title: An economic justification for autologous blood re-infusion in primary total knee replacement surgery.
abstract: BACKGROUND
  To justify economically the use of autologous blood re-infusion after total knee replacement surgery compared with vacuum drains. To determine if the patients using autologous re-infusion units have a reduced allogenic blood transfusion requirement and hospital stay.
  
  
  METHODS
  Prospectively, 50 patients undergoing primary unilateral total knee replacements with autologous re-infusion units were studied. They were matched for age, sex, type of prosthesis and the month in which surgery took place to a second group undergoing the same surgery with vacuum drains. The results for the second group were obtained retrospectively from the notes. The outcome measures were the need for allogenic blood transfusion and length of postoperative hospital stay.
  
  
  RESULTS
  The use of re-infusion units reduced the need for postoperative allogenic blood transfusion from 28% to 4% in total knee replacement surgery. The cost of using re-infusion units was the same as vacuum drains. Overall, the autologous re-infusion patients were discharged 2 days earlier (99% confidence interval).
  
  
  CONCLUSIONS
  Re-infusion units are no more expensive than vacuum drains. In addition, autologous blood has many clinical benefits compared to allogenic blood. Re-infusion may shorten the hospital stay for patients undergoing total knee replacement surgery.
authors.affiliation: Department of Orthopaedic Surgery, Weston General Hospital, Weston-super-Mare, UK.
authors.forename: J E
authors.initials: JE
authors.lastname: Rees
authors.forename: R
authors.initials: R
authors.lastname: Jeavons
authors.forename: J H
authors.initials: JH
authors.lastname: Dixon
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000191:economics*; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000191:economics* / Q000295:instrumentation; D004739:England; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D011182:Postoperative Care / Q000191:economics / Q000379:methods; D011446:Prospective Studies; D012189:Retrospective Studies