Investigation of the use of drained blood reinfusion after total knee arthroplasty: a prospective randomised controlled study.
OBJECTIVE
To compare the use of a blood salvage and reinfusion system with standard allogeneic blood transfusion after total knee arthroplasty--a procedure associated with significant postoperative blood loss.


METHODS
Between June 2002 and May 2004, 60 patients undergoing total knee arthroplasty were randomly allocated into a reinfusion group (n = 26) or a control group (n = 34). Patients in the reinfusion group had their blood reinfused from drains within 6 hours of surgery. Both groups received allogeneic blood transfusions according to specified transfusion criteria if the haemoglobin level fell below 90 g/l, or in the presence of severe anaemic symptoms. Haemoglobin levels and drain output were recorded daily for 3 consecutive days after surgery.


RESULTS
There was no significant difference between the 2 groups in demographic data, drain output, total blood loss, and mean postoperative haemoglobin levels. Significantly more allogeneic blood was required by the control group than by the reinfusion group (p = 0.022).


CONCLUSIONS
Postoperative reinfusion of drained blood reduced the need for blood transfusion after total knee arthroplasty, while having an effect on postoperative haemoglobin level equivalent to standard allogeneic blood transfusion.
Cheng
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SC
Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong. drandycheng@yahoo.com.hk
Hung
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Tse
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D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001804:Blood Transfusion, Autologous / Q000379:methods*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D016896:Treatment Outcome
D006454:Hemoglobins