Are Routine Postoperative Laboratory Tests Justified in All Patients Who Undergo Total Hip Arthroplasty?

Introduction: Post-surgical laboratory testing is commonly performed in patients after hip arthroplasty. Considering recent trends towards reduced transfusion rates, is it still necessary? Materials and Methods: We conducted clinical-laboratory follow-up on patients undergoing primary hip arthroplasty. We collected demographic data (sex, age, comorbidities, and risk factors for postoperative laboratory abnormalities), laboratory tests (hemoglobin (Hb), creatinine (Cr), sodium (Na)), pre-anesthetic assessment (ASA), surgical details (side, surgical approach, operative time, use tranexamic acid, intraoperative complications), laboratory results at 24 and 48 hours post-surgery, and changes in medical therapy based on laboratory findings. Results: 125 patients (73 women, 52 men), mean age 66.9 years. Preoperative laboratory: Hb 14.12 g/dL, Cr 0.84 mg/dL, Na 140.8 mEq/L. ASA classification: I (n=3), II (n=79), III (n=36), IV (n=2). Surgical approaches: posterior (n=74), anterolateral (n=51). Mean operative time: 76 minutes. Postoperative laboratory at 24 hours: Hb 11.69 g/dL (no differences between approaches, age, sex, IBM and operative time), Cr 0.94 mg/dL, Na 138.86 mEq/L. At 48 hours: Hb 11.07 g/dL. Tranexamic acid (TXA) was not used in 11.5% of patients, which was associated with a 13.9% transfusion rate, 0% in those who received TXA (p=0.046, Fisher’s test). Medical complications in 16% of patients. The most frequent therapy adjustment was transfusion, in 7% of patients (2.5% ASA II, 17% ASA III), though not statistically significant (Chi-square). No statistically significant associations with analyzed parameters were observed. Conclusions: Routine laboratory tests do not provide clinical benefit for most patients. Postoperative Hb testing should be reserved for those with additional indications, ASA III or higher patients in whom blood-saving strategies cannot be fully implemented.