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Use of patient-specific cutting blocks reduces blood loss after total knee arthroplasty

  • Original Article • KNEE - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Total knee arthroplasty (TKA) is associated with substantial blood loss. Sources of bleeding are the femoral and tibial intramedullary canals, which are violated during implantation using standard instrumentation. Patient-specific instrumentation (PSI) and computer-assisted surgery (CAS) do not require violation of the intramedullary canals. Therefore, we sought to assess the impact of these methods on blood loss and transfusion requirement. A retrospective cohort study was conducted in a series of 107 consecutive primary TKAs. The first group (n = 32) was operated with standard instrumentation, the second group (n = 35) with CAS and the third group (n = 40) with PSI. A tourniquet was used in all cases. Mean (standard deviation) calculated total blood loss was 442 (160), 750 (271) and 700 (401) ml for the PSI, CAS and standard instrumentation groups, respectively (p < 0.001), with no significant differences between CAS and standard instrumentation (p = 0.799). Significant differences were found in terms of transfusion requirements, with 12.5, 42.9 and 21.8% of the patients requiring transfusion (p = 0.010). Post hoc analysis revealed that only the difference between PSI and CAS were statistically significant (p = 0.003). In conclusion, PSI reduces blood loss when compared to both CAS and standard instrumentation TKA performed with the use of a tourniquet.

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Authors and Affiliations

  1. Servicio de Cirugía Ortopédica y Traumatología (Unidad de Cirugía de Rodilla), Hospital de la Vega Lorenzo Guirao, Cieza, Murcia, Spain

    Vicente J. León & Alonso J. Lisón

  2. Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de la Vega Lorenzo Guirao, Cieza, Murcia, Spain

    María A. Lengua

  3. Equipo Específico de Enfermería Quirúrgica para Cirugía Ortopédica y Traumatología, Hospital de la Vega Lorenzo Guirao, Cieza, Murcia, Spain

    Víctor Calvo

  4. C/La Ermita, número 4, 2ºD, Guadalupe de Maciascoque, 30107, Murcia, Spain

    Vicente J. León

Authors
  1. Vicente J. León
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  2. María A. Lengua
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  3. Víctor Calvo
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  4. Alonso J. Lisón
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Correspondence to Vicente J. León.

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The study complies with the current laws of the country in which it was performed.

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All authors have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cite this article

León, V.J., Lengua, M.A., Calvo, V. et al. Use of patient-specific cutting blocks reduces blood loss after total knee arthroplasty. Eur J Orthop Surg Traumatol 27, 273–277 (2017). https://doi.org/10.1007/s00590-016-1893-5

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  • DOI: https://doi.org/10.1007/s00590-016-1893-5

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