Quality of life reported by patients with ecchymosis following total knee arthroplasty

To explore the early quality of life (QOL), function, and pain of patients with ecchymosis after total knee arthroplasty (TKA) using Patient-Reported Outcome Measures (PROMs), and to investigate the incidence of post-TKA ecchymosis and its potential risk factors under anticoagulant therapy.

This single-center observational study included patients who underwent TKA at our center from June 2022 to June 2023. Data on demographic information, surgical details, pre-operative and post-operative laboratory results, imaging data, etc., were collected. Patients were divided into two groups based on the presence or absence of ecchymosis after TKA: the ecchymosis group and the non-ecchymosis group. Patients' QOL postoperatively was assessed using Visual Analog Scale (VAS), Hospital for Special Surgery (HSS) score, and Rand 36-Item Short Form Health Survey (SF-36). A binary logistic regression model was employed to analyze the risk factors for post-TKA ecchymosis.

A total of 138 participants were included, 15 males and 123 females, with a mean age of 67.91 ± 7.24 years and BMI of 25.57 ± 3.85 kg/m². There were 60 cases in the ecchymosis group and 78 cases in the non-ecchymosis group, resulting in an incidence of post-TKA ecchymosis of 43.48%. The ecchymosis group demonstrated more significant pain and poorer joint function postoperatively, with significantly lower scores in the SF-36 dimensions and 7 subdomains compared to the non-ecchymosis group. Regression analysis suggested that age may be a risk factor for post-TKA ecchymosis.

The incidence of ecchymosis after TKA is high under anticoagulant therapy, leading to increased pain sensitivity, decreased function, and quality of life in patients. Age may be a risk factor for early post-TKA ecchymosis. Incorporating information on ecchymosis into preoperative education and providing appropriate psychological interventions for patients experiencing ecchymosis may be necessary.