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

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 ( = 0.0084) and significant treatment effect ( = 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.

Patient-specific instrumentation in total knee arthroplasty: a review of the current literature

“…The total blood loss, the red blood cell volume and the transfusion requirement did not differ between the two groups. This study also demonstrated that PSI leads to a significant trend in earlier haemoglobin regain 35 .…”

“…Mehdipur et al and Menon et al report a shorter operational time in PSI group, however these results were not statistically significant 22,35 .…”

Patient-Specific or Conventional Instrumentations: A Meta-analysis of Randomized Controlled Trials

“…), which is not robust enough to determine the superiority of one over another. Furthermore, more randomized controlled trials (RCTs) have been published [10][11][12][13][14][15] recently and need to be integrated to update our knowledge (comprehensive comparison between our work and previous reviews can be found in S2 Supplemental file).…”

The Role of 3D-Printed Patient-Specific Instrumentation in Total Knee Arthroplasty: A Literature Review

“…The variation in procedural steps between PSI-TKA and conventional TKA potentially leads to differences in surgical duration. This hypothesis is supported by several clinical trials [25,29,[42][43][44][45][46][47] and meta-analyses [41,48,49] that have reported a statistically significant decrease in surgical time with the PSI technique, ranging up to 20.4 minutes [45]. However, numerous other trials [50,51] and meta-analyses [7,10,28,36] have not found a significant difference in the duration of the procedures.…”