title: Is postoperative cell salvage necessary in total hip or knee replacement? A meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The purpose of this study was to determine whether there are hematological or clinical differences with the use of postoperative cell salvage after total knee (TKR) and hip replacement (THR).
  
  
  METHODS
  A systematic literature review based on PubMed, EMBASE, the Cochrane Library Database in any language regarding postoperative cell salvage following TKR or THR was performed. High quality of randomized controlled trials were identified. The data was analyzed using Rev Man 5.2.
  
  
  RESULTS
  19 randomized controlled trials (12 in TKR, 4 in THR and 3 in both) about 3482 patients were identified and included in this meta-analysis. Postoperative cell salvage significantly reduced the allogeneic blood transfusion requirement after TKR (RR = 0.46, 95% CI = 0.30 to 0.72) and THR (RR = 0.46, 95%CI = 0.32 to 0.68). It also demonstrated a higher level of postoperative Hemoglobin (MD = 0.26 g/dL, 95%CI = 0.15 to 0.37) with the use of postoperative cell salvage. No significant differences were detected regarding length of hospital stay, the incidence of febrile reaction, wound infection and deep vein thrombosis.
  
  
  CONCLUSIONS
  The results strengthen the fact that postoperative cell salvage is effective and safe to reduce the rate of transfusion after TKR and THR. As the relatively poor methodological quality and heterogeneity, further research is needed to confirm its safety and cost-effectiveness.
authors.affiliation: Department of Orthopaedic Surgery and Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China.
authors.forename: Jinwei
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Orthopaedic Surgery and Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Orthopaedic Surgery and Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Orthopaedic Surgery and Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China.
authors.forename: Pengde
authors.initials: P
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery and Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China.
authors.forename: Bin
authors.initials: B
authors.lastname: Shen
authors.affiliation: Department of Orthopaedic Surgery and Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery and Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China.
authors.forename: Zongke
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedic Surgery and Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China. Electronic address: peifuxinghuaxi@126.com.
authors.forename: Fuxing
authors.initials: F
authors.lastname: Pei
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007902:Length of Stay; D057725:Operative Blood Salvage; D016032:Randomized Controlled Trials as Topic
chemical_list: D006454:Hemoglobins
keywords: Cell salvage; Meta-analysis; Total hip replacement; Total knee replacement