title: Efficacy and safety using autotransfusion system with postoperative shed blood following total knee arthroplasty in haemophilia.
abstract: The purpose of this study was to evaluate the efficacy and safety of postoperative wound drain salvage and autotransfusion system in haemophilic patients undergoing elective total knee arthroplasty (TKA). No literature exists on reinfusing drained blood in patient with haemophilia undergoing TKA. Eighty-eight knees of 66 patients received cemented TKA due to end-stage haemophilic arthropathy (group I; with autotransfusion in 59 knees, group II; without autotransfusion in 29 knees). In group I, the postoperative shed blood was transfused within 6 h after surgery. The amount of blood drainage and reinfused blood, rate and amount of allogenic transfusion, postoperative change of haemoglobin level, prothrombin time (PT) and activated partial thromboplastin time were analysed. The mean postoperative blood drainage was 932 ± 479 mL in group I and 830 ± 492 mL in group II (P > 0.05). The mean volume of blood reinfused was 530 ± 265 mL in group I. Allogenic transfusion was needed in six knees (10.2%) of group I and eight knees (27.6%) of group II (P = 0.036). The mean volume of allogenic transfusion was 480 ± 49 mL in group I and 1041 ± 691 mL in group II (P > 0.05). Changes of all the laboratory results before and after TKA showed no statistically significant difference except PT was prolonged in group I (P = 0.008) at postoperative day 1. Moreover, there was no significant complication related to either reinfusion or allogenic transfusion in both groups. This study showed that reinfusion of drained blood is a simple, safe and efficacious method in patients with haemophilia undergoing TKA.
authors.affiliation: Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: D G
authors.initials: DG
authors.lastname: Kang
authors.forename: S
authors.initials: S
authors.lastname: Khurana
authors.forename: J H
authors.initials: JH
authors.lastname: Baek
authors.forename: Y S
authors.initials: YS
authors.lastname: Park
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: K I
authors.initials: KI
authors.lastname: Kim
mesh_terms: D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001777:Blood Coagulation; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous / Q000009:adverse effects; D004322:Drainage; D004909:Erythrocyte Indices; D006395:Hemarthrosis / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D006467:Hemophilia A / Q000097:blood / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome
keywords: allogenic transfusion; autotransfusion; haemophilic arthropathy; total knee arthroplasty