Yuenyongviwat Varah, Tuntarattanapong Pakjai, Iamthanaporn Khanin, Hongnaparak Theerawit, Tangtrakulwanich Boonsin
Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
J Orthop Surg Res. 2019 Apr 8;14(1):96. doi: 10.1186/s13018-019-1141-x.
An intramedullary guide is an instrument that surgeons use to align the distal femoral cut. The opening may become a channel that drains intramedullary blood to the knee joint after surgery if left open during surgery. The authors aimed to evaluate the effects of an intramedullary bone plug with respect to postoperative blood loss from a meta-analysis.
The authors performed a systematic review and meta-analysis to compare a sealed opening using an intramedullary bone plug with no bone plug. PubMed, Ovid, Embase, and Cochrane Library were used to identify all publications before May 2018. All of the included studies were evaluated for bias and heterogeneity.
Six hundred and thirty-six patients from four randomized controlled trials were included in this meta-analysis. The pooled results demonstrated that patients with intramedullary plug had lower rates of blood transfusion and lower level of reduced postoperative hemoglobin than patients in whom the intramedullary canal was not plugged.
This meta-analysis demonstrated the benefit of intramedullary sealing with a bone plug in total knee arthroplasty with respect to decreased postoperative blood loss.
髓内导向器是外科医生用于使股骨远端截骨对齐的器械。如果在手术过程中开口保持开放，术后它可能会成为一条将髓内血液引流至膝关节的通道。作者旨在通过荟萃分析评估髓内骨栓对术后失血的影响。
作者进行了一项系统评价和荟萃分析，以比较使用髓内骨栓封闭开口与不使用骨栓的情况。利用PubMed、Ovid、Embase和Cochrane图书馆检索2018年5月之前的所有出版物。对所有纳入研究进行偏倚和异质性评估。
本荟萃分析纳入了来自四项随机对照试验的636例患者。汇总结果表明，与未封堵髓内通道的患者相比，使用髓内骨栓的患者输血率更低，术后血红蛋白降低水平更低。
这项荟萃分析表明，在全膝关节置换术中使用骨栓进行髓内封闭对减少术后失血有益。
