Browsing by Author "Caldeira-Dantas, Sofia"
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- Blood management in total knee arthroplasty: an exploratory study regarding the use of drain and tranexamic acid in two types of instrumentationPublication . Dias, Pedro Alexandre; Caldeira-Dantas, Sofia; Carvalho, Maria Miguel; Marreiros, Ana; de Almeida Fontes, Ana Paula; Sousa, João PauloBackground: This study investigates how presence or absence of drain or tranexamic acid (TXA) in 2 different types of instrumentation with invasion/sparing femoral canal affects hemoglobin drop after total knee arthroplasty (TKA). Methods: This was a retrospective observational study that included 736 individuals divided in five groups, regarding conventional instrumentation (CI) or patient specific instrumentation (PSI), presence or absence of drain and TXA. Mean percentage of hemoglobin drop after the first postoperative day was compared for each group. Results: Patients submitted to CI using drain and no TXA revealed the highest value (21,3%±9,1; p<0,001). Groups who received TXA and drain was not used, presented the lowest blood loss. Moreover, with the introduction of TXA PSI lost its advantage over CI. Conclusions: TKA using CI, without drain and with TXA administration showed better results, reducing mean percentage of hemoglobin drop after surgery.
- Does patient-specific instrumentation in primary total knee arthroplasty improve long-term satisfaction or function? A randomized trial with a 9-year follow-upPublication . Caldeira-Dantas, Sofia; Gonçalves, Marta; Vaz-Pinto, Gonçalo; Dias, Pedro; Marreiros, Ana; de Almeida Fontes, Ana Paula; Sousa, João P.Background: Patient-specific instrumentation (PSI) aims to increase the accuracy of total knee arthroplasty (TKA). However, the long-term benefit compared to conventional instrumentation (CI), is still controversial. This randomized controlled trial compares the long-term outcomes between PSI and CI in TKA. Methods: Patients submitted to PSI or CI TKA with a minimum follow-up of 8 years were evaluated. Satisfaction levels, forgotten joint score (FJS) and Western Ontario and McMaster university osteoarthritis index (WOMAC) scores were compared. Regarding descriptive statistics, mean, standard deviation and frequencies were obtained. For inferential statistics we used the t test for independent samples the Mann-Whitney test and the Wilcoxon Test. Results: A total of 50 TKA were included (48% CI; 52% PSI) with an average follow-up time of 9.3 years. At the final follow-up the WOMAC score was similar between groups (p=0.846; CI:26.8±22.5; PSI:26.8±25.3). Similarly, no differences were seen for the FJS (p=0.785; CI:59.6±35.1; PSI:57.1±36.2) or satisfaction (p=0.486; CI:8.1±2.8; PSI:9.1±1.4). However, at the final follow-up, the total WOMAC score had worse results when compared to the previous evaluations (p=0.013 for CI group; p=0.009 for PSI group). No significant differences in the satisfaction levels were detected regarding the initial and final evaluations (p=0.581 for CI group; p=0.936 for PSI group). Conclusions: Nine years after TKA, PSI and CI patients reported similar levels of satisfaction and functioning. Both groups achieved similar results concerning the WOMAC, FJS scores and satisfaction levels. This study suggests that long-term satisfaction and functioning levels are similar in both PSI and CI.