López VÁ, Bustos MR

Language: Spanish
References: 18
Page: 190-194
PDF size: 179.32 Kb.

ABSTRACT

The total knee arthroplasty is considered the main treatment for knee osteoarthritis. The use of ischemia with a pneumatic or elastic handle with technical-surgical advantages, such as an improvement in surgical vision by maintaining a cleaner operative field and reducing operative time, is not a safe procedure. Objective: To compare the efficacy and safety of total knee arthroplasty with or without use of ischemia in the Centro Médico Nacional de Occidente "Lic. Ignacio García Téllez". Material and methods: This is an observational, cross-sectional, retrospective and single-center study. From March 2017 to March 2020, patients with an outpatient evaluation of the Orthopedics and Traumatology Service with a diagnosis of knee osteoarthritis who required surgical management with primary total knee arthroplasty and with revision components, with and without the use of ischemia where The surgery time, bleeding, pain, the need for transfusion and the difference in hemoglobin at 24 hours postoperative were assessed. Results: 75 patients were analyzed, the average age was 71 years, with a standard deviation of 8.2, 46 patients without use of ischemia and 29 with use of ischemia. In patients in whom ischemia was used, a VAS greater than 5 was observed in 51.7%, an Andersen greater than 2 in 51.7%, the surgery time was less than or equal to 150 minutes in 93.1%, bleeding postoperative was less than or equal to 500 ml in 93.1%, no blood transfusion was required in 96.6% and a hemoglobin difference (g/dl) of 2 or greater in 82.8%. In patients who did not use ischemia, a VAS 5 or less was observed in 91.3%, an Andersen of 2 or less in 42 in 91.3%, the time of surgery was greater than 150 minutes in 69.6%, postoperative bleeding was less than or equal to 500 ml in 60.9%, blood transfusion was required in 19.6% and a hemoglobin difference (g/dl) of 2 or greater was found in 89.1%. Conclusion: The patients who use ischemia in total knee arthroplasty have less bleeding, surgical time and need for blood transfusion, but its use increases postoperative pain.

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