Effects of computer navigation versus conventional total knee arthroplasty on endothelial damage marker levels: A prospective comparative study

Shu Jui Kuo, Feng Sheng Wang, Ching Jen Wang, Jih Yang Ko, Sung Hsiung Chen, Ka Kit Siu

Research output: Contribution to journalJournal Article peer-review

15 Scopus citations

Abstract

Total knee arthroplasty (TKA) inevitably perturbs the femoral medullary canal, which increases blood loss or morbidities associated with marrow embolization postoperatively. Computer navigation TKA reportedly minimizes medullary disturbance to alleviate perioperative blood loss. We performed a prospective comparative study, enrolling 87 patients with osteoarthritic knees from March 2011 to December 2011 in our hospital. The patients were separated into two groups, according to the surgeon they visited. Fifty-four patients underwent computer navigation TKAs and 33 had conventional TKAs. Levels of cell adhesion molecules (CAMs), including intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and platelet endothelial cellular adhesion molecule-1 (PECAM-1) in sera and hemovac drainage were measured by ELISA before and 24 hours after the surgery. We showed that patients receiving computer navigation TKAs had less blood loss and lower CAMs in serum and hemovac drainage after the operation. Less postoperative elevation of serum ICAM-1 (p=0.022) and PECAM-1 (p=0.003) from the preoperative baseline after the surgery was also noted. This study provides molecular evidence for the differential extent in vascular injury between conventional and navigation TKAs and sheds light on the possible benefits of computer navigation TKAs. Trial Registration ClinicalTrials.gov NCT02206321.

Original languageEnglish
Article number0126663
JournalPLoS ONE
Volume10
Issue number5
DOIs
StatePublished - 01 05 2015

Bibliographical note

Publisher Copyright:
© 2015 Kuo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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