Does computer-assisted surgical navigation total knee arthroplasty reduce venous thromboembolism compared with conventional total knee arthroplasty?

Ooi LH, Lo NN, Yeo SJ, Ong BC, Ding ZP, Lefi A
Correspondence: Dr Ooi Lai Hock, lai_hock_ooi@ttsh.com.sg

ABSTRACT
Introduction The study aims to show that total knee arthroplasty using computer-assisted surgical navigation without intramedullary rodding is safer than conventional intramedullary techniques in preventing venous thromboembolism.
Methods 30 patients were grouped into groups of 10. Groups A and B had conventional intramedullary rodding of the femur and/or tibia. Group C had no rodding of the femur and tibia using computer-assisted surgical navigation. The degree, duration and size of the embolic shower were captured by a transoesophageal echocardiography probe. The echogenic emboli were graded according to the Mayo Clinic score. Haemodynamic parameters such as pulse oximetry oxygen saturation, end-tidal carbon dioxide, heart rate and mean arterial pressure were also recorded.
Results There was a significant difference in the size of the emboli and the Mayo Clinic score when comparing the groups with intramedullary rodding and those without. There was also a significant difference in the pulse oximetry oxygen saturation and heart rate when the group without intramedullary rodding was compared with groups with rodding.
Conclusion Surgical navigation total knee arthroplasty may be safer than conventional total knee replacement with intramedullary rodding in preventing venous thromboembolism.

Keywords: intramedullary rodding, surgical navigation, pulmonary embolism, total knee arthroplasty, venous thromboembolism
Singapore Med J 2008; 49(8): 610-4