Blood Loss and Transfusion Rates Following Patellofemoral Arthroplasty




Patellofemoral arthroplasty (PFA) is a viable treatment option of the patient with isolated patellofemoral arthritis. Some of the purported advantages of PFA compared with total knee arthroplasty (TKA) include less invasive approach, less bone resection and tissue destruction, decreased operative time, shorter rehabilitation, better knee kinematics, and decreased blood loss. This study compared the blood loss associated with PFA with that of a cohort of patients with TKA. A proposed benefit of partial knee arthroplasty is less blood loss. Patellofemoral replacement seems not to have this benefit and blood loss prevention initiatives similar to those of TKA should be maintained.








  • Patellofemoral arthroplasty (PFA) has recently been gaining in popularity for the treatment of severe arthritis of the patellofemoral joint.



  • Some of the purported advantages of PFA compared with total knee arthroplasty include less invasive approach, less bone resection and tissue destruction, decreased operative time, shorter rehabilitation, more normal knee kinematics, and decreased blood loss.



  • When performed with an effective blood loss protocol, the need for allogeneic blood transfusions can be greatly reduced in patients needing knee arthroplasty.



Key Points


Introduction


Patellofemoral arthroplasty (PFA) has recently been gaining in popularity for the treatment of severe arthritis of the patellofemoral joint. This popularity may be attributed to new design features, which include more accurate anatomic design to mimic patellofemoral joint function. These newer designs, with their encouraging short-term and intermediate-term results, make PFA a viable treatment alternative to total knee replacement for patients with isolated patellofemoral arthritis.


Some of the purported advantages of PFA compared with total knee arthroplasty (TKA) include less invasive approach, less bone resection and tissue destruction, decreased operative time, shorter rehabilitation, more normal knee kinematics, and decreased blood loss. In the current orthopedic literature, there is a paucity of data related to blood loss in PFA. In a recent PubMed search, only 1 study, conducted by Dahm and colleagues, described blood loss in PFA compared with TKA. PFA had statistically decreased intraoperative blood loss compared with TKA. They also found different transfusion rates between the groups (4% in PFA vs 27% in TKA).


We performed a retrospective review of our PFAs and compared the mean blood loss with a cohort of our patients who had TKA, to test the hypothesis that PFA results in decreased blood loss compared with TKA.

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Oct 6, 2017 | Posted by in ORTHOPEDIC | Comments Off on Blood Loss and Transfusion Rates Following Patellofemoral Arthroplasty

Full access? Get Clinical Tree

Get Clinical Tree app for offline access