Efficacy of intraoperative blood collection and reinfusion in revision total hip arthroplasty.
BACKGROUND
Patients undergoing revision total hip arthroplasty frequently require perioperative blood transfusion, increasing the risk for blood-borne disease and anaphylactic and hemolytic reactions. The purpose of this retrospective study was to evaluate the effect of intraoperative blood collection and reinfusion on net blood loss in patients undergoing revision hip arthroplasty.


METHODS
The medical records of 126 patients who had had a revision total hip arthroplasty with intraoperative blood salvage, with use of a collection and reinfusion device, during a twenty-eight-month period were reviewed. For comparison, the medical records of ninety-six patients who had undergone revision hip arthroplasty without intraoperative blood salvage were reviewed. Each of the 222 patients was categorized into a group on the basis of the type of revision.


RESULTS
Patients who had a revision of the femoral and acetabular components (Group C) had significantly higher mean intraoperative and total blood loss than did those who had a revision of the femoral component only (Group A [p = 0.009 and p = 0.02, respectively]) or a revision of the acetabular component only (Group B [p = 0.0001 for both]). Total blood loss was not significantly different between Groups A and B. The mean amount of blood reinfused intraoperatively was 356 mL for the patients in Group A, 374 mL for the patients in Group B, and 519 mL for the patients in Group C. Regression analysis showed a significant decrease in net blood loss with intraoperative collection and reinfusion in Groups B (p = 0.002) and C (p = 0.0001) but not in Group A.


CONCLUSIONS
Intraoperative collection and reinfusion substantially decreased net perioperative blood loss in patients who had a revision of both components (Group C) and in those who had a revision of the acetabular component (Group B). The use of intraoperative blood collection and reinfusion appears to be a valuable method of preserving blood volume in the perioperative period.
Zarin
Jeffrey
J
Department of Orthopaedic Surgery, Stanford University Medical Center, 300 Pasteur Drive, Room R-144, Stanford, CA 94305, USA.
Grosvenor
David
D
Schurman
David
D
Goodman
Stuart
S
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome