Abstract
Background
Bleeding during total knee arthroplasty (TKA) can cause significant morbidity and mortality. One proposed benefit of computer assisted TKA is decreased bleeding as the femoral canal is not invaded. This study assessed blood loss between computer assisted surgery (CAS) and conventional TKA.
Materials and Methods
73 consecutive patients (37 males, 36 females) underwent primary TKA between 2006 and 2009. Thirty eight patients underwent navigated TKA and 35 underwent conventional TKA for symptomatic osteoarthritis of the knee. These patients were matched for age, gender, and body mass index (BMI). Average age was 70.3 years (range 47-91 years). Mean BMI was 30 (range 17–49). Average preoperative hemoglobin was 13.26 g/dL (range 8.7–18.4 g/dL) in the navigated group and 13.47 g/dL (range 9.6–15.8 g/dL) in the conventional group (P = 0.9). Average tourniquet time was 110 min (range 90-150 min) in the navigated group and 96.7 min (range 60–145 min) in the conventional group (P = 0.77).
Results
Average postoperative hemoglobin in the navigated group was 10.34 g/dL (range 7.5-14.8 g/dL) and in the conventional group was 10.03 g/dL (range 7.5–12.2 g/dL) (P = 0.17). Six patients in both groups required blood transfusions. The mean drain collection was 599 mL (range 150–1370 mL) in the navigated group and 562 mL (range 750–1000 mL) in the conventional group (P = 0.1724). These results suggest that there is no significant reduction in blood loss in CAS TKA.
Conclusion
These results suggest that there is no significant difference in blood loss in CAS TKA and conventional TKA. This study also highlights the heterogeneity of methods used in studies related to CAS TKA. We believe that there is a need for a large multicenter prospective randomized controlled trial to be performed before a consensus can be reached on the influence of CAS techniques on blood loss during primary TKA.
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References
Available from: http://www.njrcentre.org.uk and tabid=86 and mid=523. [Last accessed on 25/4/201]
Kumar N, Saleh J, Gardiner E, Davadoss VG, Howell FR. Plugging the intramedullary canal of the femur in total knee arthroplasty: Reduction in postoperative blood loss. J Arthroplasty 2000;15:947–9.
Sutherland CJ, Schurman JR. Complications associated with warfarin prophylaxis in total knee arthroplasty. Clin Orthop 1987;219:158–62.
Chauhan SK, Clark GW, Lloyd S, Scott RG, Breidahl W, Sikorskiet JM. Computer-assisted total knee replacement: A controlled cadaver study using a multi-parameter quantitative CT assessment of alignment (the Perth CT protocol). J Bone Joint Surg 2004;86:818–23.
Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB. An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am 1999;81:2–10.
Keating EM, Meding JB, Faris PM, Ritter MA. Predictors of transfusion risk in elective knee surgery. Clin Orthop Relat Res 1998;357:50–9.
Borghi B, Casati A. Incidence and risk factors for allogenic blood transfusion during major joint replacement using an integrated autotransfusion regimen. The Rizzoli Study Group on Orthopaedic Anaesthesia. Eur J Anaesthesiol 2000;17:411–7.
Vandenbussche E, Duranthon LD, Couturier M, Podhorz L, Augereau B. The effect of tourniquet use in total knee arthroplasty. Int Orthop 2002;26:306–9.
Gasparini G, Papaleo P, Pola P, Cerciello S, Pola E, Fabbriciani C. Local infusion of norepinephrine reduces blood losses and need of transfusion in total knee arthroplasty. Int Orthop 2006;30:253–6.
Tria AJ Jr, Coon TM. Minimal incision total knee arthroplasty: Early experience. Clin Orthop Relat Res 2003;416:185–90.
Samama CM. A direct antifibrinolytic agent in major orthopaedic surgery. Orthopedics 2004;27: s675–80.
Cheung KW, Chiu KH. Effect of drain pressure in total knee arthroplasty. J Orthop Surg 2006;14:163–6.
Stucinskas J, Tarasevicius S, Cebatorius A, Robertsson O, Smailys A, Wingstrand H. Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: A prospective, randomised trial. Int Orthop 2009;33:1275–8.
Kalairajah Y, Simpson D, Cossey AJ, Verrall GM, Spriggins AJ. Blood loss after total knee replacement: Effects of computer-assisted surgery. J Bone Joint Surg Br 2005;87:1480–2.
Conteduca F, Massai R, Iorio R, Sansotto E, Luzon D, Ferretti A. Blood loss in computer-assisted mobile bearing total knee arthroplasty. A comparison of computer-assisted surgery with a conventional technique. Int Orthop 2009;33:1609–13.
Lotke PA, Faralli VJ, Orenstein EM, Ecker ML. Blood loss after total knee replacement: Effects of tourniquet release and continuous passive motion. J Bone Joint Surg Am 1991;73:1037–40.
Sehat KR, Evans RL, Newman JH. Hidden blood loss following hip and knee arthroplasty: Correct management of blood loss should be taken hidden loss into account. J Bone Joint Surg Br 2004;86:561–5.
Chang CW, Wu PT, Yang CY. Blood loss after minimally invasive total knee arthroplasty: Effects of imageless navigation. Kaohsiung J Med Sci 2010;26:237–43.
Desai AS, Dramis A, Kendoff D, Board TN. Critical review of the current practice for computer-assisted navigation in total knee replacement surgery: Cost-effectiveness and clinical outcome. Curr Rev Musculoskelet Med 2011;4:11–5.
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Mohanlal, P.K., Sandiford, N., Skinner, J.A. et al. Comparision of blood loss between computer assisted and conventional total knee arthroplasty. IJOO 47, 63–66 (2013). https://doi.org/10.4103/0019-5413.106906
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DOI: https://doi.org/10.4103/0019-5413.106906