Comparison of blood transfusion requirements using patient-specific instrument, conventional Instrument, and computer navigation in Total Knee Arthroplasty

Abstract

Introduction: Different measures have been used to minimise allogeneic blood transfusion (ABT) after total knee arthroplasty (TKA). Our study aimed to compare the blood transfusion requirement in conventional instrument (CON), computer navigation (NAV), or patient-specific instrument (PSI). Methods: Patients’ data were retrieved from a randomised controlled trial previously performed in our institution from 2010 to 2012. A total of 76 patients with unilateral TKA done were included. Three surgeons performed the surgery with standardised prostheses and surgical routine but with 3 techniques (CON, NAV, PSI) which were randomly assigned. Patient’s demographics, operative details, and the need of blood transfusion were retrospectively reviewed. Chi-square and independent Student’s t tests were used for analysis, and statistically significance was assumed if p < 0.05. Results: In all, 22 men and 54 women, with a mean (± standard deviation) age of 68.9 ± 8.0 (range, 44-91) years, were included in the study. There were 25, 23, 28 patients in CON, NAV, PSI groups, respectively. The overall rate of ABT was 27.6% (21/76). No statistically significant difference was found in the need of ABT between the 3 techniques (p = 0.26), the 3 surgeons (p = 0.20), gender (p = 0.54), diagnosis (p = 0.75), and duration of operation (p = 0.73). The preoperative haemoglobin level and haematocrit level (p < 0.05) were significantly correlated with the need of ABT. Discussion and Conclusion: Blood transfusion requirements were similar in CON, NAV, and PSI. Preoperative haemoglobin and haematocrit levels are the key factors determining the need of ABT.