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Impact of intra- and extramedullary alignment on blood loss in total knee arthroplasty: a retrospective study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

There is a scarcity of scientific data regarding the correlation between alignment techniques during total knee arthroplasty (TKA) and blood loss as well as transfusion rates. This study's hypothesis posited that intramedullary-aligned (IM) TKA exhibits higher blood loss and transfusion rates when contrasted with extramedullary-aligned (EM) TKA.

Methods

We conducted a retrospective examination of 883 patients who underwent total knee arthroplasty (TKA) in 2021 at a solitary orthopedic center in Germany. These patients were divided into two groups based on their tibial alignment technique: extramedullary alignment and intramedullary tibial alignment.

Results

In the intramedullary tibial alignment (IM) group, we observed a blood loss of 0.91 L, while in the extramedullary tibial alignment (EM) group, the blood loss was 0.89 L. These values did not demonstrate a significant difference (p = 0.69). Transfusion rates were 0.99% in the IM group and 0.21% in the EM group, and there was no significant distinction between them (Chi-squared test: p > 0.05).

Conclusion

We observed no statistically significant variance in blood loss between the IM and EM groups. Likewise, there was no substantial disparity in transfusion rates between these groups. It can be concluded that the selection of a knee arthroplasty system incorporating either intramedullary tibial alignment or extramedullary alignment does not significantly impact blood loss.

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Data availability

Data available on request.

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Funding

No funding was received for the present study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Sana Kliniken Sommerfeld, Waldhausstr. 44, 16766, Kremmen, Germany

    Nils Meißner, Andreas M. Halder, Alexander Preis, Jonas P. Sina & Daniel Schrednitzki

  2. Department of Orthopaedics, Carl-Thiem-Klinikum Cottbus, Thiemstraße 111, 03046, Cottbus, Germany

    Alexander Frenzel

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  1. Nils Meißner
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Correspondence to Nils Meißner.

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Conflict of interest

Andreas Halder and Daniel Schrednitzki declare royalties from ZimmerBiomet. They declare paid presentations for ZimmerBiomet. The other Authors declare no conflict of interest related to the present study.

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No IRB approval was necessary for this study, as this study presents the collection, analysis and publication of retrospectively obtained and anonymized data. No sensible data was presented in this study.

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All patients signed an informed consent for the surgical procedure.

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Meißner, N., Frenzel, A., Halder, A.M. et al. Impact of intra- and extramedullary alignment on blood loss in total knee arthroplasty: a retrospective study. Arch Orthop Trauma Surg 144, 1901–1905 (2024). https://doi.org/10.1007/s00402-024-05232-6

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  • DOI: https://doi.org/10.1007/s00402-024-05232-6

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