title: Sealing the intramedullary femoral canal with autologous bone plug in total knee arthroplasty.
abstract: In a prospective study of 262 consecutive patients with total knee arthroplasty, we compared the postoperative suction drainage and transfusion requirement in cases in which the defect made by the femoral intramedullary rod was either unplugged (n = 134) or plugged (n = 128). All operations were performed with a single surgical approach and technique. Inflammatory arthritis and lateral releases were excluded. Blood loss was recorded at 24, 48, and 72 hours. The difference in postoperative suction drainage was not statistically significant. The hemoglobin decrease in the unplugged group (3.5 g/dL) was different from that in the plugged group (2.3 g/dL) (P<.05). Of patients, 64.4% (n = 85) in the unplugged group and 35.9% (n = 46) in the plugged group required transfusion (P<.05). Sealing the femoral canal is effective in reducing hemoglobin decrease and blood transfusion in total knee arthroplasty.
authors.affiliation: Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, People's Republic of China. peterko@graduate.hku.hk
authors.forename: P S
authors.initials: PS
authors.lastname: Ko
authors.forename: M K
authors.initials: MK
authors.lastname: Tio
authors.forename: Y K
authors.initials: YK
authors.lastname: Tang
authors.forename: W L
authors.initials: WL
authors.lastname: Tsang
authors.forename: J J
authors.initials: JJ
authors.lastname: Lam
mesh_terms: D000704:Analysis of Variance; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016025:Bone Transplantation; D004322:Drainage; D005260:Female; D005269:Femur; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D011446:Prospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome