Archives of Orthopaedic and Trauma Surgery

, Volume 135, Issue 6, pp 867–870 | Cite as

Bleeding in TKA: posterior stabilized vs. cruciate retaining

  • Aline Mähringer-Kunz
  • Turgay Efe
  • Susanne Fuchs-Winkelmann
  • Karl F. Schüttler
  • Jürgen R. Paletta
  • Thomas J. HeyseEmail author
Knee Arthroplasty



Posterior-stabilized (PS) and cruciate-retaining (CR) total knee arthroplasties (TKA) are both successfully used for treatment of end-stage osteoarthritis. The choice of constraint depends on knee deformity and stability as well as most importantly surgeon preference. The aim of this study was to compare the amount of blood loss and required transfusions following TKA with the two different designs.

Materials and methods

In a retrospective approach, 473 patients undergoing TKA were included (240 CR and 233 PS from a single manufacturer). Demographics at base line were comparable between both groups. Blood loss [red blood cell (RBC) loss] was calculated after documentation of pre- and postoperative hematocrit levels at discharge. Transfusion requirements were recorded. Statistical analysis was done using Mann–Whitney U test.


The calculated blood loss (RBC loss) at discharge was 548 ± 216 ml in the PS group compared with 502 ± 186 ml in the CR group (p = 0.032). There were no differences in the transfusion requirements between both groups (PS 0.41 vs. CR 0.37, p = 0.39).


The blood loss was significantly higher in the PS group. This may be due to the box preparation that exposes more cancellous femoral bone, which may add to postoperative bleeding. The differences remain, however, small, as they did not lead to a significantly higher transfusion rate with PS TKA.


Total knee arthroplasty Blood loss Posterior stabilized Cruciate retaining 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Aline Mähringer-Kunz
    • 1
  • Turgay Efe
    • 2
  • Susanne Fuchs-Winkelmann
    • 2
  • Karl F. Schüttler
    • 2
  • Jürgen R. Paletta
    • 2
  • Thomas J. Heyse
    • 2
    Email author
  1. 1.Department of Diagnostic and Interventional RadiologyUniversity Hospital MainzMainzGermany
  2. 2.Department of Orthopedics and RheumatologyUniversity Hospital MarburgMarburgGermany

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