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Objective To demonstrate whether there is a difference in the time that total knee arthroplasty (TKA) takes according to the instrumentation system used. Material and methods Retrospective analysis of the duration of 243 interventions (skin-to-skin time and ischaemia time) performed by the same surgeon. 72 cases operated with conventional instruments (CI), 68 operated with computer assisted surgery (CAS) and 103 with personalized instrumentation system (PSI). Results CI skin-to-skin 87.85 min (SD 11.86). CI ischaemia 94.44 min (SD 11.49). CAS skin-to-skin 123.46 min (SD 11.27). CAS ischaemia 129.63 min (SD 11.37). PSI skin-to-skin 78.69 min (SD 13.06). PSI ischaemia 84.63 (DE 12.06). There is a significant difference between PSI and the other instrumentation systems (p 0.000). Conclusions In our study, the time taken for TKA was significantly lower when we used customized cutting blocks rather than other systems.

Objectives To non-invasively assess tissue lesion secondary to ischaemia applied during knee replacement surgery. Secondary objectives: to assess whether this lesion correlates with the duration of ischaemia and whether instrumental and gender variables influence it. Material and methods Prospective cohort study. Pre and postoperative serum lactate levels have been determined as an indicator of glycolytic activity secondary to ischaemia in 88 patients. Serum lactate determination was performed by reactive strips of enzymatic–amperometric detection on capillary blood. Results Preoperative serum lactate levels (mean and SD): 2.467 ± 1.036 mmol/L. Postoperative serum lactate levels: 3.938 ± 2.018 mmol/L. Ischaemia time 102.98 ± 18.25 min. Postoperative serum lactate levels were significantly higher than preoperative lactate levels. There are no statistical differences according to the time that the ischaemia was prolonged, gender or type of instrumentation used. Conclusions In our study, postoperative serum lactate values were significantly higher than preoperative lactate values, with no correlation to the duration of ischaemia during knee replacement surgery.