Are Routine Postoperative Laboratory Tests Really Necessary after High Tibial Osteotomy surgery?

Abstract

\n Background: The purpose of this study was to assess the necessity and cost-effectiveness of routine postoperative laboratory tests for patients undergoing high tibial osteotomy (HTO) surgery.Methods: A prospective study was conducted and 513 patients with symptomatic isolated medial compartment osteoarthritis received HTO surgery from January 2015 to May 2020 were included in this study. The associations between different clinical factors and postoperative clinical treatment were analyzed. Finally, A logistic regression analysis was performed to detect independent risk factors for patients requiring postoperative clinical treatment. Results: In this study, 482 patients had completed the full set of postoperative laboratory studies within 3 days after surgery were included in the present study. However, only a small proportion of the patients with anemia (3.9%), hypoalbuminemia (4.1%), and abnormal serum potassium levels (3.5%) required clinical intervention after surgery. Binary logistic regression model analysis showed that body mass index (BMI), preoperative hemoglobin level, estimated blood loss and operative time were the independent risk factors correlated with postoperative blood transfusion in patients with HTO surgery. Female gender and preoperative albumin level were independent risk factors for patients who had requiring albumin supplementation after HTO surgery. Finally, preoperative potassium was the independent risk factors for patients required potassium supplementation postoperatively.Conclusions: based on the analysis, we conclude that routinely ordering postoperative laboratory studies after HTO surgery are both unnecessary and cost inefficient. However, for patients with identified risk factors, routine postoperative laboratory tests are still needed.