Efficacy of Extramedullary Femoral Component Alignment Guide System for Blood Saving after Total Knee Arthroplasty
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Purpose: To compare the extramedullary femoral alignment guide system with the conventional intramedullary alignment guide system for bleeding and transfusion rate after total knee arthroplasty (TKA). Materials and Methods: Forty-nine female TKA patients were randomized into two groups: intramedullary (IM) group vs. extramedullary (EM) group. Drained volume of blood, hemoglobin concentration, hemoglobin drop, and transfusion rate were compared between the two groups. Wound problems, bleeding-related problems and thromboembolic complications were collected. Results: The mean drained volume via vacuum drainage was less in the EM group than that in the IM group (482.9 mL vs. 266.8 mL, p=0.001). Hemoglobin at 5 days after surgery was higher in the EM group (9.3 g/dL vs. 9.9 g/dL, p=0.002) than that in the IM group. The drop in hemoglobin after 5 days was smaller in the EM group (3.5 g/dL vs. 2.9 g/dL, p=0.003) than that in the IM group. The EM group had a lower prevalence of allogeneic transfusion (45.0% vs. 20.5%, p=0.026) than that in the IM group. No significant complications developed in either group. Conclusions: The results suggest that the extramedullary femoral alignment guide technique is an advantageous method that can reduce the drained volume of blood and the allogeneic transfusion rate.
Abstract
Purpose: To compare the extramedullary femoral alignment guide system with the conventional intramedullary alignment guide system for bleeding and transfusion rate after total knee arthroplasty (TKA). Materials and Methods: Forty-nine female TKA patients were randomized into two groups: intramedullary (IM) group vs. extramedullary (EM) group. Drained volume of blood, hemoglobin concentration, hemoglobin drop, and transfusion rate were compared between the two groups. Wound problems, bleeding-related problems and thromboembolic complications were collected. Results: The mean drained volume via vacuum drainage was less in the EM group than that in the IM group (482.9 mL vs. 266.8 mL, p=0.001). Hemoglobin at 5 days after surgery was higher in the EM group (9.3 g/dL vs. 9.9 g/dL, p=0.002) than that in the IM group. The drop in hemoglobin after 5 days was smaller in the EM group (3.5 g/dL vs. 2.9 g/dL, p=0.003) than that in the IM group. The EM group had a lower prevalence of allogeneic transfusion (45.0% vs. 20.5%, p=0.026) than that in the IM group. No significant complications developed in either group. Conclusions: The results suggest that the extramedullary femoral alignment guide technique is an advantageous method that can reduce the drained volume of blood and the allogeneic transfusion rate.
참고문헌 (30)
- Curran JW, "Acquired immunodeficiency syndrome (AIDS) associated with transfusions", N Engl J Med, 310, pp.69~75 (1984)
- Conrad ME, "Diseases transmissible by blood transfusion : viral hepatitis and other infectious disorders", Semin Hematol, 18, pp.122~146 (1981)
- Bottner F, "Blood management after bilateral total knee arthroplasty", Clin Orthop Relat Res, (410), pp.254~261 (2003)
- Kourtzis N, "Blood saving protocol in elective total knee arthroplasty", Am J Surg, 187, pp.261~267 (2004)
- Couvret C, "A restrictive use of both autologous donation and recombinant human erythropoietin is an efficient policy for primary total hip or knee arthroplasty", Anesth Analg, 99, pp.262~271 (2004)
- Seo ES, "Subcutaneous versus intraarticular indwelling closed suction drainage after TKA: a randomized controlled trial", Clin Orthop Relat Res, 468, pp.2168~2176 (2010)
- Yamada K, "Comparison between 1-hour and 24-hour drain clamping using diluted epinephrine solution after total knee arthroplasty", J Arthroplasty, 16, pp.458~462 (2001)
- Tenholder M, "Intraoperative blood management in joint replacement surgery", Orthopedics, 27, pp.s663~s668 (2004)
- Jonsson B, "Alignment and long-term clinical results of a semiconstrained knee prosthesis", Clin Orthop Relat Res, (226), pp.124~128 (1988)
- Ritter MA, "Postoperative alignment of total knee replacement. Its effect on survival", Clin Orthop Relat Res, (299), pp.153~156 (1994)
- Tew M, "Tibiofemoral alignment and the results of knee replacement", J Bone Joint Surg Br, 67, pp.551~556 (1985)
- Fahmy NR, "Blood-gas and circulatory changes during total knee replacement. Role of the intramedullary alignment rod", J Bone Joint Surg Am, 72, pp.19~26 (1990)
- Ishii Y, "Extramedullary versus intramedullary alignment guides in total knee arthroplasty", Clin Orthop Relat Res, (318), pp.167~175 (1995)
- Kandel L, "Extramedullary femoral alignment instrumentation reduces blood loss after uncemented total knee arthroplasty", J Knee Surg, 19, pp.256~258 (2006)
- Kalairajah Y, "Blood loss after total knee replacement: effects of computer-assisted surgery", J Bone Joint Surg Br, 87, pp.1480~1482 (2005)
- Seo JG, "A comparison of extramedullary and intramedullary femoral component alignment guide systems in TKA", J Korean Knee Soc, 18, pp.47~54 (2006)
- Berman AT, "Blood loss with total knee arthroplasty", Clin Orthop Relat Res, pp.137~138 (1988)
- de Haan J, "Retransfusion of suctioned blood during cardiopulmonary bypass impairs hemostasis", Ann Thorac Surg, 59, pp.901~907 (1995)
- Semkiw LB, "Postoperative blood salvage using the Cell Saver after total joint arthroplasty", J Bone Joint Surg Am, 71, pp.823~827 (1989)
- Marmor L, "Effect of fibrinogen concentrates on blood loss in total knee arthroplasty", Clin Orthop Relat Res, (273), pp.136~138 (1991)
- Healy WL, "Evaluation of autologous shed blood for autotransfusion after orthopaedic surgery", Clin Orthop Relat Res, (299), pp.53~59 (1994)
- Cushner FD, "Blood loss in total knee arthroplasty", Clin Orthop Relat Res, (269), pp.98~101
- Levy AS, "The role of cold compression dressings in the postoperative treatment of total knee arthroplasty", Clin Orthop Relat Res, (297), pp.174~178 (1993)
- Chauhan SK, "Computer-assisted knee arthroplasty versus a conventional jig-based technique. A randomised, prospective trial", J Bone Joint Surg Br, 86, pp.372~377 (2004)
- Dutton AQ, "Computer-assisted minimally invasive total knee arthroplasty compared with standard total knee arthroplasty. A prospective, randomized study", J Bone Joint Surg Am, 90, pp.2~9 (2008)
- Yoo JH, "Intramedullary and extramedullary combined alignment system for tibial component placement in total knee arthroplasty", J Korean Knee Soc, 16, pp.118~124 (2004)
- Bathis H, "Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique", J Bone Joint Surg Br, 86, pp.682~687 (2004)
- Saragaglia D, "Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomized study", Rev Chir Orthop Reparatrice Appar Mot, 87, pp.18~28 (2001)
- 선종근, "네비게이션 시스템을 이용한 인공 슬관절 전치환술의 하지 정열의 정확도", 대한정형외과학회지, 39(6), pp.566~571 (2004), 대한정형외과학회
- Sparmann M, "Positioning of total knee arthroplasty with and without navigation support. A prospective, randomised study", J Bone Joint Surg Br, 85, pp.830~835 (2003)
