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Functional outcome of non-resurfacing patelloplasty in primary total knee arthroplasty- A one year follow up study of 62 knee replacements

Vol 32| Issue 2 | July – Dec 2019 | page: 02-05 | Rajanish. R, M. Harisankar, Jim Thomas Malayil, Muhammad P K


Authors: Rajanish. R [1], M. Harisankar [1], Jim Thomas Malayil [1], Muhammad P K [1].

[1] Department of Orthopedics, Baby Memorial Hospital, Calicut, Kerala..

Address of Correspondence

Dr. M. Harisankar,
Department of Orthopedics, Baby Memorial Hospital, Calicut, Kerala
E-mail: drharisankarm@gmail.com


Abstract

The management of the patella during total knee arthroplasty is still controversial. This study aims at assessing the functional outcome of total knee replacements with a non-resurfacing patelloplasty technique. We had a total of 53 patients and 62 total knee replacements. The patients were assessed preoperatively with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and were treated with total knee replacements with a non-resurfacing patelloplasty technique. The patients were followed up for 1 year and WOMAC score was calculated to assess the functional outcome. The results showed a very promising improvement in the functional status of the patient. The authors recommend the use of non-resurfacingpatelloplasty, as the procedure gives comparable results with resurfacing patelloplasty while avoiding its complications.
Keywords: Anterior knee pain, Patelloplasty, Patellar resurfacing, Total knee arthroplasty.


References

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How to Cite this Article: Rajanish R, Harisankar M, Malayil J T, Muhammad P K | Functional outcome of non-resurfacing patelloplasty in primary total knee arthroplasty- A one year follow up study of 62 knee replacements | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 02-05 .

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The Ambiguous Role of Hemostatic Matrix in Total Knee Arthroplasty: A Randomized Controlled Trial

Vol 31 | Issue 1 | Jan – Jun 2018 | page: 15-18 | Appu Benny Thomas, Jacob Varghese, Gnanavel, J C Vinay, Biju Pankappilly.


Authors: Appu Benny Thomas [1], Jacob Varghese [1], Gnanavel [1], J C Vinay [1], Biju Pankappilly [1]

[1] Department of Orthopedics, VPS Lakeshore Hospital and Research Center, Kochi, Kerala, India.

Address of Correspondence
Dr. Appu Benny Thomas
Department of Orthopedics,
VPS Lakeshore Hospital and Research Center, Kochi, Kerala, India
E-mail: appu.benny.thomas@gmail.com


Abstract

Background: Blood loss which is one of the major complications following major surgeries and leads to significant morbidity and substantially increases the need for blood transfusions. Use of hemostatic agent’s intraoperatively is one of the widely used techniques to reduce blood loss. The use of hemostatic agents to reduce blood loss has been widely studied with mixed results. The aim of this study was to evaluate whether the use of Floseal®, a hemostatic most commonly used in our hospital as an adjuvant to conventional hemostasis reduces blood loss and reduces the requirement of transfusions postoperatively in patients undergoing total knee arthroplasty (TKA).
Materials and Methods: This study was a prospective randomized controlled trial conducted on 67 female patients operated between January 2012 and January 2013 with the primary endpoint being blood loss as estimated by a decrease in hemoglobin (Hb) on days 0, 1, and 4 postoperatively. The number of transfusions required postoperatively was also assessed. The patients were divided into two groups: Group A and Group B. Group A consisted of 35 patients in whom the hemostatic was not used. Group B consisted of 32 patients in whom 5ml of hemostatic matrix Floseal®. All the statistical analyses were performed using GraphPad Prism 7.0. Results: Sixty-seven patients participated in the study, and the data of all the patients were analyzed. The demographic data and the mean percentage decrease of Hb from pre-operative values were analyzed which did not show any statistical difference. The odds ratio and relative risk were less than one and were not statistically significant.
Conclusion: The use of a hemostatic agent does not necessarily decrease the need for blood transfusions postoperatively, and the role of hemostatic agents in TKA for reducing blood loss remains uncertain.
Keywords: Blood transfusion, Hemostatic Matrix, Total Knee Arthroplasty.


References

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8. Sepah YJ, Umer M, Ahmad T, Nasim F, Chaudhry MU, Umar M. Use of tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement. J Orthop Surg Res 2011;6:22.

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10. Choi YJ, Hwang JK, Ahn HS, Bae EJ, Kim CH, Kim E. The effect of aprotinin for reducing blood loss and amount of transfusion in total knee arthroplasty. J Korean Knee Soc 2005;17:241-5.

11. Camarasa MA, Olle G, Serra-Prat M, Martín A, Sanchez M, Ricos P, et al. Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: A randomized clinical trial. Br J Anaesth 2006;96:576-82.

12. Gazzeri R, Galarza M, Alfier A. Safety biocompatibility of gelatin hemostatic matrix (Floseal and Surgiflo) in neurosurgical procedures. Surg Technol Int 2012;22:49-54.

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How to Cite this Article: Thomas A B, Varghese J, Gnanavel, Vinay J C, Pankappilly B. The Ambiguous Role of Hemostatic Matrix in Total Knee Arthroplasty: A Randomized Controlled Trial. Kerala Journal of Orthopaedics Jan- Jun 2018;31(1):12-15 .

 


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