Does the correction angle affect hidden blood loss in HTO?
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(2020) 15:528
RESEARCH ARTICLE
Open Access
Does the correction angle affect hidden blood loss in HTO? Zheng Li1†, Yannong Wang2†, Guanglei Cao1* , Shuai An1*, Mingli Feng1, Liwei Wang3, Xi Wang4, Guangzhong Yang1, Guanghan Gao1, Shuai Wang1, Xufeng Jiao1 and Lei Ding2
Abstract Background: High tibial osteotomy (HTO) has a history of nearly 60 years and has been widely used in clinical practice. Biplanar open wedge high tibial osteotomy (BOWHTO), which evolved from HTO, is an important therapy for the knee osteoarthritis. In our previous research, we found that the decrease of hemoglobin levels after high tibial osteotomy ranges from between 17 to 41 g/L, but this is highly inconsistent with the intraoperative bleeding and postoperative drainage observed in clinical practice. The purpose of this study was to investigate the perioperative hidden blood loss (HBL) after biplanar open wedge high tibial osteotomy (BOWHTO), as well as to study the effect of the actual correction angle on blood loss. Methods: A retrospective analysis was performed on 21 patients who underwent BOWHTO for osteoarthritis of the knee due to proximal tibia deformity. Gross equation was used to calculate the perioperative total blood loss (TBL) and HBL. The actual correction angle was measured by postoperative anteroposterior radiograph. The correlation between HBL and correction angle was determined through correlation analysis. Results: The TBL was 823.5 ± 348.7 mL and the HBL was 601.6 ± 297.3 mL, total hemoglobin loss was 25.0 ± 10.7 g/ L, and the mean HBL/patient’s blood volume (H/P) was 13.19 ± 5.56% for 21 patients. The correlation coefficient of correction angle and H/P is statistically significant (|r| = 0.678, P = 0.001). Conclusions: The actual total blood loss after BOWHTO was significantly higher than the observed, and the HBL was objective existent after BOWHTO. The proportion of H/P is positively correlated with the correction angle. Keywords: High tibial osteotomy, Hidden blood loss, Correction angle, Tranexamic acid, Tourniquet, Knee arthroscopic surgery
Introduction High tibial osteotomy (HTO) has a history of nearly 60 years [1] and has been widely used in clinical practice. Biplanar open wedge high tibial osteotomy (BOWHTO), which evolved from HTO, is an important therapy for the knee osteoarthritis. In 1987, Hernigou [2] reported a series of long-term follow-up studies of open wedge high tibial osteotomy for varus knee arthritis, with encouraging results. * Correspondence: [email protected]; [email protected] † Zheng Li and Yannong Wang are co-first authors. 1 Department of Orthopaedics, Xuanwu Hospital Capital Medical University, Changchun Street, Xicheng District, Beijing 100053, China Full list of author information is available at the end of the article
Compared with total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) and other therapy, BOWHTO has the following advantages: simple technique, small incision injury, accurate correction of deformity, convenient adjustment of mechanical axis corr
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