Khanasuk Yutthana, Ngarmukos Srihatach, Tanavalee Aree
Department of Orthopedics, Queen Savang Vadhana Memorial Hospital, 290 Jermjomphon Road, Sri-Racha, Chonburi, 20110, Thailand.
Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
Knee Surg Relat Res. 2022 Jun 28;34(1):31. doi: 10.1186/s43019-022-00160-4.
The benefit of the femoral canal bone plug during total knee arthroplasty (TKA) in reducing blood loss has never been proven. The aim of this meta-analysis was to determine whether the femoral canal bone plug significantly reduces blood loss in primary TKA.
All studies published before December 2021 were searched. The inclusion criteria were randomized controlled trials comparing blood loss between TKA with plugged and unplugged femoral intramedullary canal, respectively. The primary outcome was postoperative hemoglobin reduction.
Five studies with a total of 717 patients (361 in the plugged group, 356 in the unplugged group) met the criteria for inclusion in the meta-analysis. The mean difference in hemoglobin level between the two groups was 0.92 g/dL, with significantly less hemoglobin reduction in the plugged group (95% confidence interval [CI] - 1.64 to - 0.21, p = 0.01). The patients in the plugged group also had a significantly lower risk of receiving a blood transfusion (risk ratio 0.58, 95% CI 0.47-0.73, p < 0.00001).
This meta-analysis demonstrates that using a femoral canal bone plug can significantly reduce blood loss and lower the risk ratio of blood transfusion in patients undergoing TKA.
全膝关节置换术（TKA）中股骨骨髓腔骨栓在减少失血方面的益处尚未得到证实。本荟萃分析的目的是确定股骨骨髓腔骨栓是否能显著减少初次全膝关节置换术的失血量。
检索2021年12月之前发表的所有研究。纳入标准为分别比较股骨骨髓腔堵塞和未堵塞的全膝关节置换术之间失血量的随机对照试验。主要结局是术后血红蛋白降低。
五项研究共717例患者（堵塞组361例，未堵塞组356例）符合纳入荟萃分析的标准。两组之间血红蛋白水平的平均差异为0.92g/dL，堵塞组血红蛋白降低明显较少（95%置信区间[CI] -1.64至-0.21，p = 0.01）。堵塞组患者接受输血的风险也显著较低（风险比0.58，95%CI 0.47 - 0.73，p < 0.00001）。
本荟萃分析表明，使用股骨骨髓腔骨栓可显著减少全膝关节置换术患者的失血量，并降低输血风险比。
