Background: Platelet activation promotes blood clot formation meanwhile alpha granules secretion stimulates repair process during surgery. β-thromboglobulin (β-TG) released from alpha-granules can be used as a marker of platelet activation.

Aims: To study β-TG levels and its correlation with platelets number and blood clot formation parameters after total hip replacement (THR).

Methods: The study included 54 patients (59.2 ± 10.4 years (mean±SD); 20 men) underwent THR. Concentration of β-TG, D-dimer, platelets number and thromboelastography parameters (R, Ang, MA, CI) were determined. Blood samples were taken 1 day before surgery, 30 minutes, 1, 3, 7, 14 days after surgery. Statistical analysis was performed using nonparametric criteria (Friedman ANOVA, Wilcoxon matched pairs test, Spearman rank order correlations). Study was approved by the local ethics committee, informed consent was obtained from all patients included in the study.

Results: At the end of the operation, β-TG concentration in blood increased to maximum and after that decrease gradually. (Figure 1). β-TG concentration in blood remained increased relative to the preoperative level on 7 and 14 days after the operation (Figure 1). Dynamics of platelets number differed from β-TG dynamics in postoperative period (Figure 2). Analysis did not reveal significant correlation between platelet number and β-G concentration in blood throughout the study period. Significant correlation was found between maximum concentration of β-G in blood and D-dimer level (ρ=0.49, p< 0.05), as well as between β-TG and thromboelastogram parameters: R, Ang and CI (ρ=-0.46; ρ=0.39; ρ=0.45 respectively; p< 0.05 for all).

Conclusions: Blood clot as primary matrix for tissue repair has a significant correlation with alpha granules secretion level in the early postoperative period. Increased β-G level in blood persists for at least 2 weeks after surgery. The duration of alpha granule secretion increased level after THR seem to be important for successful reparative regeneration.

[β-TG in the blood before and after hip replacement. Friedman ANOVA p<0.001; *-differences with the preoperative level are significant, p<0.05]

[Platelets in the blood before and after hip replacement. Friedman ANOVA p<0.001; * - differences with the preoperative level are significant, p <0.05]

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/platelet-alpha-granule-secretion-in-total-hip-replacement/