title: Effect of re-transfusion systems on physiotherapy participation and transfusion in total knee joint arthroplasty.
abstract: BACKGROUND
  Total knee joint arthroplasty is associated with significant blood loss. We hypothesized that re-transfusion drains would be associated with a lesser requirement for allogeneic blood transfusion and result in earlier physiotherapy participation and decreased length of hospital stay.
  
  
  METHODS
  We performed a retrospective analysis of 303 patients with a mean age of 68.3 years (44-91) who underwent unilateral primary total knee joint arthroplasty within a single orthopaedic unit. A re-transfusion drain, deep drain, superficial drain or no drain was placed at the time of surgery. Blood tests were taken pre- and post-operatively, and blood transfusions were given based on the haemoglobin and clinical symptoms. Medical records data were used to determine the day patients sat out of bed, mobilized more than 10 m and were discharged from hospital.
  
  
  RESULTS
  Patients with a re-transfusion drain were able to sit out of bed (P = 0.006), mobilize more than 10 m (P = 0.006) and were ready for discharge earlier (P = 0.013) than those without a re-transfusion drain. The use of a re-transfusion drain showed no effect on allogenic blood transfusion requirement; however, it was associated with decreased haemoglobin drop when compared with other drain types (P = 0.003).
  
  
  CONCLUSIONS
  Our results suggest that the use of a re-transfusion system following total knee arthroplasty has beneficial physiotherapy outcomes and a decreased length of stay.
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia. nathananderson9@gmail.com.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Anderson
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.|The University of Melbourne Department of Surgery, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Dowsey
authors.affiliation: Department of Orthopaedics, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.|The University of Melbourne Department of Surgery, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
authors.forename: Peter F M
authors.initials: PF
authors.lastname: Choong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D001803:Blood Transfusion / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D019106:Postoperative Hemorrhage / Q000628:therapy*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: re-transfusion system; total knee joint arthroplasty