the effect of these on blood loss was evaluated.

Results: The mean intra‑ and post‑operative blood losses were 1222.7 ml and  574.3 ml, respectively. These showed a strong positive correlation with total blood loss (r = 0.790, P < 0.001 and r = 0.517, P < 0.001). Higher intra‑ and  post‑operative blood losses were recorded in patients with surgical time >2 h, with a significant difference on postoperative days 2 and 3 (P = 0.003 and P = 0.014, respectively).

Conclusion: Blood loss in total hip replacement is an important factor and may be influenced by a shorter surgical time.

Keywords: Blood loss, primary total hip arthroplasty, surgical time