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Personalized bleeding management in total knee arthroplasty using reference change value: comparative analysis of tourniquet versus non-tourniquet techniques   
Yazarlar (6)
Dr. Öğr. Üyesi Fatih UĞUR Dr. Öğr. Üyesi Fatih UĞUR
Kastamonu Üniversitesi, Türkiye
Dr. Öğr. Üyesi Mehmet Akif BİLDİRİCİ Dr. Öğr. Üyesi Mehmet Akif BİLDİRİCİ
Kastamonu Üniversitesi, Türkiye
Dr. Öğr. Üyesi Recep TAŞKİN Dr. Öğr. Üyesi Recep TAŞKİN
Kastamonu Üniversitesi, Türkiye
Bedrettin Akar
Mehmet Albayrak
Engin Karadeniz
Devamını Göster
Özet
Total knee arthroplasty (TKA) is a commonly performed surgical procedure for the treatment of advanced-stage knee osteoarthritis. This study aims to compare perioperative blood loss between tourniquet-assisted and tourniquet-free TKA using the reference change value (RCV), a personalized analytical tool that accounts for both biological and analytical variability. A retrospective analysis was conducted on 137 patients (tourniquet group (n = 68) and non-tourniquet group (n = 69) who underwent primary TKA. Hematological parameters-including red blood cell count (RBC), hemoglobin (HGB), and hematocrit (HCT)-were evaluated preoperatively, on the day of surgery, and on postoperative day one. Blood loss was assessed using both conventional statistical methods and RCV-based analysis. No statistically significant differences were observed between the two groups in terms of age and gender (p > 0.05). Although preoperative hemoglobin levels were significantly different between groups (p < 0.05), there were no significant intergroup differences in pre- or postoperative RBC and HCT values. Traditional statistical analysis showed no significant difference in blood loss (p > 0.05). However, RCV analysis revealed that while bleeding had stabilized by the first postoperative day in the non-tourniquet group, it remained significantly elevated in the tourniquet group. The findings suggest that RCV offers a more individualized and sensitive approach to assessing perioperative blood loss in TKA. Although conventional methods did not demonstrate significant differences, RCV analysis indicated a more rapid hemostatic response in the non-tourniquet group. Incorporating RCV into routine clinical practice may enhance patient-specific blood management and support earlier postoperative decision making.
Anahtar Kelimeler
Total knee arthroplasty | Perioperative blood loss | Reference change value | Tourniquet | Individualized hemostasis assessment
Makale Türü Özgün Makale
Makale Alt Türü ESCI dergilerinde yayımlanan tam makale
Dergi Adı ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
Dergi ISSN 0936-8051 Wos Dergi Scopus Dergi
Makale Dili İngilizce
Basım Tarihi 06-2025
Cilt No 145
Sayı 1
Doi Numarası 10.1007/s00402-025-05946-1