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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 11, 1480-1482.
doi: 10.1302/0301-620X.87B11.16474  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Blood loss after total knee replacement

EFFECTS OF COMPUTER-ASSISTED SURGERY

Y. Kalairajah, MA, MPhil, FRCS(Tr & Orth), Orthopaedic Arthroplasty and Sports Surgery Fellow1; D. Simpson, FRCS(Tr & Orth), Orthopaedic Arthroplasty and Sports Surgery Fellow1; A. J. Cossey, FRCS(Tr & Orth), Orthopaedic Arthroplasty and Sports Surgery Fellow1; G. M. Verrall, MBBS, Sports Physician1; and A. J. Spriggins, MS, FRCS, FRACS, FAOrthA, Consultant Orthopaedic Surgeon1

1 Sportsmed SA, 32 Payneham Road, Stepney, Adelaide 5069, South Australia.

Correspondence should be sent to Mr Y. Kalairajah; e-mail: yega{at}orthospecialist.net

We carried out a prospective randomised study to evaluate the blood loss in 60 patients having a total knee arthroplasty and divided randomly into two equal groups, one having a computer-assisted procedure and the other a standard operation. The surgery was carried out by a single surgeon at one institution using a uniform approach. The only variable in the groups was the use of intramedullary femoral and tibial alignment jigs in the standard group and single tracker pins of the imageless navigation system in the tibia and femur in the navigated group.

The mean drainage of blood was 1351 ml (715 to 2890; 95% confidence interval (CI) 1183 to 1518) in the computer-aided group and 1747 ml (1100 to 3030; CI 1581 to 1912) in the conventional group. This difference was statistically significant (p = 0.001). The mean calculated loss of haemoglobin was 36 g/dl in the navigated group versus 53 g/dl in the conventional group; this was significant at p < 0.00001.

There was a highly significant reduction in blood drainage and the calculated Hb loss between the computer-assisted and the conventional techniques. This allows the ordering of less blood before the operation, reduces risks at transfusion and gives financial saving. Computer-assisted surgery may also be useful for patients in whom blood products are not acceptable.




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eLetters:

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Blood loss after total knee replacement: effects of computer-assisted surgery
Winston Y Kim
J Bone Joint Surg Br Online, 17 Nov 2005 [Full text]
Blood loss after total knee replacement: effects of computer-assisted surgery
Shashank D Chitgopkar, et al.
J Bone Joint Surg Br Online, 17 Feb 2006 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General