Effects of bone cement on coagulation functions during total hip arthroplasty in elderly patients

Abstract

Objective To assess the effects of bone cement implantation on coagulation functions during the total hip arthroplasty in elderly patients. Methods Thirty-four patients admitted to our hospital between February 2004 and August 2005 involved in this study. The relative parameters were observed in all patients, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and plasma protamine paracoagulation test (3P test). Blood samples were measured 5 minutes before, 30 minutes and 3 hours after bone cement implantation. All data were analyzed with Medical Statistics Software. Results PT significantly decreased at 30 minutes after bone cement implantation, compared with 5 minutes before implantation ( P ＜ 0. 05), and significantly recovered at 3 hours after implantation (P ＜ 0.05). FIB significantly increased at 30 minutes after implantation compared with 5 minutes before implantation ( P ＜ 0.05), and significanlty decreased again at 3 hours after implantation (P ＜ 0.05 ). A higher rate of positive results in 3P test was observed at 30 minutes after implantation compared with 5 minutes before implantation ( P ＜ 0.05 ). There was no significant difference in APTT before and after implantation. Conclusions PT significantly decreased at 30 minutes after bone cement implantation, and FIB or positive rate of 3P test increased, but these parameters recovered at 3 hours after implantation. It showed we must monitor patients in 3 hours after implantation. And bone cement shows a tendency to activate blood coagulation, especially in elderly patients, but the relative indexes are still in normal range. Key words: Arthroplasty ; Total hip arthroplasty ; Methylmethacrylates ; Blood coagulation factors ;