Ajwani Sanil H, Jones Morgan, Jarratt Jeremy W, Shepard Gordon J, Ryan William G
Institution- Royal Bolton NHS Foundation Trust, Minerva Road, Bolton, Lancashire BL4 0JR, United Kingdom.
Knee. 2012 Oct;19(5):606-10. doi: 10.1016/j.knee.2011.11.006. Epub 2011 Dec 23.
AIMS AND INTRODUCTION: The aim of this study was to assess whether navigated total knee arthroplasty (TKA) reduces peri-operative blood loss and post-operative length of stay when compared to conventional total knee arthroplasty techniques.
A retrospective case-note review of 143 patients undergoing primary elective total knee arthroplasty was carried out. Two surgeons in this institution perform conventional knee arthroplasty using intramedullary alignment with another two surgeons using the computer assisted technique. Blood losses were calculated using the Meunier et al. (2008) [23] method for calculation of peri-operative blood loss. This is based on changes in peri-operative blood indices compared to the patient's theoretical total blood volume which is calculated using the patient's pre-operative height and weight. Tourniquet time and post-operative length of stay for the two techniques of arthroplasty were also recorded.
Sixty eight patients underwent conventional TKA and 75 patients had navigated TKA's performed. This data showed no significant difference in blood loss (p=0.56) or post-operative length of stay (p=0.36). A significant difference in tourniquet time between the two techniques was demonstrated (p=0.01).
In this study there was no significant reduction in post-operative length of stay and peri-operative blood loss when using computer-assisted techniques. There was an increase in tourniquet time with the computer-assisted technique that may have implications upon work productivity for primary cemented knee arthroplasty.
目的与引言:本研究的目的是评估与传统全膝关节置换术(TKA)技术相比,导航全膝关节置换术是否能减少围手术期失血和术后住院时间。
对143例行初次择期全膝关节置换术的患者进行回顾性病例记录审查。该机构的两名外科医生采用髓内对线法进行传统膝关节置换术,另外两名外科医生采用计算机辅助技术。使用Meunier等人(2008年)[23]计算围手术期失血的方法来计算失血量。这是基于围手术期血液指标相对于患者理论总血容量的变化,而患者理论总血容量是根据患者术前身高和体重计算得出的。还记录了两种置换术的止血带使用时间和术后住院时间。
68例患者接受了传统TKA,75例患者接受了导航TKA。该数据显示在失血量(p = 0.56)或术后住院时间(p = 0.36)方面无显著差异。两种技术在止血带使用时间上存在显著差异(p = 0.01)。
在本研究中,使用计算机辅助技术时,术后住院时间和围手术期失血没有显著减少。计算机辅助技术导致止血带使用时间增加,这可能对初次骨水泥型膝关节置换术的工作效率产生影响。