Singla Amit, Malhotra Rajesh, Kumar Vijay, Lekha Chandra, Karthikeyan G, Malik Vishwas
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India.
Clin Orthop Surg. 2015 Jun;7(2):211-6. doi: 10.4055/cios.2015.7.2.211. Epub 2015 May 18.
Total knee arthroplasty (TKA) is associated with considerable blood loss. Computer-assisted surgery (CAS) is different from conventional TKA as it avoids opening the intramedullary canal. Hence, CAS should be associated with less blood loss.
Fifty-seven patients were randomized into two groups of CAS and conventional TKA. In conventional group intramedullary femoral and extramedullary tibial jigs were used whereas in CAS group imageless navigation system was used. All surgeries were done under tourniquet. Total and hidden blood loss was calculated in both groups and compared.
The mean total blood loss was 980 mL in conventional group and 970 mL in CAS group with median of 1,067 mL (range, 59 to 1,791 mL) in conventional group and 863 mL (range, 111 to 2,032 mL) in CAS group. There was no significant difference in total blood loss between the two groups (p = 0.811). We have found significant hidden blood loss in both techniques, which is 54.8% of the total loss in the conventional technique and 59.5% in the computer-assisted navigation technique.
There is no significant difference in total and hidden blood loss in the TKA in CAS and conventional TKA. However, there is significant hidden blood loss in both techniques. There was no relation of tourniquet time with blood loss.
全膝关节置换术（TKA）会导致大量失血。计算机辅助手术（CAS）与传统TKA不同，因为它避免打开髓腔。因此，CAS导致的失血应该更少。
57例患者被随机分为CAS组和传统TKA组。传统组使用髓内股骨和髓外胫骨夹具，而CAS组使用无图像导航系统。所有手术均在止血带下进行。计算两组的总失血量和隐性失血量并进行比较。
传统组平均总失血量为980 mL，CAS组为970 mL，传统组中位数为1067 mL（范围59至1791 mL），CAS组为863 mL（范围111至2032 mL）。两组总失血量无显著差异（p = 0.811）。我们发现在两种技术中均存在显著的隐性失血，传统技术中隐性失血占总失血量的54.8%，计算机辅助导航技术中为59.5%。
CAS和传统TKA在TKA中的总失血量和隐性失血量无显著差异。然而，两种技术中均存在显著的隐性失血。止血带时间与失血量无关。
