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J Knee Surg 2019; 32(06): 483-489
DOI: 10.1055/s-0038-1651530
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

Davide Cucchi
1   Department of Orthopaedics and Trauma Surgery, Universitätsklinikum Bonn, Bonn, Germany
2   Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
,
Alessandra Menon
2   Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
3   1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
,
Beatrice Zanini
4   Dipartimento di Scienze della Salute, Università del Piemonte Orientale A. Avogadro, Novara, Italy
,
Riccardo Compagnoni
3   1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
,
Paolo Ferrua
5   S.S.D. Chirurgia Articolare del Ginocchio, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
,
Pietro Randelli
2   Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
3   1° Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy
› Author Affiliations
Funding None.
Further Information

Publication History

30 September 2017

08 April 2018

Publication Date:
23 May 2018 (online)

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Abstract

Patient-specific instrumentation (PSI) may contribute to reduced blood loss related to total knee arthroplasty (TKA). The purpose of this study was to compare the estimated hemoglobin (Hb) and red blood cell volume (RBC) losses in two groups of patients undergoing TKA with PSI and conventional instrumentation. Pre- and postoperative blood samples were collected from 22 patients randomly assigned to receive a PSI-assisted or conventional TKA. Post- to preoperative Hb difference was calculated and RBC loss was estimated according to Sehat et al. A significant difference in Hb reduction in favor of the PSI group was registered on the last day of stay (p = 0.0084) and significant treatment effect (p = 0.027) on Hb reduction after intervention was found with a regression model for longitudinal measurements. This study demonstrated that PSI leads to a significant trend in earlier Hb regain. These promising results suggest a beneficial effect of PSI in blood loss reduction.

Keywords

patient-specific instrumentation - blood loss - hemoglobin loss - knee arthroplasty - outcomes

Authors' Contributions

D.C.: study design, patient recruitment and data collection, and original draft preparation; A.M.: statistical analysis, figures and tables, and draft revision; B.Z.: patient recruitment and data collection; R.C. and P.F.: discussion and manuscript correction; P.R.: study design, surgical procedures, and manuscript correction.


Note

This investigation was performed at I.R.C.C.S. Policlinico San Donato, Piazza Malan 1, 20097 San Donato Milanese, Milan, Italy. Informed consent was obtained from all individual participants included in the study. The ClinicalTrials.gov Identifier no. is NCT01876654.


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.