The association between bone mineral density and postoperative drainage volume following primary total knee arthroplasty: a cross-sectional study

Abstract

\n Background\n\nThe prevalence of osteoporosis in patients who undergo a primary total knee arthroplasty (TKA) is increasing. Low bone mineral density (BMD) is related to unfavorable outcomes following TKA such as migration of uncemented tibia components. Postoperative blood loss in TKA is an important complication. Non-modifying predicting factors for postoperative blood loss in primary TKA patients need further elucidation. Studies on the association between BMD and blood loss after TKA are limited. We aimed to demonstrate the relationship between BMD and postoperative drainage volume following primary TKA.\nMethod:\n\nA cross-sectional study was conducted between January 2014 and August 2020. A total of 119 primary varus osteoarthritis knees with BMD results were included in the study. Patients with secondary causes for osteoporosis were excluded.\nResult\n\nThe prevalence of osteopenia and osteoporosis diagnosed by the lowest T-score among two sites (hip and lumbar spine) were 55.5% and 28.6%, respectively. The median postoperative drainage volume of participants in the normal total hip BMD group and the normal trochanter BMD group was higher than that of patients in the low total hip BMD group and the low trochanter BMD group (285.0 ml vs. 230.0 ml, P\u2009=\u20090.003; 282.5 ml vs. 240.0 ml, P\u2009=\u20090.013, respectively). Multivariate regression analyses showed that operative time, spinal anesthesia, and normal total hip BMD status were significant predictive factors associated with increased postoperative drainage volume (P\u2009=\u20090.014, 0.022, 0.013, respectively). No association was identified between the lumbar spine BMD status and postoperative drainage volume.\nConclusion\n\nThe relationship between BMD and postoperative blood loss in primary TKA was identified in this study. Normal total hip BMD was found to be associated with an increased postoperative drainage volume after primary TKA compared with low BMD.