» Articles » PMID: 38467938

Impact of Intra- and Extramedullary Alignment on Blood Loss in Total Knee Arthroplasty: a Retrospective Study

Overview
Date 2024 Mar 12
PMID 38467938
Authors
Affiliations
Soon will be listed here.
Abstract

Background: There is a scarcity of scientific data regarding the correlation between alignment techniques during total knee arthroplasty (TKA) and blood loss as well as transfusion rates. This study's hypothesis posited that intramedullary-aligned (IM) TKA exhibits higher blood loss and transfusion rates when contrasted with extramedullary-aligned (EM) TKA.

Methods: We conducted a retrospective examination of 883 patients who underwent total knee arthroplasty (TKA) in 2021 at a solitary orthopedic center in Germany. These patients were divided into two groups based on their tibial alignment technique: extramedullary alignment and intramedullary tibial alignment.

Results: In the intramedullary tibial alignment (IM) group, we observed a blood loss of 0.91 L, while in the extramedullary tibial alignment (EM) group, the blood loss was 0.89 L. These values did not demonstrate a significant difference (p = 0.69). Transfusion rates were 0.99% in the IM group and 0.21% in the EM group, and there was no significant distinction between them (Chi-squared test: p > 0.05).

Conclusion: We observed no statistically significant variance in blood loss between the IM and EM groups. Likewise, there was no substantial disparity in transfusion rates between these groups. It can be concluded that the selection of a knee arthroplasty system incorporating either intramedullary tibial alignment or extramedullary alignment does not significantly impact blood loss.

References
1.
Klug A, Gramlich Y, Rudert M, Drees P, Hoffmann R, Weissenberger M . The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years. Knee Surg Sports Traumatol Arthrosc. 2020; 29(10):3287-3298. PMC: 7362328. DOI: 10.1007/s00167-020-06154-7. View

2.
Engh G, Petersen T . Comparative experience with intramedullary and extramedullary alignment in total knee arthroplasty. J Arthroplasty. 1990; 5(1):1-8. DOI: 10.1016/s0883-5403(06)80002-1. View

3.
Frisch N, Wessell N, Charters M, Yu S, Jeffries J, Silverton C . Predictors and complications of blood transfusion in total hip and knee arthroplasty. J Arthroplasty. 2014; 29(9 Suppl):189-92. DOI: 10.1016/j.arth.2014.03.048. View

4.
Jo C, Ko S, Shin W, Han H, Lee M, Ko T . Transfusion after total knee arthroplasty can be predicted using the machine learning algorithm. Knee Surg Sports Traumatol Arthrosc. 2019; 28(6):1757-1764. DOI: 10.1007/s00167-019-05602-3. View

5.
Jeschke E, Citak M, Halder A, Heller K, Niethard F, Schrader P . Blood transfusion and venous thromboembolism trends and risk factors in primary and aseptic revision total hip and knee arthroplasties: A nationwide investigation of 736,061 cases. Orthop Traumatol Surg Res. 2021; 108(1):102987. DOI: 10.1016/j.otsr.2021.102987. View