Using Bone Plugs to Cut TKA Blood Loss– New Data

A new meta-analysis based on four randomized controlled trials and 636 patients has found that using a bone plug for intramedullary sealing in total knee arthroplasty (TKA) can be effective in reducing blood loss.

Concerned that the opening created during a distal femoral cut may become a channel that drains intramedullary blood to the knee joint after surgery if left open during surgery, the researchers compared a sealed opening using an intramedullary bone plug with no bone plug. The team conducted literature searches of PubMed, Ovid, Embase, and Cochrane Library in order to identify all publications before May 2018.

The study, “Intramedullary sealing with a bone plug in total knee arthroplasty to reduce blood loss: a meta-analysis of randomized controlled trials,” was published in the April 8, 2019 edition of the Journal of Orthopaedic Surgery and Research.

Varah Yuenyongviwat, M.D., assistant professor of orthopedics at Prince of Songkla University in Thailand and co-author on the study, told OTW, “Intramedullary sealing with a bone plug in total knee arthroplasty is a common procedure which many orthopedic surgeons use. However, there are some surgeons who are ignoring this method because they believe that the benefit of this procedure has not been proved. So, I performed this study to evaluate the real benefit of this procedure.”

“Our study demonstrated that patients with intramedullary plug had lower rates of blood transfusion and lower level of reduced postoperative hemoglobin than patients in whom the intramedullary canal was not plugged.”

“Our study proved that intramedullary sealing with a bone plug in total knee arthroplasty worked. We suggest that all of total knee arthroplasty operation should apply this method because there is no additional of cost or operative time for this method.”