Does the intramedullary femoral canal plug reduce blood loss during total knee arthroplasty?

Khanasuk, Yutthana; Ngarmukos, Srihatach; Tanavalee, Aree

doi:10.1186/s43019-022-00160-4

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…When comparing post-operative hemoglobin drop, previous literature reports a decrease in blood loss in RATKA by avoiding intramedullary violation [16,20]. In this study, blood loss was objectiied by comparing pre-and 2 day postoperative hemoglobin levels, which did not difer signiicantly in NAVIO RATKA vs CTKA.…”

Section: Discussionmentioning

confidence: 86%

NAVIO RATKA shows similar rates of hemoglobin‐drop, adverse events, readmission and early revision vs conventional TKA: a single centre retrospective cohort study

Vandenberk,

Mievis,

Deferm

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Despite widespread adoption of NAVIO robotic-assisted total knee arthroplasty (NAVIO RATKA) in clinical practice, clinical outcome in terms of adverse events and complications remains unclear. The purpose of this study was to compare adverse events, length of stay, surgical time, hemoglobin drop, early readmission rate and revision rate between conventional TKA (CTKA) and NAVIO RATKA. Methods This single-centre retrospective cohort analysis compared 230 NAVIO RATKA patients to 489 CTKA patients with a minimal follow-up of 12 months. Baseline demographic and comorbidity parameters were collected, as well as length of stay, revision rate and reason for revision, early readmission rate (< 6w) and reason for readmission, post-operative hemoglobin levels, adverse events, surgical time and operating room time. Data were compared using Mann-Whitney U test for continuous data without normal distribution and ordinal data, categorical variables were compared using the Chi-square or Fisher exact test. Results There were no clinically relevant baseline demographic or comorbidity diferences between groups. CTKA had shorter length of stay than NAVIO RATKA (5.0 days vs 5.4 days, p = 0.010) but trended towards a higher reoperation rate (4.1% vs 1.7%, p = .144, n.s). No diferences were found in hemoglobin drop, readmission rate or overall incidence of adverse events, but CTKA showed more hematoma formation (1.6% vs 0%, p = .044) and higher incidence of periprosthetic joint infection (PJI) (1% vs 0%, p = n.s.), whilst NAVIO RATKA showed more periprosthetic fractures and persistent wound drainage (0.4% vs 2.2%, p = .038 and 0.6% vs 4.3%, p = .001, respectively). Surgical time remained signiicantly longer in NAVIO RATKA during all 230 cases (87 min vs 67.6 min) and showed a continuous downward trend. Conclusions This study further validates the usage of NAVIO RATKA as a safe method to perform TKA, with comparable short term outcomes to CTKA in terms of early revisions and adverse events. Surgeons should be mindful of the difering adverse event proile in NAVIO RATKA and adjust their patient selection accordingly to ensure optimal outcomes. In addition, surgeons using NAVIO RATKA should expect a linear learning curve and a surgical time exceeding that of CTKA. Level of evidence Level III (therapeutic retrospective cohort study).

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Section: Discussionmentioning

confidence: 86%

NAVIO RATKA shows similar rates of hemoglobin‐drop, adverse events, readmission and early revision vs conventional TKA: a single centre retrospective cohort study

Vandenberk,

Mievis,

Deferm

et al. 2023

Knee surg. sports traumatol. arthrosc.

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“…The main purpose of TKA is to relieve the patient’s pain and restore function for a long time [ 37 ]. It is well known as the most effective and satisfactory surgical treatment in the field of orthopedic surgery and has a very good survival rate [ 38 , 39 , 40 , 41 , 42 ]. The 15-year survival rate is 93.0%; the 20-year survival rate is 90.1%; and the 25-year survival rate is reported to be 82.3% [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Machine Learning for Detecting Total Knee Arthroplasty Implant Loosening on Plain Radiographs

et al. 2023

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(1) Background: The purpose of this study was to investigate whether the loosening of total knee arthroplasty (TKA) implants could be detected accurately on plain radiographs using a deep convolution neural network (CNN). (2) Methods: We analyzed data for 100 patients who underwent revision TKA due to prosthetic loosening at a single institution from 2012 to 2020. We extracted 100 patients who underwent primary TKA without loosening through a propensity score, matching for age, gender, body mass index, operation side, and American Society of Anesthesiologists class. Transfer learning was used to prepare a detection model using a pre-trained Visual Geometry Group (VGG) 19. For transfer learning, two methods were used. First, the fully connected layer was removed, and a new fully connected layer was added to construct a new model. The convolutional layer was frozen without training, and only the fully connected layer was trained (transfer learning model 1). Second, a new model was constructed by adding a fully connected layer and varying the range of freezing for the convolutional layer (transfer learning model 2). (3) Results: The transfer learning model 1 gradually increased in accuracy and ultimately reached 87.5%. After processing through the confusion matrix, the sensitivity was 90% and the specificity was 100%. Transfer learning model 2, which was trained on the convolutional layer, gradually increased in accuracy and ultimately reached 97.5%, which represented a better improvement than for model 1. Processing through the confusion matrix affirmed that the sensitivity was 100% and the specificity was 97.5%. (4) Conclusions: The CNN algorithm, through transfer learning, shows high accuracy for detecting the loosening of TKA implants on plain radiographs.

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“…The cement was mixed with antibiotics, reducing the chances of postsurgical infection. The distal intramedullary femoral plug was also used, which would contribute to the survival of the implant [18]. It reduces blood loss in the THR procedure.…”

Section: Discussionmentioning

confidence: 99%

The Quality of Life After a Total Hip Replacement Procedure: The Factors Attributed to a 24-Year Survival Case

Rajvinder¹,

Mohan²,

Simanjuntak³

2022

Act Scie Ortho

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Does the intramedullary femoral canal plug reduce blood loss during total knee arthroplasty?

Cited by 7 publications

References 16 publications

NAVIO RATKA shows similar rates of hemoglobin‐drop, adverse events, readmission and early revision vs conventional TKA: a single centre retrospective cohort study

NAVIO RATKA shows similar rates of hemoglobin‐drop, adverse events, readmission and early revision vs conventional TKA: a single centre retrospective cohort study

Machine Learning for Detecting Total Knee Arthroplasty Implant Loosening on Plain Radiographs

The Quality of Life After a Total Hip Replacement Procedure: The Factors Attributed to a 24-Year Survival Case

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