Management Leg Positioning After Total Knee Arthroplasty: An Evidence Based Nursing Practice

Authors

  • Adelina Vidya Ardiyati Adel UIN Syarif Hidayatullah Jakarta
  • Debie Dahlia
  • Dikha Ayu Kurnia

DOI:

https://doi.org/10.35654/ijnhs.v4i6.530

Keywords:

Leg positioning, Knee Flexion, Total Knee Arthroplasty, Hidden Blood Loss.

Abstract

Abstract. Total Knee Arthroplasty (TKA) is an effective surgical treatment in patients with moderate to severe knee arthritis. This surgical intervention has the potential to cause blood loss of up to 1000cc, which can lead to a decrease in haemoglobin levels and postoperative functional abilities. There are many methods to reduce the amount of blood loss after TKA surgery, one of the most effective and efficient methods is to position the knee flexion 45° for 24 hours post-operative TKA. This study was the application of Evidence Based Nursing (EBN) with a sample of 10 that meet theInclusion criteria were patients with knee osteoarthritis stage III and IV and underwent TKA Total Knee Arthroplasty (TKA) is an effective surgical treatment in patients with moderate to severe knee arthritis. This surgical intervention has the potential to cause blood loss of up to 1000cc, which can lead to a decrease in haemoglobin levels and postoperative functional abilities. There are many methods to reduce the amount of blood loss after TKA surgery, one of the most effective and efficient methods is to position the knee flexion 45° for 24 hours post-operative TKA. This case series aims to present the result of applying evidence-based leg positioning after TKA to reduce blood loss with a sample of 10 that meet the Inclusion criteria were patients with knee osteoarthritis stage III and IV and underwent TKA (Total Knee Arthroplasty) surgical procedures. The results show that all respondents are female, most of them are <60 years old (60%), and BMI in the overweight category is 70%, the amount of Hidden Blood Loss is in the range of 420cc-700cc, 30% of respondents have post-op Hb levels <10gr/dl, and 60% of respondents have a ROM value of 90° on day 5 Post Operation. The Implementation of EBN Knee flexion position for 24 hours post TKA effective to reduce the amount of blood loss and improve the patient's functional ability by facilitating the patient to start rehabilitation exercises early

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References

Hu Y, Li Q, Wei B, Zhang X, Torsha TT, Xiao J. Blood loss of total knee arthroplasty in osteoarthritis?: an analysis of influential factors. J Orthop Surg Res. 2018;0:1–8.

Wu Y, Yang T, Zeng Y, Si H, Li C, Shen B. Effect of different postoperative limb positions on blood loss and range of motion in total knee arthroplasty: An updated meta-analysis of randomized controlled trials. Int J Surg [Internet]. 2017;37:15–23. Available from: http://dx.doi.org/10.1016/j.ijsu.2016.11.135

Faldini C, Traina F, De Fine M, Pedrini M, Sambri A. Post-operative limb position can influence blood loss and range of motion after total knee arthroplasty: a systematic review. Knee Surgery, Sport Traumatol Arthrosc. 2015;23(3):852–9.

Cao L, Yang H, Sun K, Wang H, Fan H, Cheng W. The Role of Knee Position in Blood Loss and Enhancement of Recovery after Total Knee Arthroplasty. J Knee Surg. 2020;1(212).

Wu Y, Zeng Y, Li C, Zhong J, Hu Q, Pei F, et al. The effect of post-operative limb positioning on blood loss and early outcomes after primary total knee arthroplasty: a randomized controlled trial. Int Orthop. 2019;43(9):2083–91.

Wu Y, Lu X, Ma Y, Zeng Y, Xiong H, Bao X, et al. Efficacy and safety of limb position on blood loss and range of motion after total knee arthroplasty without tourniquet: A randomized clinical trial. Int J Surg [Internet]. 2018;60(September):182–7. Available from: https://doi.org/10.1016/j.ijsu.2018.11.008

Carlson VR, Ong AC, Orozco FR, Hernandez VH, Lutz RW, Post ZD. Compliance with the AAOS Guidelines for Treatment of Osteoarthritis of the Knee: A Survey of the American Association of Hip and Knee Surgeons. J Am Acad Orthop Surg. 2018;26(3):103–7.

Wang HY, Yu GS, Li JH, Zhang SX, Lin Y Bin. An updated meta-analysis evaluating limb management after total knee arthroplasty - What is the optimal method? J Orthop Surg Res. 2019;14(1):1–15.

Yang Y, Yong-ming L, Pei-jian D, Jia L, Ying-Ze Z. Leg position influences early blood loss and functional recovery following total knee arthroplasty: A randomized study. Int J Surg [Internet]. 2015;23:82–6. Available from: http://dx.doi.org/10.1016/j.ijsu.2015.09.053

Dan M, Martos SM, Beller E, Jones P, Randle R, Liu D. Blood loss in primary total knee arthroplasty — body temperature is not a significant risk factor — a prospective , consecutive , observational cohort study. J Orthop Surg Res [Internet]. 2015;1–7. Available from: http://dx.doi.org/10.1186/s13018-015-0241-5

Gao FQ, Li ZJ, Zhang K, Sun W, Zhang H. Four methods for calculating blood-loss after total knee arthroplasty. Chin Med J (Engl). 2015;128(21):2856–60.

Liu J, Li Y min, Cao J gang, Wang L. Effects of knee position on blood loss following total knee arthroplasty: A randomized, controlled study. J Orthop Surg Res [Internet]. 2015;10(1):15–8. Available from: ???

Chen ZY, Wu HZ, Zhu P, Feng XB. Postoperative changes in hemoglobin and hematocrit in patients undergoing primary total hip and knee arthroplasty. Chin Med J (Engl). 2015;128(14):1977–9.

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Published

2021-12-21