The effect of total knee arthroplasty surgery on mean platelet volume, platelet count, and mean platelet volume/platelet count ratio

Year 2025, Volume: 16 Issue: 54, 50 - 55, 12.04.2025

Esma Karaarslan , Yasin Tire , Aydın Mermer , Nuran Akıncı Ekinci , Muhammed Halit Satıcı , Betül Kozanhan , Ahmet Yıldırım

https://doi.org/10.17944/interdiscip.1573618

Abstract

Objective: This study aims to investigate the effects of total knee arthroplasty (TKA) surgery on mean platelet volume (MPV), platelet count (Plt), and the MPV/Plt ratio.
Methods: This retrospective study examined the data of 379 patients who underwent total knee arthroplasty at Konya City Hospital between January 1, 2023, and January 1, 2024. Preoperative and postoperative blood tests were analyzed at 12-24 hours (postop1) and 24-48 hours (postop2) intervals. MPV, Plt, and MPV/Plt ratio were recorded and compared. Repeated measures ANOVA test was used for statistical analysis.
Results: A significant increase in MPV and MPV/Plt ratio and a significant decrease in Plt were observed in the postoperative period (p<0.001).
Conclusion: The increase in MPV and the decrease in Plt after total knee arthroplasty may indicate an elevated risk of thromboembolic complications. Routine monitoring of MPV, Plt, and the MPV/Plt ratio could be necessary for the erly detection and management of these complications.

Keywords

Total knee arthroplasty, mean platelet volume, platelet count, mean platelet

Ethical Statement

Ethical approval for the study was obtained from the Ethics Committee of KTO Karatay University on October 14, 2024 (Decision No:2024/039 ). The research was carried out in accordance with the Declaration of Helsinki and relevant ethical principles.

References

• Zuckerman JD. Inpatient rehabilitation after total joint replacement. JAMA. 1998;279(11):880. doi: 10.1001/jama.279.11.880.
• Harris WH, Sledge CB. Total hip and total knee replacement. JNEJoM. 1990;323(11):725-31. doi: 10.1056/NEJM199009133231106.
• Liang MH, Cullen KE, Larson MG, Thompson MS, Schwartz JA, Fossel AH, et al. Cost-effectiveness of total joint arthroplasty in osteoarthritis. 1986;29(8):937-43. Arthritis Rheum. doi: 10.1002/art.1780290801.
• Yuri Gasparyan A, Ayvazyan LP, Mikhailidis DD, Kitas G. Mean platelet volume: a link between thrombosis and inflammation. Curr Pharm Des? 2011;17(1):47-58. doi: 10.2174/138161211795049804.
• Gasparyan AY, Stavropoulos-Kalinoglou A, Toms TE, Douglas KM, Kitas G, Targets AD. Association of mean platelet volume with hypertension in rheumatoid arthritis. Inflamm Allergy Drug Targets. 2010;9(1):45-50. doi: 10.2174/187152810791292854.
• Chu S, Becker R, Berger P, Bhatt D, Eikelboom J, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010;8(1):148-56. doi: 10.1111/j.1538-7836.2009.03584.x.
• Hou Y, Carrim N, Wang Y, Gallant RC, Marshall A, Ni H. Platelets in hemostasis and thrombosis: Novel mechanisms of fibrinogen-independent platelet aggregation and fibronectin-mediated protein wave of hemostasis. J Biomed Res. 2015;29(6):437. doi: 10.7555/JBR.29.20150121.
• Chu H, Chen WL, Huang CC, Chang HY, Kuo HY, Gau CM, et al. Diagnostic performance of mean platelet volume for patients with acute coronary syndrome visiting an emergency department with acute chest pain: the Chinese scenario. Emerg Med J. 2011; 28(7):569-74. doi: 10.1136/emj.2010.093096.
• Azab B, Torbey E, Singh J, Akerman M, Khoueiry G, Mcginn JT, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets. 2011;22(8):557-66. doi: 10.3109/09537104.2011.584086.
• Cho SY, Yang JJ, Suh J-T, Lee W-I, Lee HJ, Park TS. Mean platelet volume/platelet count ratio in anemia. Platelets. 2013;24(3):244-5. doi: 10.3109/09537104.2012.684734.
• Colkesen Y, Muderrisoglu H. medicine l. The role of mean platelet volume in predicting thrombotic events. Clin Chem Lab Med. 2012;50(4):631-4. doi: 10.1515/CCLM.2011.806.
• Thompson CB, Jakubowski JA, Quinn PG, Deykin D, Valeri CR. Platelet size as a determinant of platelet function. J Lab Clin Med. 1983;101(2):205-13.
• Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019;2019(1):9213074. doi: 10.1155/2019/9213074.
• Ranjith M, Divya R, Mehta V, Krishnan M, KamalRaj R, Kavishwar A. Significance of platelet volume indices and platelet count in ischaemic heart disease. J Clin Pathol. 2009;62(9):830-3. doi: 10.1136/jcp.2009.066787.
• Ates S, Oksuz H, Dogu B, Bozkus F, Ucmak H, Yanıt F. Can mean platelet volume and mean platelet volume/platelet count ratio be used as a diagnostic marker for sepsis and systemic inflammato ry response syndrome? Saudi Med J. 2015;36(10):1186. doi: 10.15537/smj.2015.10.10718.
• Kageyama K, Nakajima Y, Shibasaki M, Hashimoto S, Mizobe T. Haemostasis. Increased platelet, leukocyte, and endothelial cell activity are associated with increased coagulability in patients after total knee arthroplasty. J Thromb Haemost. 2007;5(4):738-45. doi: 10.1111/j.1538-7836.2007.02443.x.
• Aliosmanoglu I, Gul M, Oguz A, Basol O, Uslukaya O, Keles C, et al. Can mean platelet volume be a new risk factor in portal venous thrombosis? Clin Appl Thromb Hemost. 2013;19(4):433-6. doi: 10.1177/1076029612464903.
• Butterworth R, Bath PM. The relationship between mean platelet volume, stroke subtype and clinical outcome. Platelets. 1998;9(6):359-64. doi:10.1080/09537109876429.
• Cameron H, Phillips R, Ibbotson R, Carson PH. Platelet size in myocardial infarction. Br Med J (Clin Res Ed). 1983;287(6390):449-51. doi: 10.1136/bmj.287.6390.449.
• Kiliçli-Çamur N, Demirtunç R, Konuralp C, Eskiser A, Başaran Y. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit. 2005;11(8):392.
• Bath P, Algert C, Chapman N, Neal B. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke. 2004;35(3):622-6. doi: 10.1161/01.STR.0000116105.26237.EC.
• Braekkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB. Mean platelet volume is a risk factor for venous thromboembolism: the Tromsø study. J Thromb Haemost. 2010;8(1):157-62. doi: 10.1111/j.1538-7836.2009.03498.x. Çil H, Yavuz C, İslamoğlu Y, Tekbaş EÖ, Demirtaş S, Atılgan ZA, et al. Platelet count and mean platelet volume in patients with in-hospital deep venous thrombosis. Clin Appl Thromb Hemost. 2012;18(6):650-3. doi: 10.1177/1076029611435838.
• Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol. 2002;117(2):399-04. doi: 10.1046/j.1365-2141.2002.03441.x.
• O’malley T, Langhorne P, Elton R, Stewart C. Platelet size in stroke patients. Stroke. 1995;26(6):995-9. doi: 10.1161/01.str.26.6.995.
• Mutlu H, Artış TA, Erden A, Akca Z. thrombosis/hemostasis a. Alteration in mean platelet volume and platicrit values in patients with cancer that developed thrombosis. Clin Appl Thromb Hemost. 2013;19(3):331-3. doi: 10.1177/1076029611433644.
• Icli A, Aksoy F, Turker Y, Uysal BA, Alpay MF, Dogan A, et al. Relationship between mean platelet volume and pulmonary embolism in patients with deep vein thrombosis. Heart Lung Circ. 2015;24(11):1081-6. doi: 10.1016/j.hlc.2015.04.170.
• Gulcan M, Varol E, Etli M, Aksoy F, Kayan M. Mean platelet volume is increased in patients with deep vein thrombosis. Clin Appl Thromb Hemost. 2012;18(4):427-30. doi: 10.1177/1076029611427437.
• Greinacher A, Selleng K. Thrombocytopenia in the intensive care unit patient. Hematology Am Soc Hematol Educ Program. 2010;2010(1):135-43. doi: 10.1182/asheducation-2010.1.135.
• Warkentin TE, Levine MN, Hirsh J, Horsewood P, Roberts RS, Gent M, et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med. 1995;332(20):1330-6. doi: 10.1056/NEJM199505183322003.
• Skeith L, Baumann Kreuziger L, Crowther MA, Warkentin TE. A practical approach to evaluating postoperative thrombocytopenia. Blood Adv. 2020;4(4):776-83.. doi: 10.1182/bloodadvances.2019001414.
• D’erasmo E, Aliberti G, Celi F, Romagnoli E, Vecci E, Mazzuoli GF. Platelet count, mean platelet volume and their relation to prognosis in cerebral infarction. J Intern Med. 1990;227(1):11-4. doi: 10.1111/j.1365-2796.1990.tb00111.x.
• Han JS, Park TS, Cho SY, Joh JH, Ahn HJ. Increased mean platelet volume and mean platelet volume/platelet count ratio in Korean patients with deep vein thrombosis. Platelets. 2013;24(8):590-3. doi: 10.3109/09537104.2012.748187.
• Glud T, Schmidt EB, Kristensen SD, Arnfred T. Platelet number and volume during myocardial infarction in relation to infarct size. Acta Med Scand. 1986;220(5):401-5. doi: 10.1111/j.0954-6820.1986.tb02787.x.
• Fagher B, Sjögren A, Sjögren U. Platelet counts in myocardial infarction, angina pectoris and peripheral artery disease. Acta Med Scand. 1985;217(1):21-6. doi: 10.1111/j.0954-6820.1985.tb01629.x.
• Cho SY, Yang JJ, You E, Kim B-H, Shim J, Lee HJ, et al. Mean platelet volume/platelet count ratio in hepatocellular carcinoma. Plateletes. 2013;24(5):375-7. doi: 10.3109/09537104.2012.701028.
• David Bessman J, Williams LJ, Ridgway Gilmer Jr. Mean platelet volume. The inverse relation of platelet size and count in normal subjects, and an artifact of other particles. Am J Clin Pathol. 1981;76(3):289-93. doi: 10.1093/ajcp/76.3.289.
• Lamparelli R, Baynes RD, Atkinson P, Bezwoda WR, Mendelow BV. Platelet parameters-Part I.-Platelet counts and mean platelet volume in normal pregnant subjects. S Afr Med J. 1988;73(1):36-9.
• Lozano M, Narvaez J, Faundez A, Mazzara R, Cid J, Jou J, et al. Platelet count and mean platelet volume in the Spanish population. Med Clin (Barc). 1998;110(20):774-7.
• Elsayed AM, Mohamed GA. Mean platelet volume and mean platelet volume/platelet count ratio as a risk stratification tool in the assessment of severity of acute ischemic stroke. Alexandria Journal of Medicine. 2017;53(1):67-70. doi: 10.1016/j.ajme.2016.03.003.