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No effect of PMMA bone cement on thrombocyte levels after total hip arthroplasty
Thomas J Heyse1, Turgay Efe, Jelena Baetz
1Department of Orthopaedics and Rheumatology, University Hospital, Marburg, Germany. heyse@med.uni-marburg.de
Abstract:
Thrombocytopenia has been reported to occur after total hip arthroplasty (THA). Several in vitro studies have investigated whether polymethylmethacrylate (PMMA) bone cement could be a possible origin for toxic agents that interfere with platelet function and survival. The aim of this study was to screen patient data for postoperative thrombocytopenia and the level of platelet concentrations in relation with the fixation method of THA. A consecutive series of 499 THAs was studied (24.6% fully cemented, 45.5% hybrid and 29.9% uncemented). Pre- and postoperative thrombocyte levels were recorded. Patient data were reviewed for age, indication, BMI, blood cell count, and thromboembolic events. Patients in the noncemented group were significantly younger and their thrombocyte levels were higher. There were no statistically significant differences in platelet loss between groups at any point in time following THA. Platelet concentrations had fully recovered at the time of discharge from hospital. Power analysis revealed that the cohort was large enough to show even small effect sizes. The use of PMMA cement in THA does not appear to affect postoperative platelet concentrations to any significant extent.
Insights
Total hip arthroplasty (THA) may cause thrombocytopenia. This study found no significant difference in platelet levels between cemented and uncemented THA, suggesting polymethylmethacrylate (PMMA) bone cement does not impact platelet counts post-surgery.
Area of Science:
- Orthopedic Surgery
- Hematology
- Biomaterials Science
Background:
- Thrombocytopenia is a potential complication after total hip arthroplasty (THA).
- In vitro studies suggest polymethylmethacrylate (PMMA) bone cement may affect platelet function.
- The impact of THA fixation methods on postoperative platelet levels requires clinical investigation.
Purpose of the Study:
- To evaluate the incidence of postoperative thrombocytopenia in relation to THA fixation methods.
- To compare platelet concentrations between cemented, hybrid, and uncemented THA procedures.
- To determine if PMMA bone cement influences postoperative platelet levels.
Main Methods:
- Retrospective analysis of 499 consecutive THA cases.
- Categorization of THA by fixation: fully cemented, hybrid, and uncemented.
- Recording and comparison of pre- and postoperative platelet counts across fixation groups.
- Review of patient data including age, BMI, and thromboembolic events.
Main Results:
- No statistically significant differences in platelet loss were observed between fixation groups.
- Patients receiving uncemented THA were younger and had higher baseline platelet levels.
- Platelet concentrations returned to normal levels by hospital discharge in all groups.
Conclusions:
- The use of PMMA bone cement in THA does not significantly affect postoperative platelet concentrations.
- Fixation method (cemented vs. uncemented) does not appear to be a major determinant of thrombocytopenia after THA.
- Postoperative platelet levels recover irrespective of the cementation status in THA.