Femoral Bone Plug in Total Knee Replacement

Vulcano, Ettore; Regazzola, Gianmarco M V; Murena, Luigi; Ronga, Mario; Cherubino, Paolo; Surace, Michele Francesco

doi:10.3928/01477447-20151002-03

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…The resected bone piece is commonly used for the femoral canal bone plug [ 19 ]. Some surgeons also use bone cement to seal the femoral canal opening.…”

Section: Discussionmentioning

confidence: 99%

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

Khanasuk¹,

Ngarmukos

Tanavalee

2022

Knee Surg & Relat Res

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Introduction The benefit of the femoral canal bone plug during total knee arthroplasty (TKA) in reducing blood loss has never been proven. The aim of this meta-analysis was to determine whether the femoral canal bone plug significantly reduces blood loss in primary TKA. Method All studies published before December 2021 were searched. The inclusion criteria were randomized controlled trials comparing blood loss between TKA with plugged and unplugged femoral intramedullary canal, respectively. The primary outcome was postoperative hemoglobin reduction. Results Five studies with a total of 717 patients (361 in the plugged group, 356 in the unplugged group) met the criteria for inclusion in the meta-analysis. The mean difference in hemoglobin level between the two groups was 0.92 g/dL, with significantly less hemoglobin reduction in the plugged group (95% confidence interval [CI] − 1.64 to − 0.21, p = 0.01). The patients in the plugged group also had a significantly lower risk of receiving a blood transfusion (risk ratio 0.58, 95% CI 0.47–0.73, p < 0.00001). Conclusions This meta-analysis demonstrates that using a femoral canal bone plug can significantly reduce blood loss and lower the risk ratio of blood transfusion in patients undergoing TKA.

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“…The resected bone piece is commonly used for the femoral canal bone plug [ 19 ]. Some surgeons also use bone cement to seal the femoral canal opening.…”

Section: Discussionmentioning

confidence: 99%

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

Khanasuk¹,

Ngarmukos

Tanavalee

2022

Knee Surg & Relat Res

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show abstract

“…Through the communication created by the alignment rod, blood can then flow from the medullary canal into the joint cavity, which was associated with potentially increased risk of blood loss, fat embolism, and postoperative hypoxia. 20 Thus, some surgeons have routinely used autologous bone graft to seal this hole, with the aim of decreasing blood loss.…”

Section: Discussionmentioning

confidence: 99%

“…Second, several techniques have been described to directly sealing the femoral canal for reducing blood loss, including autologous bone plugs, cement plugs, fibrin sealant, or thrombin-based The Journal of Knee Surgery sealant. 9,20 However, only the autologous bone that plugs for sealing the femoral canal was assessed; future studies should be designed to discuss the efficacy of other methods, such as cement plugs. Third, although only randomized controlled trials were included, the methodology of included studies was not high, for instance, half of all studies lacked the information about the detailed random generation sequence.…”

Section: Discussionmentioning

confidence: 99%

Sealing the Intramedullary Femoral Canal for Blood Loss in Total Knee Arthroplasty: A Meta-analysis of Randomized Controlled Trials

Wang

Yuan

et al. 2019

J Knee Surg

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Blood loss after total knee arthroplasty (TKA) is a potentially serious medical problem since it leads to anemia, increased need for transfusion, and prolonged hospitalization. Some studies have reported that sealing of the intramedullary femoral canal during TKA may decrease postoperative blood loss. The purpose of this study is to determine the effects of sealing of the intramedullary femoral canal during TKA on blood loss and transfusion rate. Electronic databases, PubMed, EMBASE, the Cochrane Library, Web of Science, and Chinese Biomedical Database, were systematically searched. Only randomized controlled trials (RCTs) that compared the sealing group with the control group during TKA were included up to March 2019. Two reviewers independently extracted data and assessed the quality of included studies. The statistical analysis was performed by using Review Manager 5.3 software. Cochrane Risk of Bias tool was used for quality assessment. Overall, eight RCTs involving 996 patients met our criteria and were analyzed. The results of meta-analysis showed that patients in the sealed group had less total blood loss, less total drain output and less hidden blood loss, less transfusion rates, a lower drop of hemoglobin level at day 1 postoperatively, and less hematoma than the control group. On the other hand, there were no significant differences in infection, deep vein thrombosis, and redness of incision between sealed and control group. Current meta-analysis found that sealing the femoral canal during TKA was an effective method for the control of blood loss.

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“…In summary, avoidance of the femoral intramedullary canal may account for the lower blood loss with the aforementioned techniques. From this standpoint, it is advocated to routinely plug the entry hole when using conventional cutting guides [45,83].…”

Section: Surgical Techniquementioning

confidence: 99%

Optimizing Intraoperative Blood Management for One-Stage Bilateral Total Knee Arthroplasty

Soranoglou

Poultsides

Triantafyllopoulos

et al. 2018

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Femoral Bone Plug in Total Knee Replacement

Cited by 4 publications

References 9 publications

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

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

Sealing the Intramedullary Femoral Canal for Blood Loss in Total Knee Arthroplasty: A Meta-analysis of Randomized Controlled Trials

Optimizing Intraoperative Blood Management for One-Stage Bilateral Total Knee Arthroplasty

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