ArticleBMC surgery2026
Risk factors for postoperative ecchymosis after medial open-wedge high tibial osteotomy: an exploratory analysis of thromboelastography parameters.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aims to identify risk factors for ecchymosis and its associated coagulation characteristics following medial open-wedge high tibial osteotomy (OWHTO) using thromboelastography (TEG).
methodsThis single-center retrospective study included 220 consecutive patients undergoing unilateral medial OWHTO between January 2023 and September 2025. All patients received rivaroxaban 10 mg orally once daily for 14 days, commencing 12 h postoperatively. The primary endpoint was the incidence of peri-incisional ecchymosis, assessed daily during the hospital stay (postoperative days 1-4). Patients were categorized into ecchymosis (n = 74) and no-ecchymosis groups. Pre-operative and post-operative day-4 TEG parameters, blood loss volumes, and baseline characteristics were analyzed. Multivariable logistic regression (variables selected based on clinical relevance and univariate P < 0.10) determined independent factors, while group discrimination was assessed descriptively using AUC.
resultsEcchymosis occurred in 33.6% (74/220) of patients. The ecchymosis group demonstrated higher BMI (mean difference 1.57 kg/m
conclusionsThis exploratory single-center retrospective analysis identified BMI, tourniquet time, and impaired perioperative recovery of the coagulation index as independently associated with ecchymosis following medial OWHTO. These findings detail a post-event coagulation status in patients developing ecchymosis under consistent perioperative anticoagulation; however, they do not support temporal or predictive inferences and remain hypothesis-generating. Prospective multicenter validation is necessary before any clinical utility can be inferred.
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