کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5732403 1611942 2017 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
ReviewEffect of different postoperative limb positions on blood loss and range of motion in total knee arthroplasty: An updated meta-analysis of randomized controlled trials
ترجمه فارسی عنوان
بررسی تأثیر موقعیت های مختلف پس از عمل جراحی بر میزان خونریزی و محدوده حرکت در آرتروپلاستی کل زانو: متاآنالیز به روز شده از آزمایشات تصادفی کنترل شده
کلمات کلیدی
آرتروپلاستی کامل زانو، خفیف فلکسن، بالا خم شدن از دست دادن خون،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی عمل جراحی
چکیده انگلیسی


- We compared the efficacy of the two different limb position in primary TKA.
- Subgroup analysis was performed based mild-flexion and high-flexion position.
- High-flexion has a similar efficacy to mild-flexion position in reducing blood loss.
- High-flexion position is more advantageous in improving range of motion.

BackgroundPostoperative limb positioning has been reported to be an efficient and simple way to reduce blood loss and improve range of motion following total knee arthroplasty (TKA). This meta-analysis was designed to compare the effectiveness of two different limb positions in primary TKA.Materials and methodsA meta-analysis of the PubMed, CENTRAL, Web of Science, EMBASE and Google Search Engine electronic databases was performed. In this meta-analysis, two postoperative limb positions were considered: mild-flexion (flexion less than 60°) and high-flexion (flexion at 60° or more). The subgroups were analysed using RevMan 5.3.ResultsNine RCTs were included with a total sample size of 913 patients. The mild- and high-flexion positions significantly reduced postoperative total blood loss (P = 0.04 and P = 0.01; respectively). Subgroup analysis indicated that knee flexion significantly reduced hidden blood loss when the knee was fixed in mild-flexion (P = 0.0004) and significantly reduced transfusion requirements (P = 0.03) and improved range of motion (ROM) (P < 0.00001) when the knee was fixed in high-flexion. However, the rates of wound-related infection, deep venous thrombosis (DVT) and pulmonary embolism (PE) did not significantly differ between the two flexion groups.ConclusionThis meta-analysis suggests that mild- and high-flexion positions have similar efficacy in reducing total blood loss. In addition, subgroup analysis indicates that the mild-flexion position is superior in decreasing hidden blood loss compared with high-flexion; the high-flexion position is superior to mild-flexion in reducing transfusion requirements and improving postoperative ROM. Thus, the use of the high-flexion position is a viable option to reduce blood loss in patients following primary TKA without increasing the risk of wound-related infection, DVT or PE.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Surgery - Volume 37, January 2017, Pages 15-23
نویسندگان
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