Cao Jian, Liao Kai, Li Ze-Xi, Wang Duan, Chen Jia-Li, Wang Hao-Yang, Zhou Zong-Ke
Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.
Department of Radiology, West China Hospital, West China Hospital, Sichuan University, Chengdu, China.
Front Surg. 2023 Jan 4;9:1079120. doi: 10.3389/fsurg.2022.1079120. eCollection 2022.
Whether cementless fixation on femoral and tibial components increases blood loss during total knee arthroplasty (TKA) is unclear. The purpose of this randomized controlled trial was to compare blood loss and early functional recovery between patients who underwent cementless or cemented TKA.
Between November 2021 and April 2022, sixty-one eligible patients at our medical center were randomized to cementless and cemented group. The primary outcome was total blood loss (TBL). Secondary outcomes were drainage, knee swelling, anemia, transfusion, hematological indicators, early functional recovery, and postoperative complications. The early functional recovery included range of motion (ROM), Hospital for Special Surgery (HSS) score, walking distance.
A total of 61 patients were analyzed, of whom 30 underwent cementless fixation. On postoperative day 1, the mean TBL was 394.39 ml (SD 182.97 ml) in the cementless group and 382.41 ml (SD 208.67 ml) in the cemented group ( = 0.863). By postoperative day 3, the corresponding mean TBL was higher at 593.48 ml (SD 230.04 ml) and 603.80 ml (SD 213.16 ml) ( = 0.751). The two groups did not differ significantly in drainage, knee swelling, anemia, levels of hemoglobin or hematocrit or platelets, ROM, HSS score, walking distance, or rates of transfusion or postoperative complications.
Cementless fixation on femoral and tibial components during TKA does not increase blood loss or impede early functional recovery, which suggests that clinicians need not worry about blood loss and early functional recovery when deciding what type of fixation to perform during TKA.
Number: ChiCTR2100052857; Date: November 6, 2021.
在全膝关节置换术（TKA）中，股骨和胫骨假体的非骨水泥固定是否会增加失血尚不清楚。本随机对照试验的目的是比较接受非骨水泥或骨水泥TKA的患者之间的失血量和早期功能恢复情况。
2021年11月至2022年4月期间，我们医疗中心的61名符合条件的患者被随机分为非骨水泥组和骨水泥组。主要结局是总失血量（TBL）。次要结局包括引流量、膝关节肿胀、贫血、输血情况、血液学指标、早期功能恢复及术后并发症。早期功能恢复包括活动范围（ROM）、特种外科医院（HSS）评分、行走距离。
共分析了61例患者，其中30例行非骨水泥固定。术后第1天，非骨水泥组的平均TBL为394.39 ml（标准差182.97 ml），骨水泥组为382.41 ml（标准差208.67 ml）（P = 0.863）。到术后第3天，相应的平均TBL更高，分别为593.48 ml（标准差230.04 ml）和603.80 ml（标准差213.16 ml）（P = 0.751）。两组在引流量、膝关节肿胀、贫血、血红蛋白或血细胞比容或血小板水平、ROM、HSS评分、行走距离、输血率或术后并发症方面无显著差异。
TKA期间股骨和胫骨假体的非骨水泥固定不会增加失血量或妨碍早期功能恢复，这表明临床医生在决定TKA期间采用何种固定方式时无需担心失血量和早期功能恢复问题。
编号：ChiCTR2100052857；日期：2021年11月6日。
