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Blood loss following total knee replacement in the morbidly obese: Effects of computer navigation.
Knee. 2011 Mar; 18(2):108-12.KNEE

Abstract

Computer navigated total knee arthroplasty (TKA) has several proposed benefits including reduced post-operative blood loss. We compared the total blood volume loss in a cohort of morbidly obese (BMI>40) patients undergoing computer navigated (n=30) or standard intramedullary techniques (n=30) with a cohort of matched patients with a BMI<30 also undergoing navigated (n=31) or standard TKA (n=31). Total body blood loss was calculated from body weight, height and haemotocrit change, using a model which accurately assesses true blood loss as was maximum allowable blood loss which represents the volume of blood that can be lost until a transfusion trigger is required. The groups were matched for age, gender, diagnosis and operative technique. The mean true blood volume loss across all BMI's was significantly (p<0.001) less in the computer assisted group (1014±312ml) compared to the conventional group (1287±330ml). Patients with a BMI>40 and a computer navigated procedure (1105±321ml) had a significantly lower (p<0.001) blood volume loss compared to those who underwent a conventional TKA (1399±330ml). There was no significant difference in the transfusion rate or those reaching the maximum allowable blood loss between groups. This study confirms a significant reduction in total body blood loss between computer assisted and conventional TKA in morbidly obese patients. However computer navigation did not affect the transfusion rate or those reaching the transfusion trigger in the morbidly obese group. Therefore computer navigation may reduce blood loss in the morbidly obese patient but this may not be clinically relevant to transfusion requirements as previously suggested.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Millar NL
Golden Jubilee National Hospital, Department of Orthopaedics, Clydebank, Glasgow, Scotland, UK.
Deakin AH
No affiliation info available
Millar LL
No affiliation info available
Kinnimonth AW
No affiliation info available
Picard F
No affiliation info available

MeSH

AgedArthroplasty, Replacement, KneeBlood Loss, SurgicalBlood TransfusionBody Mass IndexCohort StudiesFemaleHemoglobinsHumansMaleMinimally Invasive Surgical ProceduresObesity, MorbidProspective StudiesSurgery, Computer-Assisted

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

20591675

Citation

Millar, Neal L., et al. "Blood Loss Following Total Knee Replacement in the Morbidly Obese: Effects of Computer Navigation." The Knee, vol. 18, no. 2, 2011, pp. 108-12.
Millar NL, Deakin AH, Millar LL, et al. Blood loss following total knee replacement in the morbidly obese: Effects of computer navigation. Knee. 2011;18(2):108-12.
Millar, N. L., Deakin, A. H., Millar, L. L., Kinnimonth, A. W., & Picard, F. (2011). Blood loss following total knee replacement in the morbidly obese: Effects of computer navigation. The Knee, 18(2), 108-12. https://doi.org/10.1016/j.knee.2010.03.002
Millar NL, et al. Blood Loss Following Total Knee Replacement in the Morbidly Obese: Effects of Computer Navigation. Knee. 2011;18(2):108-12. PubMed PMID: 20591675.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blood loss following total knee replacement in the morbidly obese: Effects of computer navigation. AU - Millar,Neal L, AU - Deakin,Angela H, AU - Millar,Lauren L, AU - Kinnimonth,Andrew W G, AU - Picard,Frederic, Y1 - 2010/06/29/ PY - 2009/09/10/received PY - 2010/03/13/revised PY - 2010/03/18/accepted PY - 2010/7/2/entrez PY - 2010/7/2/pubmed PY - 2011/6/3/medline SP - 108 EP - 12 JF - The Knee JO - Knee VL - 18 IS - 2 N2 - Computer navigated total knee arthroplasty (TKA) has several proposed benefits including reduced post-operative blood loss. We compared the total blood volume loss in a cohort of morbidly obese (BMI>40) patients undergoing computer navigated (n=30) or standard intramedullary techniques (n=30) with a cohort of matched patients with a BMI<30 also undergoing navigated (n=31) or standard TKA (n=31). Total body blood loss was calculated from body weight, height and haemotocrit change, using a model which accurately assesses true blood loss as was maximum allowable blood loss which represents the volume of blood that can be lost until a transfusion trigger is required. The groups were matched for age, gender, diagnosis and operative technique. The mean true blood volume loss across all BMI's was significantly (p<0.001) less in the computer assisted group (1014±312ml) compared to the conventional group (1287±330ml). Patients with a BMI>40 and a computer navigated procedure (1105±321ml) had a significantly lower (p<0.001) blood volume loss compared to those who underwent a conventional TKA (1399±330ml). There was no significant difference in the transfusion rate or those reaching the maximum allowable blood loss between groups. This study confirms a significant reduction in total body blood loss between computer assisted and conventional TKA in morbidly obese patients. However computer navigation did not affect the transfusion rate or those reaching the transfusion trigger in the morbidly obese group. Therefore computer navigation may reduce blood loss in the morbidly obese patient but this may not be clinically relevant to transfusion requirements as previously suggested. SN - 1873-5800 UR - https://www.unboundmedicine.com/medline/citation/20591675/Blood_loss_following_total_knee_replacement_in_the_morbidly_obese:_Effects_of_computer_navigation_ DB - PRIME DP - Unbound Medicine ER -