Fat Emboli in Total Knee Arthroplasty: A Prospective Randomized Study of Computer-Assisted Navigation vs Standard Surgical Technique
Received 2 February 2009; accepted 7 August 2009. published online 02 November 2009. Corrected Proof
Abstract
A prospective exploratory study of fat emboli in patients undergoing total knee arthroplasty was performed in patients randomly assigned to surgery with computer-assisted navigation or standard technique. Transesophageal echocardiography of the right atrium was recorded for 5 consecutive 1-minute intervals after tourniquet deflation. Emboli were graded on a scale of 0 to 3 based on embolism size, amount of atrium filled, and duration of embolic shower, creating an overall score of 0 to 9. The mean (SD, range) of the 5 overall scores for each total knee arthroplasty was 6.00 (0.76, 4.6-7.4) for computer-assisted navigation (22 patients) and 6.42 (0.97, 4.6-7.9) for standard technique (22 patients) (P = .14), with a 95% confidence interval for the difference of −0.11 to 0.95. We conclude that any difference in extent of emboli between the 2 surgical techniques is unlikely to be of clinical significance.
⁎Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida
†Division of Anesthesia Services, Mayo Clinic, Jacksonville, Florida
‡Biostatistics Unit, Mayo Clinic, Jacksonville, Florida
Reprint requests: Mary I. O'Connor, MD, Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224.
Benefits or funds were received in partial or total support of the research material subscribed in this article. This substudy did not receive any outside funding; however, the parent study was supported by research funding from DePuy, a Johnson and Johnson Company.
Disclaimers: Dr O'Connor received consulting fees from DePuy exceeding the federal threshold for significant financial interest in the 12 months preceding initiation of the trial. Dr O'Connor's consulting activity ended before the onset of the trial.
ABSTRACT