"Background: Strengthening the coagulation and fibrinolytic activities in response to surgical trauma greatly increases the risk of bleeding and thromboembolic complications in orthopedic patients. The thromboelastography (TEG) can detect hypercoagulable and hypocoagulable states, it is useful for monitoring coagulation during surgical procedures. In this work we studied the dynamics of blood clot formation and lysis as well its relation to hemostasis markers by total hip arthroplasty.
Materials and Methods: Blood samples were examined in 61 patients (29 men and 32 women, ranging in age from 33 to 72 years, with an average of 54±2 years) undergoing primary total hip arthroplasty. Anticoagulant prophylaxis was carried out using low molecular weight heparin (enoxaparin); to prevent excessive blood loss it was administrated tranexamic acid perioperatively. Conventional TEG and common coagulation tests, fibrinogen, thrombin-antithrombin complexes (TAT), D-dimer, the platelet count, β-thromboglobulin were determined preoperatively, 30 minutes after the end of surgery, and at 1, 3, 7 and 14 days after arthroplasty. The data was assessed using descriptive statistics, ANOVA, Pearson’s correlation analysis.
Results: The TAT concentration reached maximum level up to the end of the operation, decreased in a day and normalized on the third day after surgery. The highest concentration of fibrinogen was noted by the 3 day after surgery and remained elevated for up to 14 day. The platelet levels decreased during the first postoperative day and increased after the third postoperative day, with the highest concentration measured from 7 till 14 postoperative days. The β-thromboglobulin level increased sharply to the maximum level at the end of surgery, which was followed by active release of β-thromboglobulin for seven days, after which it returned to its initial level."