Revision total knee arthroplasty (rTKA) is a complex procedure with increased risk of blood loss and transfusions. The Musculoskeletal Infection Society has included D-dimer as a serology marker for peri-prosthetic infection. The study's intent is to understand the impact of preoperative D-dimer levels on blood loss and venous thromboembolism in revision TKA. Following IRB approval, rTKA performed by a single surgeon between January 1, 2017 and December 31, 2019 were reviewed. Inclusion criteria consisted of pre-operative D-Dimer, cemented revision TKA of one or both components under tourniquet control. 89 patients met the criteria including 37 males (41.6%) and 52 females (58.4%). Mean ages were 65 for males and 67 for females. The data revealed 54 patients (61%) had an elevated D-dimer (group 1) and 35 patients (39%) had a normal D-dimer (group 2). Sex stratification showed 21 males (57.8%) and 33 females (63.5%) with elevated D-dimer. TXA protocol included 2 grams intravenous (82 patients) or 2 grams intra-articular application (7 patients). Post-operative anticoagulation included Lovenox 40mg daily for 2 weeks followed by aspirin 325 twice daily for 4 weeks. Pre-operative and post-operative hemoglobin, transfusion rates and post-operative VTE within 90 days of surgery were recorded.Background
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