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The Influence of Femoral Cementing on Perioperative Blood Loss in Total Knee ArthroplastyA Prospective Randomized Study
Guillaume Demey, MD1; Elvire Servien, MD1; Alban Pinaroli, MD1; Sébastien Lustig, MD1; Tarik Aït Si Selmi, MD1; Philippe Neyret, MD1
1 Centre Albert-Trillat, Hôpitaux de la Croix-Rousse, 8 rue de Margnolles, 69300 Caluire-Lyon, France. E-mail address for G. Demey: guillaume.demey@chu-lyon.fr
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Tornier Laboratory, Saint-Ismier, France).

A commentary by Kace A. Ezzet, MD, is available at www.jbjs.org/commentary and as supplemental material to the online version of this article.
Investigation performed at the Centre Albert-Trillat, Hôpitaux de la Croix-Rousse, Lyon, and Université Claude Bernard Lyon 1, Lyon, France

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Mar 01;92(3):536-541. doi: 10.2106/JBJS.H.01159
The erratum to this article has been published | view the erratum
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Total knee arthroplasty can involve substantial blood loss. We prospectively studied a consecutive series of patients undergoing primary total knee arthroplasty to assess the influence of femoral cementing on perioperative blood loss. We hypothesized that an uncemented femoral component is a risk factor for bleeding.


A semiconstrained posterior stabilized prosthesis was used in all patients. Preoperatively, 130 patients were randomly assigned to either the cement group (Group 1) or the hybrid group (Group 2). We selected all patients who underwent a knee replacement through a medial parapatellar approach (n = 107). Group 1 consisted of forty-two women and twelve men ranging in age from fifty-six to eighty-five years. Group 2 consisted of thirty-seven women and sixteen men ranging in age from fifty-six to eighty-five years. The hemoglobin and hematocrit levels were recorded preoperatively and five days postoperatively for each patient. The volumes of postoperative suction drainage and the rate of blood transfusion were recorded.


No differences between the two groups were identified with regard to hemoglobin and hematocrit levels, total measured blood loss, postoperative drainage amounts, or transfusion rates. The total measured blood loss was 1758.9 mL for Group 1 and 1759 mL for Group 2.


Cementing the femoral component during a total knee arthroplasty does not appear to influence the amount of perioperative blood loss or the need for postoperative blood transfusion.

Level of Evidence: 

Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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