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Computer navigation is effective in reducing blood loss but has no effect on transfusion requirement following primary total knee arthroplasty: a meta-analysis

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This meta-analysis was designed to evaluate the effects of computer navigation on blood conservation after total knee arthroplasty (TKA) by comparing postoperative blood loss and need for allogenic blood transfusion in patients undergoing computer navigation and conventional primary TKAs.

Methods

Studies were included in this meta-analysis if they compared change in haemoglobin concentration before and after surgery, postoperative blood loss via drainage or calculated total blood loss, and/or allogenic blood transfusion rate following TKA using computer navigation and conventional methods. For all comparisons, odds ratios and 95 % confidence intervals (CI) were calculated for binary outcomes, while mean difference and 95 % CI were calculated for continuous outcomes.

Results

Twelve studies were included in this meta-analysis. The change in haemoglobin concentration was 0.39 g/dl lower with computer navigation than with conventional TKA (P = 0.006). Blood loss via drainage was 83.1 ml (P = 0.03) lower and calculated blood loss was 185.4 ml (P = 0.002) lower with computer navigation than with conventional TKA. However, the need for blood transfusion was similar for the two approaches (n.s.).

Conclusions

The primary TKA with computer navigation was effective in reducing haemoglobin loss and blood loss, but had no effect on transfusion requirement, compared with conventional primary TKA. These findings suggest the importance of analysing several blood loss parameters, because each may not always accurately reflect true postsurgical bleeding.

Level of evidence

Meta-analysis, Level III.

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Author notes

    Authors and Affiliations

    1. Department of Orthopaedic Surgery, College of Medicine, Anam Hospital, Korea University, Seoul, South Korea

      Seung-Beom Han

    2. Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea

      Hyun-Jung Kim

    3. Department of Orthopaedic Surgery, College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Seongnam, South Korea

      Tae-Kyun Kim

    4. Department of Orthopaedic Surgery, College of Medicine, Seoul St. Mary’s Hospital, Catholic University, Seoul, South Korea

      Yong In & In-Jun Koh

    5. Department of Orthopaedic Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, South Korea

      Kwang-Jun Oh

    6. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, 135-710, South Korea

      Dae-Hee Lee

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    1. Seung-Beom Han
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    Correspondence to Dae-Hee Lee.

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    Seung-Beom Han and Hyun-Jung Kim have contributed equally to the work.

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    Han, SB., Kim, HJ., Kim, TK. et al. Computer navigation is effective in reducing blood loss but has no effect on transfusion requirement following primary total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 24, 3474–3481 (2016). https://doi.org/10.1007/s00167-016-4053-x

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    • DOI: https://doi.org/10.1007/s00167-016-4053-x

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