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Accelerometer-Based Handheld Navigation Instrumentation in Total Knee Arthroplasty Decrease Blood Loss Compared to
Nuthan Jagadeesh1,2, Ambareesh Parameshwar1, Hiranya Kumar1
1Trauma and Orthopedics, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND.
Cureus
|December 21, 2022
Summary
Handheld navigation systems (HHNS) significantly reduce blood loss during total knee arthroplasty (TKA) compared to conventional methods. This innovative approach minimizes perioperative bleeding and hemoglobin loss, enhancing patient outcomes in TKA procedures.
Area of Science:
- Orthopedic Surgery
- Surgical Navigation
- Arthroplasty
Background:
- Total knee arthroplasty (TKA) often involves substantial perioperative blood loss, frequently requiring transfusions.
- Conventional instrumentation in TKA may lead to increased blood loss due to intramedullary reaming and pin insertions.
- Accelerometer-based handheld navigation systems (HHNS) offer a potential alternative to mitigate blood loss.
Purpose of the Study:
- To test the hypothesis that HHNS instrumentation reduces perioperative blood loss in TKA compared to conventional instrumentation.
- To compare perioperative parameters including tourniquet time, hemoglobin loss, and estimated blood loss between HHNS and conventional TKA groups.
Main Methods:
- A prospective comparative study involving 40 patients in the HHNS group and 40 in the conventional instrumentation group.
- All TKA procedures utilized a tourniquet.
- Perioperative data, including tourniquet time, estimated blood loss, hemoglobin loss, and blood transfusion details, were meticulously recorded and compared.
Main Results:
- The HHNS group demonstrated significantly lower estimated hemoglobin loss (2.5 ± 1.6 vs. 3.0 ± 1.8) and estimated blood loss (830 ± 285ml vs. 1088 ± 228ml) compared to the conventional group (p<0.001).
- Tourniquet time was slightly longer in the HHNS group (83.7 ± 9.6 min) versus the conventional group (73.9 ± 10.3 min).
- While fewer patients in the HHNS group received transfusions (2 patients, 4 units) compared to the conventional group (3 patients, 5 units), this difference was not statistically significant.
Conclusions:
- The study confirmed the primary hypothesis: HHNS instrumentation significantly decreases perioperative blood loss, drain volume, and hemoglobin loss in TKA.
- HHNS provides a viable alternative for reducing blood loss during TKA without significantly increasing operative time.
- Further research may be needed to establish the clinical significance of reduced blood loss in terms of transfusion requirements.
