Blood loss in primary total knee arthroplasty-body temperature is not a significant risk factor-a prospective, consecutive, observational cohort study

Background: Hypothermia related to anaesthesia and operating theatre environment is associated with increased blood loss in a number of surgical disciplines, including total hip arthroplasty. The influence of patient temperature on blood loss in total knee arthroplasty (TKA) has not been previously studied. Methods: We recorded patient axillary temperature in the peri-operative period, up to 24 h post-operatively, and analysed the effect on transfusion rate and blood loss from a consecutive cohort of 101 patients undergoing primary TKA. Results: No relationship between peri-operative patient temperature and blood loss was found within the recorded patient temperature range of 34.7-37.8 degrees C. Multivariable analysis found increasing age, surgical technique, type of anaesthesia and the use of anti-platelet and anticoagulant medications as significant factors affecting blood loss following TKA. Conclusion: Patient temperature within a clinically observed range does not have a significant impact on blood loss in primary TKA patients. As long as patient temperature is maintained within a reasonable range during the intra-operative and post-operative periods, strategies other than rigid temperature control above 36.5 degrees C may be more effective in reducing blood loss following TKA.