{"title":"全膝关节置换术中髓内股管堵塞能减少失血量吗?","authors":"Yutthana Khanasuk, Srihatach Ngarmukos, Aree Tanavalee","doi":"10.1186/s43019-022-00160-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The benefit of the femoral canal bone plug during total knee arthroplasty (TKA) in reducing blood loss has never been proven. The aim of this meta-analysis was to determine whether the femoral canal bone plug significantly reduces blood loss in primary TKA.</p><p><strong>Method: </strong>All studies published before December 2021 were searched. The inclusion criteria were randomized controlled trials comparing blood loss between TKA with plugged and unplugged femoral intramedullary canal, respectively. The primary outcome was postoperative hemoglobin reduction.</p><p><strong>Results: </strong>Five studies with a total of 717 patients (361 in the plugged group, 356 in the unplugged group) met the criteria for inclusion in the meta-analysis. The mean difference in hemoglobin level between the two groups was 0.92 g/dL, with significantly less hemoglobin reduction in the plugged group (95% confidence interval [CI] - 1.64 to - 0.21, p = 0.01). The patients in the plugged group also had a significantly lower risk of receiving a blood transfusion (risk ratio 0.58, 95% CI 0.47-0.73, p < 0.00001).</p><p><strong>Conclusions: </strong>This meta-analysis demonstrates that using a femoral canal bone plug can significantly reduce blood loss and lower the risk ratio of blood transfusion in patients undergoing TKA.</p>","PeriodicalId":17886,"journal":{"name":"Knee Surgery & Related Research","volume":null,"pages":null},"PeriodicalIF":4.1000,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238037/pdf/","citationCount":"5","resultStr":"{\"title\":\"Does the intramedullary femoral canal plug reduce blood loss during total knee arthroplasty?\",\"authors\":\"Yutthana Khanasuk, Srihatach Ngarmukos, Aree Tanavalee\",\"doi\":\"10.1186/s43019-022-00160-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The benefit of the femoral canal bone plug during total knee arthroplasty (TKA) in reducing blood loss has never been proven. The aim of this meta-analysis was to determine whether the femoral canal bone plug significantly reduces blood loss in primary TKA.</p><p><strong>Method: </strong>All studies published before December 2021 were searched. The inclusion criteria were randomized controlled trials comparing blood loss between TKA with plugged and unplugged femoral intramedullary canal, respectively. The primary outcome was postoperative hemoglobin reduction.</p><p><strong>Results: </strong>Five studies with a total of 717 patients (361 in the plugged group, 356 in the unplugged group) met the criteria for inclusion in the meta-analysis. The mean difference in hemoglobin level between the two groups was 0.92 g/dL, with significantly less hemoglobin reduction in the plugged group (95% confidence interval [CI] - 1.64 to - 0.21, p = 0.01). The patients in the plugged group also had a significantly lower risk of receiving a blood transfusion (risk ratio 0.58, 95% CI 0.47-0.73, p < 0.00001).</p><p><strong>Conclusions: </strong>This meta-analysis demonstrates that using a femoral canal bone plug can significantly reduce blood loss and lower the risk ratio of blood transfusion in patients undergoing TKA.</p>\",\"PeriodicalId\":17886,\"journal\":{\"name\":\"Knee Surgery & Related Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2022-06-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9238037/pdf/\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery & Related Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s43019-022-00160-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery & Related Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s43019-022-00160-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 5
摘要
导论:在全膝关节置换术(TKA)期间,股骨管骨塞在减少失血量方面的益处从未得到证实。本荟萃分析的目的是确定股骨管骨塞是否能显著减少原发性TKA的失血量。方法:检索2021年12月之前发表的所有研究。纳入标准是随机对照试验,分别比较TKA与未堵塞股髓内管之间的出血量。主要结局为术后血红蛋白降低。结果:5项研究共717例患者(361例插入组,356例未插入组)符合纳入meta分析的标准。两组之间血红蛋白水平的平均差异为0.92 g/dL,堵塞组血红蛋白下降明显较少(95%置信区间[CI] - 1.64至- 0.21,p = 0.01)。栓塞组患者接受输血的风险也显著降低(风险比0.58,95% CI 0.47-0.73, p)。结论:本荟萃分析表明,在TKA患者中,使用股骨管骨栓可以显著减少出血量,降低输血的风险比。
Does the intramedullary femoral canal plug reduce blood loss during total knee arthroplasty?
Introduction: The benefit of the femoral canal bone plug during total knee arthroplasty (TKA) in reducing blood loss has never been proven. The aim of this meta-analysis was to determine whether the femoral canal bone plug significantly reduces blood loss in primary TKA.
Method: All studies published before December 2021 were searched. The inclusion criteria were randomized controlled trials comparing blood loss between TKA with plugged and unplugged femoral intramedullary canal, respectively. The primary outcome was postoperative hemoglobin reduction.
Results: Five studies with a total of 717 patients (361 in the plugged group, 356 in the unplugged group) met the criteria for inclusion in the meta-analysis. The mean difference in hemoglobin level between the two groups was 0.92 g/dL, with significantly less hemoglobin reduction in the plugged group (95% confidence interval [CI] - 1.64 to - 0.21, p = 0.01). The patients in the plugged group also had a significantly lower risk of receiving a blood transfusion (risk ratio 0.58, 95% CI 0.47-0.73, p < 0.00001).
Conclusions: This meta-analysis demonstrates that using a femoral canal bone plug can significantly reduce blood loss and lower the risk ratio of blood transfusion in patients undergoing TKA.