J Curr Surg

Journal of Current Surgery, ISSN 1927-1298 print, 1927-1301 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Curr Surg and Elmer Press Inc

Journal website https://www.currentsurgery.org

Original Article

Volume 12, Number 1, March 2022, pages 7-14

Effect of Upper Limb Warming Blanket on Body Temperature Control During Total Hip Arthroplasty and Total Knee Arthroplasty

Figure 1. Flowchart for patient selection. During the study, 173 patients were diagnosed with osteoarthritis and rheumatoid arthritis of the hip and knee joints and were eligible for THA and TKA. Eventually, 156 patients were included in the analysis; 105 and 51 patients were divided into the THA group and TKA group, respectively. THA: total hip arthroplasty; TKA: total knee arthroplasty.

Figure 2. Trends in tympanic membrane temperature for THA and TKA groups. The results of tympanic temperature measurements were analyzed using two-way analysis of variance. At the beginning of the measurement, the THA group demonstrated significantly lower values than the TKA group (P = 0.001). THA: total hip arthroplasty; TKA: total knee arthroplasty.

**Table 1.** Patient Background and Method of Anesthesia
	THA group (n = 105)	TKA group (n = 51)	P value
Data are expressed as means ± standard deviation. Categorical variables were compared using Fisher’s exact test, and continuous variables were compared using the Mann-Whitney U test. IV-PCA: intravenous patient-controlled analgesia; ASA-PS: American Society of Anesthesiologists-Physical Status; BMI: body mass index.
Types of general anesthesia			0.321
IV-PCA	12 ± 11.14	9 ± 17.16
Epidural anesthesia	93 ± 88.6	42 ± 82.4
ASA-PS			0.592
I	14 (60.9)	9 (39.1)
II	83 (67.5)	40 (32.5)
III	8 (80.0)	2 (20.0)
Age (years)	64.86 ± 10.7	74.63 ± 6.10	< 0.001
Sex, n (%)			0.548
Woman	82 (68.9)	37 (31.1)
Man	23 (62.2)	14 (37.8)
BMI	23.09 ± 3.64	25.20 ± 3.91	0.001
During admission	30.31 ± 29.56	27.16 ± 11.02	0.462
Operation time	64.97 ± 24.49	74.04 ± 14.93	0.016
Anesthesia time	109.21 ± 26.78	116.24 ± 17.48	0.09

Table 1. Patient Background and Method of Anesthesia

THA group (n = 105)

TKA group (n = 51)

P value

Data are expressed as means ± standard deviation. Categorical variables were compared using Fisher’s exact test, and continuous variables were compared using the Mann-Whitney U test. IV-PCA: intravenous patient-controlled analgesia; ASA-PS: American Society of Anesthesiologists-Physical Status; BMI: body mass index.

Types of general anesthesia

0.321

IV-PCA

12 ± 11.14

9 ± 17.16

Epidural anesthesia

93 ± 88.6

42 ± 82.4

ASA-PS

0.592

14 (60.9)

9 (39.1)

83 (67.5)

40 (32.5)

III

8 (80.0)

2 (20.0)

Age (years)

64.86 ± 10.7

74.63 ± 6.10

< 0.001

Sex, n (%)

0.548

Woman

82 (68.9)

37 (31.1)

Man

23 (62.2)

14 (37.8)

BMI

23.09 ± 3.64

25.20 ± 3.91

0.001

During admission

30.31 ± 29.56

27.16 ± 11.02

0.462

Operation time

64.97 ± 24.49

74.04 ± 14.93

0.016

Anesthesia time

109.21 ± 26.78

116.24 ± 17.48

0.09

**Table 2.** Preoperative Blood Test Data
	THA group (n=105)	TKA group (n=51)	P value
Data are expressed as means ± standard deviation. Continuous variables were compared using the Mann-Whitney U test. Alb: albumin; ALP: alkaline phosphatase; ALT: alanine aminotransferase; APTT: activated partial thromboplastin time; AST: aspartate aminotransferase; BUN: blood urea nitrogen; Cl: chloride; Cre: creatinine; CRP: C-reactive protein; γ-GTP: γ-glutamyl transpeptidase; Hb: hemoglobin; HbA1c: hemoglobin A1c; HT: hematocrit; K: potassium; Na: sodium; PLT: platelet; PT: prothrombin time; PTINR: prothrombin time-international normalized ratio; PT: prothrombin time; RBC: red blood cell; TP: total protein; WBC: white blood cell.
Alb (g/dL)	4.15 ± 0.44	4.15 ± 0.34	0.961
ALP (U/L)	291.04 ± 98.66	250.35 ± 75.27	0.01
ALT (U/L)	19.88 ± 12.03	21.00 ± 9.87	0.564
APTT (s)	29.23 ± 3.71	28.34 ± 4.30	0.185
AST (U/L)	21.99 ± 6.24	23.94 ± 7.56	0.09
BUN (mg/dL)	16.35 ± 5.24	18.13 ± 4.68	0.042
Cl (mmol/L)	104.00 ± 3.39	104.47 ± 2.18	0.368
Cre (mg/dL)	0.75 ± 0.37	0.81 ± 0.26	0.303
CRP (mg/dL)	0.75 ± 1.57	0.65 ± 2.29	0.752
γ-GTP (U/L)	38.57 ± 50.10	40.33 ± 59.11	0.846
Hb (g/dL)	13.07 ± 1.63	13.58 ± 1.84	0.08
HbA1c (%)	5.75 ± 0.58	6.02 ± 0.64	0.01
HT (%)	38.70 ± 4.38	40.05 ± 4.89	0.085
K (mmol/L)	4.08 ± 0.40	4.18 ± 0.33	0.117
Na (mmol/L)	140.86 ± 2.95	140.90 ± 2.15	0.923
PLT (× 10⁴/µL)	24.58 ± 7.03	21.47 ± 5.89	0.007
PT (%)	103.87 ± 14.53	102.54 ± 12.54	0.577
PTINR (s)	0.99(± 0.17)	0.99 ± 0.10	0.952
PT (s)	11.41(± 1.88)	11.36 ± 1.16	0.868
RBC (× 10⁴/µL)	420.77 ± 52.64	435.71 ± 56.77	0.107
TP (g/dL)	7.12 ± 0.59	7.17 ± 0.43	0.525
WBC (× 10³/µL)	69.78 ± 24.91	61.10 ± 14.71	0.023

Table 2. Preoperative Blood Test Data

THA group (n=105)

TKA group (n=51)

P value

Data are expressed as means ± standard deviation. Continuous variables were compared using the Mann-Whitney U test. Alb: albumin; ALP: alkaline phosphatase; ALT: alanine aminotransferase; APTT: activated partial thromboplastin time; AST: aspartate aminotransferase; BUN: blood urea nitrogen; Cl: chloride; Cre: creatinine; CRP: C-reactive protein; γ-GTP: γ-glutamyl transpeptidase; Hb: hemoglobin; HbA1c: hemoglobin A1c; HT: hematocrit; K: potassium; Na: sodium; PLT: platelet; PT: prothrombin time; PTINR: prothrombin time-international normalized ratio; PT: prothrombin time; RBC: red blood cell; TP: total protein; WBC: white blood cell.

Alb (g/dL)

4.15 ± 0.44

4.15 ± 0.34

0.961

ALP (U/L)

291.04 ± 98.66

250.35 ± 75.27

0.01

ALT (U/L)

19.88 ± 12.03

21.00 ± 9.87

0.564

APTT (s)

29.23 ± 3.71

28.34 ± 4.30

0.185

AST (U/L)

21.99 ± 6.24

23.94 ± 7.56

0.09

BUN (mg/dL)

16.35 ± 5.24

18.13 ± 4.68

0.042

Cl (mmol/L)

104.00 ± 3.39

104.47 ± 2.18

0.368

Cre (mg/dL)

0.75 ± 0.37

0.81 ± 0.26

0.303

CRP (mg/dL)

0.75 ± 1.57

0.65 ± 2.29

0.752

γ-GTP (U/L)

38.57 ± 50.10

40.33 ± 59.11

0.846

Hb (g/dL)

13.07 ± 1.63

13.58 ± 1.84

0.08

HbA1c (%)

5.75 ± 0.58

6.02 ± 0.64

0.01

HT (%)

38.70 ± 4.38

40.05 ± 4.89

0.085

K (mmol/L)

4.08 ± 0.40

4.18 ± 0.33

0.117

Na (mmol/L)

140.86 ± 2.95

140.90 ± 2.15

0.923

PLT (× 10⁴/µL)

24.58 ± 7.03

21.47 ± 5.89

0.007

PT (%)

103.87 ± 14.53

102.54 ± 12.54

0.577

PTINR (s)

0.99(± 0.17)

0.99 ± 0.10

0.952

PT (s)

11.41(± 1.88)

11.36 ± 1.16

0.868

RBC (× 10⁴/µL)

420.77 ± 52.64

435.71 ± 56.77

0.107

TP (g/dL)

7.12 ± 0.59

7.17 ± 0.43

0.525

WBC (× 10³/µL)

69.78 ± 24.91

61.10 ± 14.71

0.023

**Table 3.** Comparison From the Start of Tympanic Membrane Temperature Measurement to the End of Tympanic Membrane Temperature Measurement
	THA group (n = 105)	TKA group (n = 51)	P value
Data are expressed as means ± standard deviation. Continuous variables were compared using the Mann-Whitney U test. THA: total hip arthroplasty; TKA: total knee arthroplasty.
Start	34.67 ± 1.50	35.68 ± 0.45	0.001
After 5 points	35.98 ± 0.72	36.06 ± 0.49	0.46
10 min later	36.14 ± 0.59	36.13 ± 0.47	0.862
15 min later	36.28 ± 0.65	36.14 ± 0.50	0.167
20 min later	36.31 ± 0.64	36.17 ± 0.49	0.153
25 min later	36.28 ± 0.53	36.19 ± 0.53	0.326
30 min later	36.32 ± 0.51	36.24 ± 0.49	0.35
After 35 min	36.32 ± 0.52	36.27 ± 0.50	0.584
After 40 min	36.29 ± 0.66	36.31 ± 0.49	0.881

Table 3. Comparison From the Start of Tympanic Membrane Temperature Measurement to the End of Tympanic Membrane Temperature Measurement

THA group (n = 105)

TKA group (n = 51)

P value

Data are expressed as means ± standard deviation. Continuous variables were compared using the Mann-Whitney U test. THA: total hip arthroplasty; TKA: total knee arthroplasty.

Start

34.67 ± 1.50

35.68 ± 0.45

0.001

After 5 points

35.98 ± 0.72

36.06 ± 0.49

0.46

10 min later

36.14 ± 0.59

36.13 ± 0.47

0.862

15 min later

36.28 ± 0.65

36.14 ± 0.50

0.167

20 min later

36.31 ± 0.64

36.17 ± 0.49

0.153

25 min later

36.28 ± 0.53

36.19 ± 0.53

0.326

30 min later

36.32 ± 0.51

36.24 ± 0.49

0.35

After 35 min

36.32 ± 0.52

36.27 ± 0.50

0.584

After 40 min

36.29 ± 0.66

36.31 ± 0.49

0.881