Perioperative differences in conventional and computer-assisted surgery in bilateral total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Surgical Technology

Background:

• Bilateral total knee arthroplasties (bTKAs) are performed sequentially or staged, with ongoing debate regarding optimal surgical approaches.
• Computer-assisted surgery (CAS) offers potential advantages in orthopedic procedures, but its comparative efficacy in sequential bTKAs remains underexplored.

Purpose of the Study:

• To compare the outcomes of computer-assisted surgery (CAS) versus conventional (CON) techniques in sequential bilateral total knee arthroplasties (bTKAs).

Main Methods:

• Retrospective review of 124 sequential bTKAs, divided equally between CAS and CON groups (62 patients each).
• Analysis of key perioperative and postoperative outcomes, including blood transfusions, hemoglobin levels, range of motion, and complication rates.

Main Results:

• CAS-bTKAs demonstrated significantly lower rates of blood transfusion (0.9 units vs. 1.7 units) and improved postoperative hemoglobin levels on POD-1 and POD-2 (P < .05).
• No significant differences were observed in postoperative range of motion, tourniquet time, length of stay, readmissions, or reoperations between the CAS and CON groups (P > .05).

Conclusions:

• Computer-assisted surgery may offer benefits in reducing blood loss during sequential bilateral total knee arthroplasties compared to conventional methods.
• Potential violation of the femoral intramedullary canal in the CON technique might explain the observed differences in transfusion requirements.