Relationships of hemostasis indexes and microcirculatory hemodynamics indicators in knee and hip joint transplantation

Aim of investigation. The development of a non-invasive express method for assessing the state of the hemostasis system during transplantation of large joints is an urgent task, since it allows you to adjust the appointment of anticoagulant therapy and prevent the development of thromboembolic complications. Target. To assess the informative value of the non-invasive express method, which makes it possible to judge the state of the hemostasis system during transplantation of the knee and hip joints.

Methods. The studies were carried out on 136 patients, divided into 2 groups. The first group included 46 patients with arthrosis of the hip or knee joints of I–II stages, the second group consisted of 90 patients with similar arthrosis of III–IV degrees, in whom the studies were carried out in the preoperative period and on the 6th day after arthroplasty. The state of blood flow was studied using an mDLS sensor (Dynamic Light Scattering, Rehovot, Israel). At the same time, the main indicators of the coagulogram were studied according to generally accepted methods and the spatial growth of the fibrin clot, carried out on the apparatus "Trombodynamics Registrar T-2". To assess the relationship between the parameters of hemodynamics and the hemostasis system, the Spearman rank correlation method was used.

Results. Correlation relationships were established between individual hemodynamic parameters and the state of the blood coagulation system and fibroinolysis cascade. It is important to note that these relationships are found between all shear flows (HI1, HI2, and HI3) and the APTT, INR, and D-dimer indices, which allows not only to roughly judge the state of the hemostasis and fibrinolysis system, but also the intensity of the intravascular blood coagulation process.

Conclusion. Based on the data obtained, by measuring hemodynamic parameters, the dose of direct and indirect anticoagulants used can be adjusted during transplantation of large joints.