The effect of flexing the knee after total knee arthroplasty on reducing postoperative bleeding

CHEN Jiarong; SHEN Hongyuan; LI Pingyue

doi:10.3969/j.issn.1674-666X.2024.03.002

Abstract：Objective To explore the effect of flexing the knee for 4 h under the concept of fast track surgery(FTS)after total knee arthroplasty(TKA)on reducing postoperative bleeding.Methods From January 2018 to December 2019,60 patients(60 knees)who received TKA due to knee osteoarthritis in General Hospital of Southern Theater Command were selected as research objects,and randomly divided into an observation group and a control group(each of 30 patients/knees)by systematic random sampling,with perioperative FST management in both groups.In the control group,the knee joints of the patients were placed in the conventional extension position after TKA,while in the observation group,the knee joints were placed in the conventional flexion position(90 degrees)after TKA for 4 h,and then changed to the extension position.Wound drainage volume,hemoglobin and hematocrit values within 1 d after operation,as well as the swelling of the lower limb(the thigh circumference of 10 cm above the patella)on the operation side at preoperation and 3 d after the operation were observed,and the scores of American Hospital of Speical Surgery(HSS)at preoperation and one month after operation and complications were recorded in two groups.Results On the first day after operation,the drainage volume was(183.6±25.8)mL in the control group and(90.6±18.5)mL in the observation group,there was statistical difference between the two groups(P<0.05);the postoperative hemoglobin and hematocrit values were(104.6±15.6)g/L,(31.5±4.5)%in control group and(126.2±9.6)g/L,(35.7±3.5)%in observation group,respectively,with statistical differences between two groups(P<0.05).At 3 d postoperatively,knee joint swelling in observation group was less than that in control group(P<0.05).At one month after the surgery,HSS scores in two groups were similar(P>0.05),and no deep vein thrombosis had happened in either group.Conclusion Limb management program of the flexion of knee joint within 4 h after TKA under the FTS concept could reduce the postoperative bleeding and limb swelling without affecting knee joint function,which is helpful to accelerate the recovery after the operation.