Li Xu, Qi Xiang-Bei, Han Xue, Wang Wei, Liu Jian-Ning, Guo Ji-Chao, Li Zhi-Yong
Department of Orthopedics, The Third Hospital of Hebei Medical University Hebei Sport Science Institute, Shijiazhuang, Hebei Province, People's Republic of China.
Medicine (Baltimore). 2017 Jul;96(29):e7388. doi: 10.1097/MD.0000000000007388.
This study investigates the clinical effects of sealing the femoral canal by intramedullary alignment instrumentation in total knee arthroplasty (TKA).
One hundred twenty consecutive patients with knee osteoarthritis, who underwent unilateral TKA, were enrolled in the study and equally randomized into 2 groups: the sealing group and the control group. In the sealing group, the femoral canal was sealed with autogenous bone and cement using intramedullary alignment instrumentation, while the femoral hole was left open for patients in the control group. Blood loss, hemoglobin (Hb) reduction, and other parameters were recorded, as well as the duration of hospital stay and complications. The Hospital for Special Surgery (HSS) knee score was used to assess knee function at the final follow-up appointment.
The calculated blood loss, hidden blood loss, transfusion requirements, drainage volume, and Hb reduction measurements were significantly different (P < .05) between the 2 groups. There were no significant differences in the surgery time, intraoperative blood loss, length of hospital stay, HSS score or complications between the 2 groups (P > .05).
Sealing the intramedullary canal with autologous bone and a cement plug is an effective method for reducing blood loss and decreasing blood transfusion requirements during TKA procedures that have increasing complication rates.
本研究探讨全膝关节置换术（TKA）中通过髓内定位器械封闭股骨髓腔的临床效果。
连续纳入120例接受单侧TKA的膝骨关节炎患者，将其随机分为两组：封闭组和对照组。封闭组使用髓内定位器械用自体骨和骨水泥封闭股骨髓腔，而对照组患者的股骨髓腔保持开放。记录失血量、血红蛋白（Hb）降低情况及其他参数，以及住院时间和并发症。在最后一次随访时使用特殊外科医院（HSS）膝关节评分评估膝关节功能。
两组间计算得出的失血量、隐性失血量、输血需求、引流量和Hb降低量测量值有显著差异（P<0.05）。两组间手术时间、术中失血量、住院时间、HSS评分或并发症无显著差异（P>0.05）。
在并发症发生率不断增加的TKA手术中，用自体骨和骨水泥塞封闭髓腔是减少失血量和降低输血需求的有效方法。
