title: No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls.
abstract: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA.
  
  
  
  In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet. Twenty-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group.
  
  
  
  No significant differences were found neither for calculated blood loss, with 1397 (standard deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up.
  
  
  
  The use of a bipolar sealer in a TKA revision setting without the use of a tourniquet did not reduce blood loss or blood transfusion rates.
authors.affiliation: Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark; Orthopedic Department, Harris Orthopedic Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Christian Skovgaard
authors.initials: CS
authors.lastname: Nielsen
authors.affiliation: Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Kirill
authors.initials: K
authors.lastname: Gromov
authors.affiliation: Section of Surgical Pathophysiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Øivind
authors.initials: Ø
authors.lastname: Jans
authors.affiliation: Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Troelsen
authors.affiliation: Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Husted
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D004564:Electrocoagulation; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014111:Tourniquets
keywords: Aquamantys; bipolar sealer; blood loss; blood transfusion; revision knee arthroplasty