Autologous blood donation in total knee arthroplasties is not necessary.
BACKGROUND
This study intends to prove the hypothesis that preoperative autologous blood donation in total knee arthroplasties (TKA) is dispensable.


METHODS
The study comprises a prospective analysis of 81 consecutive TKA without preoperative autologous blood donation (AB-donation). Guidelines for blood retransfusion were used. Surgery, as well as the pre- and postoperative procedures were identical for each patient. In the analysis of the data, the consecutive TKAs were divided into patients who were eligible for preoperative autologous blood donation (group 1, n = 46) and those with relevant risk factors not permitting preoperative autologous blood donation (group 2, n = 35).


RESULTS
None of the patients in group 1 needed a blood transfusion. 14 of 35 patients in group 2 needed an allogenic blood transfusion.


CONCLUSIONS
Total knee arthroplasty can be managed without preoperative AB-donation if it is performed using a tourniquet, if a postoperative collection and direct retransfusion system is used for the wound blood, and if the transfusion algorithm is defined according to compulsory and practical guidelines.
Müller
Urs
U
Institute for Evaluative Research in Orthopaedic Surgery, University of Bern, CH-3008 Bern, Switzerland. umueller@memced.org
Röder
Christoph
C
Pisan
Markus
M
Orler
Rene
R
El-Kerdi
Amer
A
Eggli
Stefan
S
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D001804:Blood Transfusion, Autologous / Q000379:methods*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D020896:Hypovolemia / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D016037:Single-Blind Method