NEW TECHNIQUE FOR REDUCING BLOOD LOSS IN TOTAL KNEE ARTHROPLASTY

Abstract A prospective randomised study was carried out to evaluate the blood loss in 30 total knee arthropasty patients, who were divided randomly into two equal groups; one having new technique bone plug and bone wax, while the other used a bone plug only. The surgery was carried out by a single surgeon at one institution using the uniform approach and standard operation. The mean drainage of blood was lower in the bone plug and bone wax group. This differ-ence was statistically significant (p=0.001). There was a highly significant reduction in blood drainage in the bone plug and bone wax group when compared to the bone plug only group. This finding allows for the order of less blood before an operation, reduces the risks of transfusion and gives financial saving. This new technique of surgery may also be useful for patients in whom blood products are not acceptable. Chiang Mai Medical Journal 2007; 46(4):147-152. Total knee arthroplasty (TKA) is a com-mon orthopedic surgery that can result in considerable blood loss.(1,2) Many techniques and procedures have been used to minimize intra-operative bleeding and blood transfusion, including application of a tourniquet,(3) mini-mally-invasive surgery,(4) diathermy coagula-tion, sealing of the intramedullary femoral canal,(5) positioning of the knee(6) and use of antifibrinolytic agents.(7) Although computer navigation has been developed to allow accurate intra-operative positioning of the components, without breach-ing the intra-medullary cavities(8) but providing an opportunity for reducing blood loss, it can prolong the operating time, as commonly occurs in computer-assisted surgery, and this may negate the benefit This study was carried out as a prospec-tive, randomized study to evaluate the new technique of bone plug and bone wax in com-parison to the standard conventional surgical technique, in terms of reducing blood loss during TKA. Patients and methods This study was carried out in all patients who underwent TKA at Phayao Hospita