title: A Randomized Controlled Study to Compare the Total and Hidden Blood Loss in Computer-Assisted Surgery and Conventional Surgical Technique of Total Knee Replacement.
abstract: BACKGROUND
  Total knee arthroplasty (TKA) is associated with considerable blood loss. Computer-assisted surgery (CAS) is different from conventional TKA as it avoids opening the intramedullary canal. Hence, CAS should be associated with less blood loss.
  
  
  METHODS
  Fifty-seven patients were randomized into two groups of CAS and conventional TKA. In conventional group intramedullary femoral and extramedullary tibial jigs were used whereas in CAS group imageless navigation system was used. All surgeries were done under tourniquet. Total and hidden blood loss was calculated in both groups and compared.
  
  
  RESULTS
  The mean total blood loss was 980 mL in conventional group and 970 mL in CAS group with median of 1,067 mL (range, 59 to 1,791 mL) in conventional group and 863 mL (range, 111 to 2,032 mL) in CAS group. There was no significant difference in total blood loss between the two groups (p = 0.811). We have found significant hidden blood loss in both techniques, which is 54.8% of the total loss in the conventional technique and 59.5% in the computer-assisted navigation technique.
  
  
  CONCLUSIONS
  There is no significant difference in total and hidden blood loss in the TKA in CAS and conventional TKA. However, there is significant hidden blood loss in both techniques. There was no relation of tourniquet time with blood loss.
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Singla
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Chandra
authors.initials: C
authors.lastname: Lekha
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: G
authors.initials: G
authors.lastname: Karthikeyan
authors.affiliation: Department of Cardiac Anesthesia, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vishwas
authors.initials: V
authors.lastname: Malik
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted; D013997:Time Factors; D014111:Tourniquets
keywords: Adverse effects; Arthroplasty, replacement, knee; Blood loss; Computer assisted surgery; Tourniquets