title: Fat emboli in total knee arthroplasty: a prospective randomized study of computer-assisted navigation vs standard surgical technique.
abstract: A prospective exploratory study of fat emboli in patients undergoing total knee arthroplasty was performed in patients randomly assigned to surgery with computer-assisted navigation or standard technique. Transesophageal echocardiography of the right atrium was recorded for 5 consecutive 1-minute intervals after tourniquet deflation. Emboli were graded on a scale of 0 to 3 based on embolism size, amount of atrium filled, and duration of embolic shower, creating an overall score of 0 to 9. The mean (SD, range) of the 5 overall scores for each total knee arthroplasty was 6.00 (0.76, 4.6-7.4) for computer-assisted navigation (22 patients) and 6.42 (0.97, 4.6-7.9) for standard technique (22 patients) (P=.14), with a 95% confidence interval for the difference of -0.11 to 0.95. We conclude that any difference in extent of emboli between the 2 surgical techniques is unlikely to be of clinical significance.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA.
authors.forename: Mary I
authors.initials: MI
authors.lastname: O'Connor
authors.forename: Mark P
authors.initials: MP
authors.lastname: Brodersen
authors.forename: Neil G
authors.initials: NG
authors.lastname: Feinglass
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Leone
authors.forename: Julia E
authors.initials: JE
authors.lastname: Crook
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Switzer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D017548:Echocardiography, Transesophageal; D004620:Embolism, Fat / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D025321:Surgery, Computer-Assisted / Q000379:methods*