title: Reducing blood loss in bilateral total knee arthroplasty with patient-specific instrumentation.
abstract: Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) has been introduced to obtain consistent alignment, prevent instrumentation of the medullary canal and improve operating room efficiency. This article compares simultaneous bilateral TKA performed with and without the use of PSI in terms of surgical time; blood loss and transfusion requirements; length-of-stay, early thromboembolic events and complication rates. There was a trend to reduced total blood loss (as measured by drop in hemoglobin values) and lower transfusion rate after surgery. Further research in the form of high quality randomized trials and cost-benefit analyses may help in further consolidation of these findings.
authors.affiliation: NYU Hospital for Joint Diseases, Woodhull Hospital, NYU Langone Medical Center, New York, NY, USA. Electronic address: drparthivrathod@gmail.com.
authors.forename: Parthiv A
authors.initials: PA
authors.lastname: Rathod
authors.affiliation: VA New York Harbor Healthcare System, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY, USA.
authors.forename: Ajit J
authors.initials: AJ
authors.lastname: Deshmukh
authors.affiliation: Southside Hospital, North Shore LIJ Health System, New York, NY, USA.
authors.forename: Fred D
authors.initials: FD
authors.lastname: Cushner
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation*; D016063:Blood Loss, Surgical / Q000503:physiopathology / Q000517:prevention & control*; D001803:Blood Transfusion / Q000379:methods*; D015331:Cohort Studies; D017076:Computer-Aided Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D066230:Patient-Specific Modeling; D011182:Postoperative Care; D011475:Prosthesis Failure; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bilateral knee arthroplasty; Blood loss; Patient-specific instrumentation