Blood loss and transfusion risk in robotic‐assisted knee arthroplasty: A retrospective analysis

Abstract

Background:The purpose of this study was to compare total blood loss and the risk of receiving a blood transfusion in robotic-assisted total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) against conventional jig-based techniques.Methods: Robotic TKA (n = 50) and UKA (n = 50) patients were matched to contemporary controls for TKA (n = 50) and UKA (n = 50) and retrospectively analysed.Results: Robotic TKA patients experienced 23.7% less blood loss compared to conventional TKA patients (911.0 ml vs 1193.7 ml, p < 0.01), and were associated with an 83% relative risk reduction of receiving a transfusion (2% of patients vs 12%, p = 0.02). Robotic UKA patients did not demonstrate less blood loss compared to corresponding controls (821.7 ml vs 854.7 ml, p = 0.69). Both UKA groups received no transfusions.Conclusions: Robotic surgical systems in TKA reduces blood loss and lowers the risk of requiring a blood transfusion. In UKA, robotic-assisted arthroplasty did not reduce blood loss compared to conventional arthroplasty.

Comparison of Robotic and Conventional Unicompartmental Knee Arthroplasty Outcomes in Patients with Osteoarthritis: A Retrospective Cohort Study

“…The surgical time may decrease as surgeons gain familiarity [ 7 ]. In our study, blood loss was greater in RUKA than in CUKA, which is consistent with the results of Khan et al [ 18 ]. The blood loss in RUKA could also be associated with surgeons’ lack of familiarity with the technique.…”

Evaluation of Blood Loss in Conventional vs MAKOplasty Total Knee Arthroplasty

“…Based on these inherent differences between RATKA and CTKA, as well as the aforementioned studies by Khan et al. [ 11 ] and Onggo et al. [ 15 ], we hypothesized that patients treated with CTKA would have a larger decline in postoperative hemoglobin values and higher rates of postoperative PRBC transfusions.…”

“…In addition to multimodal approaches to blood management in TKA, some literature has shown decreased blood loss and transfusion requirements in RATKA compared to CTKA [ [11] , [12] , [13] , [14] , [15] ]. In a single-institution retrospective review, Khan et al.…”

“…In a single-institution retrospective review, Khan et al [11] found a statistically significant reduction in the percentage of patients requiring a blood transfusion who underwent RATKA using the NAVIO surgical system (Smith & Nephew, Watford, England) compared to CTKA. In their cohort of 100 patients, 12% of patients in the CTKA group required blood transfusion compared to 2% of patients in the RATKA group, P ¼ .01 [11]. A meta-analysis by Onggo et al [15] evaluating 2 studies with a total of 80 patients compared RATKA using ROBODOC (Integrated Surgical Systems, Sacramento, CA) to CTKA.…”

“…These include preoperative hemoglobin optimization, use of regional anesthesia, tourniquet application, stringent postoperative transfusion criteria, and administration of perioperative tranexamic acid (TXA) [ 5 , 10 ]. In addition to blood management programs, preliminary literature has shown that robot-assisted TKA (RATKA) when compared to conventional TKA (CTKA) results in significant decreases in perioperative blood loss and rates of postoperative blood transfusion [ [11] , [12] , [13] , [14] , [15] ].…”