title: Cell Saver Use in Acetabular Surgery: Does Approach Matter?
abstract: OBJECTIVE
  To determine if intraoperative autologous transfusion using a Cell Saver (CS) was routinely indicated for open reduction internal fixation (ORIF) of acetabular fractures, and if so, was there a difference between differing surgical approaches.
  
  
  METHODS
  Retrospective single-center cohort study.
  
  
  METHODS
  University Level 1 trauma center.
  
  
  METHODS
  One hundred forty-five consecutive acetabular fractures using intraoperative autologous transfusion, either treated with an anterior ilioinguinal or a posterior-based Kocher-Langenbeck approach, were compared.
  
  
  METHODS
  Use of CS in ORIF acetabular cases.
  
  
  METHODS
  CS utilization and CS blood return for acetabular ORIF. Mean intraoperative blood loss between the 2 approaches.
  
  
  RESULTS
  CS blood was returned in 29 of the 145 total cases [23/65 anterior (ilioinguinal approach) and 6/80 posterior approach (Kocher-Langenbeck)]. Mean intraoperative blood loss was 786 mL for the anterior approach and 485 mL for the posterior approach. Subgroup analysis identified anterior approach as the only risk factor for elevated blood loss and CS blood return.
  
  
  CONCLUSIONS
  CS is not indicated for routine use when performing ORIF of the acetabulum. Use of the CS may be warranted with anterior approaches if large amounts of blood loss are anticipated.
  
  
  METHODS
  Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors: Orthopaedics and Sports Medicine, UW Medicine, University of Washington, Seattle, WA.
authors: Reza
authors: R
authors: Firoozabadi
authors: Alan
authors: A
authors: Swenson
authors: Conor
authors: C
authors: Kleweno
authors: Milton C
authors: MC
authors: Routt
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D004867:Equipment Design; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data; D050723:Fractures, Bone / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014861:Washington / Q000453:epidemiology; D055815:Young Adult