No Blood Loss Increase in Cementless vs. Cemented Fixation Following Bilateral Total Knee Arthroplasty: A Propensity Score Matching Study
<i>Background and Objectives</i>: Recent advancements in three-dimensional printing technology have enhanced the biologic fixation of cementless total knee arthroplasty (TKA), therefore increasing the utilization of newer-generation cementless implants. However, the lack of sealing and t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/8/1458 |
| _version_ | 1797583934007017472 |
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| author | Sueen Sohn Nicole Cho Hyunjoo Oh Yong Deok Kim Hoon Jo In Jun Koh |
| author_facet | Sueen Sohn Nicole Cho Hyunjoo Oh Yong Deok Kim Hoon Jo In Jun Koh |
| author_sort | Sueen Sohn |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Recent advancements in three-dimensional printing technology have enhanced the biologic fixation of cementless total knee arthroplasty (TKA), therefore increasing the utilization of newer-generation cementless implants. However, the lack of sealing and tamponade effect of cement on the resected bone surface after cementless TKA raises concerns regarding the potential for greater blood loss compared to cemented TKA. The aim of this study was to (1) compare blood loss and transfusion rates between cementless and cemented TKAs and (2) identify the risk factor for higher blood loss in patients who underwent 1-week-interval staggered bilateral (SB) TKA. <i>Materials and Methods</i>: This retrospective, propensity-matched study included 54 cementless and 53 cemented SB TKAs performed by a single surgeon from 2019 to 2023 with a single implant that has similar design features in both cementless and cemented implants. All patients underwent 1-week-interval SB TKA and received the same patient blood management (PBM) and rehabilitation protocol. The estimated total blood loss (TBL), transfusion rate, and total hemoglobin drop were assessed. Patients were categorized according to TBL into average TBL and higher TBL groups. Univariate and multiple logistic regression analyses were performed to identify risk factors for higher blood loss. <i>Results</i>: There was no difference in TBL between cementless and cemented TKA groups (1233 ± 299 and 1282 ± 309 mL, respectively; <i>p</i> > 0.05). In addition, no between-group differences in the transfusion rate and mean total hemoglobin drop were observed. The logistic regression analyses revealed that whether TKA was cementless or cemented was not associated with higher blood loss; rather, the only identified risk factor was the pre-TKA patient blood volume (odd ratio 1.001, 95% confidence interval 1.000–1002, <i>p</i> = 0.026). <i>Conclusions</i>: Contemporary cementless fixation does not increase blood loss or transfusion rates compared to cemented fixation in patients undergoing 1-week-interval staggered bilateral TKA. |
| first_indexed | 2024-03-10T23:46:05Z |
| format | Article |
| id | doaj.art-f163a5934d404d8c98ec5db46f10770c |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T23:46:05Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-f163a5934d404d8c98ec5db46f10770c2023-11-19T02:06:38ZengMDPI AGMedicina1010-660X1648-91442023-08-01598145810.3390/medicina59081458No Blood Loss Increase in Cementless vs. Cemented Fixation Following Bilateral Total Knee Arthroplasty: A Propensity Score Matching StudySueen Sohn0Nicole Cho1Hyunjoo Oh2Yong Deok Kim3Hoon Jo4In Jun Koh5Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul 01757, Republic of KoreaLauren E Wiznia MD PLLC, 1016 Fifth Avenue, New York, NY 10028, USAJoint Replacement Center, Eunpyeong St. Mary’s Hospital, Seoul 03312, Republic of KoreaJoint Replacement Center, Eunpyeong St. Mary’s Hospital, Seoul 03312, Republic of KoreaDepartment of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, Seoul 01757, Republic of KoreaJoint Replacement Center, Eunpyeong St. Mary’s Hospital, Seoul 03312, Republic of Korea<i>Background and Objectives</i>: Recent advancements in three-dimensional printing technology have enhanced the biologic fixation of cementless total knee arthroplasty (TKA), therefore increasing the utilization of newer-generation cementless implants. However, the lack of sealing and tamponade effect of cement on the resected bone surface after cementless TKA raises concerns regarding the potential for greater blood loss compared to cemented TKA. The aim of this study was to (1) compare blood loss and transfusion rates between cementless and cemented TKAs and (2) identify the risk factor for higher blood loss in patients who underwent 1-week-interval staggered bilateral (SB) TKA. <i>Materials and Methods</i>: This retrospective, propensity-matched study included 54 cementless and 53 cemented SB TKAs performed by a single surgeon from 2019 to 2023 with a single implant that has similar design features in both cementless and cemented implants. All patients underwent 1-week-interval SB TKA and received the same patient blood management (PBM) and rehabilitation protocol. The estimated total blood loss (TBL), transfusion rate, and total hemoglobin drop were assessed. Patients were categorized according to TBL into average TBL and higher TBL groups. Univariate and multiple logistic regression analyses were performed to identify risk factors for higher blood loss. <i>Results</i>: There was no difference in TBL between cementless and cemented TKA groups (1233 ± 299 and 1282 ± 309 mL, respectively; <i>p</i> > 0.05). In addition, no between-group differences in the transfusion rate and mean total hemoglobin drop were observed. The logistic regression analyses revealed that whether TKA was cementless or cemented was not associated with higher blood loss; rather, the only identified risk factor was the pre-TKA patient blood volume (odd ratio 1.001, 95% confidence interval 1.000–1002, <i>p</i> = 0.026). <i>Conclusions</i>: Contemporary cementless fixation does not increase blood loss or transfusion rates compared to cemented fixation in patients undergoing 1-week-interval staggered bilateral TKA.https://www.mdpi.com/1648-9144/59/8/1458cementlessblood losstransfusionpatient blood managementstaggered bilateraltotal knee arthroplasty |
| spellingShingle | Sueen Sohn Nicole Cho Hyunjoo Oh Yong Deok Kim Hoon Jo In Jun Koh No Blood Loss Increase in Cementless vs. Cemented Fixation Following Bilateral Total Knee Arthroplasty: A Propensity Score Matching Study Medicina cementless blood loss transfusion patient blood management staggered bilateral total knee arthroplasty |
| title | No Blood Loss Increase in Cementless vs. Cemented Fixation Following Bilateral Total Knee Arthroplasty: A Propensity Score Matching Study |
| title_full | No Blood Loss Increase in Cementless vs. Cemented Fixation Following Bilateral Total Knee Arthroplasty: A Propensity Score Matching Study |
| title_fullStr | No Blood Loss Increase in Cementless vs. Cemented Fixation Following Bilateral Total Knee Arthroplasty: A Propensity Score Matching Study |
| title_full_unstemmed | No Blood Loss Increase in Cementless vs. Cemented Fixation Following Bilateral Total Knee Arthroplasty: A Propensity Score Matching Study |
| title_short | No Blood Loss Increase in Cementless vs. Cemented Fixation Following Bilateral Total Knee Arthroplasty: A Propensity Score Matching Study |
| title_sort | no blood loss increase in cementless vs cemented fixation following bilateral total knee arthroplasty a propensity score matching study |
| topic | cementless blood loss transfusion patient blood management staggered bilateral total knee arthroplasty |
| url | https://www.mdpi.com/1648-9144/59/8/1458 |
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