Discussion
®, blood loss, intraoperative blood loss, pain, blood loss or blood transfusion, TKA, RBC loss
BLOOD LOSS, CAVITY, INTRAOPERATIVE BLOOD LOSS
TKA is a surgical procedure that is associated with large volume of blood loss and increased postoperative blood transfusion. Various techniques to reduce perioperative visible and hidden blood loss, including intravenous injection of tranexamic acid with/without intra-articular combination, or applying topical hemostatic agent e.g., Floseal® at the surgical site, were shown to reduce total blood loss and blood transfusion in patients undergoing TKA or SBTKA [Accordingly, this study is the first randomized double-blind controlled trial to investigate blood loss and transfusion compared between patients undergoing SBTKA with the ABN device and patients undergoing the conventional SBTKA technique. We used the Merculiari formula to calculate the estimated total RBC loss because of well reproducible and using the parameter which covers the overall perioperative period, including total blood volume and the blood transfusion volume. One of the strengths of this formula is comparison of blood-related parameters at specified time points (e.g., preoperative Hct compared to Hct at postoperative day 5) [A retrospective case-control study by Jhurani et al. found that patients who underwent SBTKA with computer navigation experienced no blood loss or blood transfusion benefit compared to those who underwent conventional SBTKA [Intramedullary breaching and guide rod insertion in conventional TKA may stimulate pain and aggravate the inflammatory process in the medullary cavity [This study has some mentionable limitations. First, the vast majority of subjects in this study were female, which may be a factor influencing blood loss during TKA. Prasad et al. reported that gender plays a role in postoperative blood loss, but not in intraoperative blood loss, and they found no significant difference in the amount of blood transfusion between genders [