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Published in: Archives of Orthopaedic and Trauma Surgery 6/2010

01-06-2010 | Orthopaedic Surgery

Prospective comparative study of two different autotransfusion methods versus control group in total knee replacement

Authors: Konstantinos S. Blatsoukas, Georgios I. Drosos, Konstantinos Kazakos, Miltiadis Papaioakim, Theodora Gioka, Pelagia Chloropoulou, Dionisios-Alexandros Verettas

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2010

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Abstract

Aim

The aim of this study was to evaluate the efficacy of two different autotransfusion methods in total knee replacement (TKR) performed without tourniquet, in comparison to allogeneic blood transfusion (ABT) only.

Method

In a comparative study, 248 patients with knee osteoarthritis were randomized in three groups: in control Group 85 the patients underwent only ABT post-operatively, in Group 1 (n:92) an intraoperative and postoperative autotransfusion were utilized, and in Group 2 (n:71) only a postoperative autotransfusion was applied. Post-operative ABT was utilized according to predetermined criteria.

Results

Comparing Group 0 to Group 1 and 2 the difference in need for ABT post-operatively was statistically highly significant (p < 0.001) even when the results were analyzed classifying the patients according to the preoperative Hb levels. The difference between Group 1 and 2 was not significant.

Conclusion

According to the results of this study, auto-transfusion reduces the need for ABT in TKR performed without tourniquet.
Literature
1.
go back to reference Albert GM, Matthew PF, Daniel EM, Parsons JR (1990) Perioperative blood loss associated with total knee arthroplasty. J Bone Joint Surg Am 72:1010–1012 Albert GM, Matthew PF, Daniel EM, Parsons JR (1990) Perioperative blood loss associated with total knee arthroplasty. J Bone Joint Surg Am 72:1010–1012
2.
go back to reference Keating EM, Meding JB, Faris PM, Ritter MA (1998) Predictors of transfusion risk in elective knee surgery. Clin Orthop Relat Res 357:50–59CrossRefPubMed Keating EM, Meding JB, Faris PM, Ritter MA (1998) Predictors of transfusion risk in elective knee surgery. Clin Orthop Relat Res 357:50–59CrossRefPubMed
3.
go back to reference Rosencher N, Kerkkamp HE, Macheras G, Munuera LM, Menichella G, Barton DM, Cremers S, Abraham IL, OSTHEO Investigation (2003) Orthopedic surgery transfusion hemoglobin european overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe. Transfusion 43:459–469CrossRefPubMed Rosencher N, Kerkkamp HE, Macheras G, Munuera LM, Menichella G, Barton DM, Cremers S, Abraham IL, OSTHEO Investigation (2003) Orthopedic surgery transfusion hemoglobin european overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe. Transfusion 43:459–469CrossRefPubMed
4.
go back to reference Sehat KR, Evans RL, Newman JH (2004) Hidden blood loss following hip and knee arthroplasty: correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br 86-B:561–565 Sehat KR, Evans RL, Newman JH (2004) Hidden blood loss following hip and knee arthroplasty: correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br 86-B:561–565
5.
go back to reference Williamson LM, Lowe S (1999) Serious hazards of transfusion (SHOT) initiative: analysis of the two annual reports. Br Med J 319:16–19 Williamson LM, Lowe S (1999) Serious hazards of transfusion (SHOT) initiative: analysis of the two annual reports. Br Med J 319:16–19
6.
go back to reference Hill GF, Frawley WH, Griffith KF, Forestner JE, Minei JP (2003) Allogeneic blood transfusion increases the risk of postoperative bacterial infection: a meta-analysis. J Trauma 54(5):908–914CrossRefPubMed Hill GF, Frawley WH, Griffith KF, Forestner JE, Minei JP (2003) Allogeneic blood transfusion increases the risk of postoperative bacterial infection: a meta-analysis. J Trauma 54(5):908–914CrossRefPubMed
7.
go back to reference Keating EM, Ritter MA (2002) Transfusion options in total joint arthroplasty. J Arthroplasty 17(4 Suppl 1):125–128CrossRefPubMed Keating EM, Ritter MA (2002) Transfusion options in total joint arthroplasty. J Arthroplasty 17(4 Suppl 1):125–128CrossRefPubMed
8.
go back to reference Spence RK (2004) Current concepts and issues in blood management. Orthopedics 27(6 Suppl):s643–s651PubMed Spence RK (2004) Current concepts and issues in blood management. Orthopedics 27(6 Suppl):s643–s651PubMed
9.
go back to reference Moonen AF, Neal TD, Pilot P (2006) Pre-operative blood management in elective orthopaedic surgery. A critical review of the literature. Injury 37(Suppl 5):S11–S16CrossRefPubMed Moonen AF, Neal TD, Pilot P (2006) Pre-operative blood management in elective orthopaedic surgery. A critical review of the literature. Injury 37(Suppl 5):S11–S16CrossRefPubMed
10.
go back to reference Majkowski RS, Currie IC, Newman JH (1991) Postoperative collection and reinfusion of autologous blood in total knee arthroplasty. Ann R Coll Surg Engl 73:381–384PubMed Majkowski RS, Currie IC, Newman JH (1991) Postoperative collection and reinfusion of autologous blood in total knee arthroplasty. Ann R Coll Surg Engl 73:381–384PubMed
11.
go back to reference Gannon DM, Lombardi AV Jr, Mallroy TH et al (1991) An evaluation of the efficacy of postoperative blood salvage after total joint arthroplasty: a prospective randomised trial. J Arthroplasty 6:109–114PubMed Gannon DM, Lombardi AV Jr, Mallroy TH et al (1991) An evaluation of the efficacy of postoperative blood salvage after total joint arthroplasty: a prospective randomised trial. J Arthroplasty 6:109–114PubMed
12.
go back to reference Heddle NM, Brox WT, Klama LN, Dickson LL, Levine MN (1992) A randomized trial on the efficacy of an autologous blood drainage and transfusion device in patients undergoing elective knee arthroplasty. Transfusion 32:742–746CrossRefPubMed Heddle NM, Brox WT, Klama LN, Dickson LL, Levine MN (1992) A randomized trial on the efficacy of an autologous blood drainage and transfusion device in patients undergoing elective knee arthroplasty. Transfusion 32:742–746CrossRefPubMed
13.
go back to reference Newman JH, Bowers M, Murphy J (1997) The clinical advantages of autologous transfusion. J Bone Joint Surg [Br] 79-B:630–632CrossRef Newman JH, Bowers M, Murphy J (1997) The clinical advantages of autologous transfusion. J Bone Joint Surg [Br] 79-B:630–632CrossRef
14.
go back to reference Han CD, Shin DE (1997) Postoperative blood salvage and reinfusion after total joint arthroplasty. J Arthroplasty 12:511–516CrossRefPubMed Han CD, Shin DE (1997) Postoperative blood salvage and reinfusion after total joint arthroplasty. J Arthroplasty 12:511–516CrossRefPubMed
15.
go back to reference Rizzi L, Bertacchi P, Ghezzi LM, Bellavita P, Scudeller G (1998) Postoperative blood salvage in hip and knee arthroplasty: a prospective study on cost effectiveness in 161 patients. Acta Orthop Scand 69:31–34PubMed Rizzi L, Bertacchi P, Ghezzi LM, Bellavita P, Scudeller G (1998) Postoperative blood salvage in hip and knee arthroplasty: a prospective study on cost effectiveness in 161 patients. Acta Orthop Scand 69:31–34PubMed
16.
go back to reference Henderson MS, Newman JH, Hand GC (1999) Blood loss following knee replacement surgery, use it don’t lose it. Knee 6:125–129CrossRef Henderson MS, Newman JH, Hand GC (1999) Blood loss following knee replacement surgery, use it don’t lose it. Knee 6:125–129CrossRef
17.
go back to reference Friederichs MG, Mariani EM, Bourne MH (2002) Perioperative blood salvage as an alternative to predonating blood for primary total knee and hip arthroplasty. J Arthroplasty 17:298–303CrossRefPubMed Friederichs MG, Mariani EM, Bourne MH (2002) Perioperative blood salvage as an alternative to predonating blood for primary total knee and hip arthroplasty. J Arthroplasty 17:298–303CrossRefPubMed
18.
go back to reference Steinberg EL, Ben-Galim P, Yaniv Y, Dekel S, Menahem A (2004) Comparative analysis of the benefits of autotransfusion of blood by a shed blood collector after total knee replacement. Arch Orthop Trauma Surg 124:114–118CrossRefPubMed Steinberg EL, Ben-Galim P, Yaniv Y, Dekel S, Menahem A (2004) Comparative analysis of the benefits of autotransfusion of blood by a shed blood collector after total knee replacement. Arch Orthop Trauma Surg 124:114–118CrossRefPubMed
19.
go back to reference Tsumara N, Yoshiya S, Chin T, Shiba R, Kohso K, Doita M (2006) A prospective comparison of clamping the drain or post-operative salvage of blood in reducing blood loss after total knee arthroplasty. J Bone Joint Surg [Br] 88-B:49–53 Tsumara N, Yoshiya S, Chin T, Shiba R, Kohso K, Doita M (2006) A prospective comparison of clamping the drain or post-operative salvage of blood in reducing blood loss after total knee arthroplasty. J Bone Joint Surg [Br] 88-B:49–53
20.
go back to reference Slagis SV, Benjamin JB, Volz RG, Giordano GF (1991) Postoperative blood salvage in total hip and knee arthroplasty: a randomised controlled trial. J Bone Joint Surg [Br] 73-B:591–594 Slagis SV, Benjamin JB, Volz RG, Giordano GF (1991) Postoperative blood salvage in total hip and knee arthroplasty: a randomised controlled trial. J Bone Joint Surg [Br] 73-B:591–594
21.
go back to reference Marks RM, Vaccaro AR, Balderston RA, Hozack WJ, Booth RE Jr, Rothman RH (1995) Postoperative blood salvage in total knee arthroplasty using the Solcotrans autotransfusion system. J Arthroplasty 10:433–437CrossRefPubMed Marks RM, Vaccaro AR, Balderston RA, Hozack WJ, Booth RE Jr, Rothman RH (1995) Postoperative blood salvage in total knee arthroplasty using the Solcotrans autotransfusion system. J Arthroplasty 10:433–437CrossRefPubMed
22.
go back to reference Adalberth G, Byström S, Kolstad K, Mallmin H, Milbrink J (1998) Postoperative drainage of knee arthroplasty is not necessary: a randomised study of 90 patients. Acta Orthop Scand 69:475–478PubMedCrossRef Adalberth G, Byström S, Kolstad K, Mallmin H, Milbrink J (1998) Postoperative drainage of knee arthroplasty is not necessary: a randomised study of 90 patients. Acta Orthop Scand 69:475–478PubMedCrossRef
23.
go back to reference Abuzakuk T, Senthil Kumar V, Shenava Y, Bulstrode C, Skinner JA, Cannon SR, Briggs TW (2007) Autotransfusion drains in total knee replacement: are they alternatives to homologous transfusion? Int Orthop 31:235–239CrossRefPubMed Abuzakuk T, Senthil Kumar V, Shenava Y, Bulstrode C, Skinner JA, Cannon SR, Briggs TW (2007) Autotransfusion drains in total knee replacement: are they alternatives to homologous transfusion? Int Orthop 31:235–239CrossRefPubMed
24.
go back to reference Amin A, Watson A, Mangwani J, Nawabi D, Ahluwalia R, Loeffler M (2008) A prospective randomised controlled trial of autologous retransfusion in total knee replacement. J Bone Joint Surg Br 90:451–454CrossRefPubMed Amin A, Watson A, Mangwani J, Nawabi D, Ahluwalia R, Loeffler M (2008) A prospective randomised controlled trial of autologous retransfusion in total knee replacement. J Bone Joint Surg Br 90:451–454CrossRefPubMed
25.
go back to reference Tetro AM, Rudan JF (2001) The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty. Can J Surg 44:33–38PubMed Tetro AM, Rudan JF (2001) The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty. Can J Surg 44:33–38PubMed
26.
go back to reference Vandenbussche E, Duranthon LD, Couturier M, Pidhorz L, Augereau B (2002) The effect of tourniquet use in total knee arthroplasty. Int Orthop 26:306–309CrossRefPubMed Vandenbussche E, Duranthon LD, Couturier M, Pidhorz L, Augereau B (2002) The effect of tourniquet use in total knee arthroplasty. Int Orthop 26:306–309CrossRefPubMed
27.
go back to reference Grimaldi NA, Sicuranza M, Eck JC (2006) Perioperative autotransfusion systems in TKA are not necessary. Orthopedics 29:1027–1029PubMed Grimaldi NA, Sicuranza M, Eck JC (2006) Perioperative autotransfusion systems in TKA are not necessary. Orthopedics 29:1027–1029PubMed
28.
go back to reference Carless PA, Henry DA, Moxey AJ, O’Connell DL, Fergusson DA (2003) Cell salvage for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 4:CD001888PubMed Carless PA, Henry DA, Moxey AJ, O’Connell DL, Fergusson DA (2003) Cell salvage for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 4:CD001888PubMed
29.
go back to reference Carless P, Moxey A, O’Connell D, Henry D (2004) Autologous transfusion techniques: a systematic review of their efficacy. Transf Med 14:123–144CrossRef Carless P, Moxey A, O’Connell D, Henry D (2004) Autologous transfusion techniques: a systematic review of their efficacy. Transf Med 14:123–144CrossRef
30.
go back to reference Muñoz M, Kühlmorgen B, Ariza D, Haro E, Marroquí A, Ramirez G (2007) Which patients are more likely to benefit from postoperative shed blood salvage after unilateral total knee replacement? An analysis of 581 consecutive procedures. Vox Sang 92:136–141CrossRefPubMed Muñoz M, Kühlmorgen B, Ariza D, Haro E, Marroquí A, Ramirez G (2007) Which patients are more likely to benefit from postoperative shed blood salvage after unilateral total knee replacement? An analysis of 581 consecutive procedures. Vox Sang 92:136–141CrossRefPubMed
31.
go back to reference Strümper D, Weber EWG, Gielen-Wijffels S, van Drumpt R, Bulstra S, Slappendel R, Durieux ME, Marcus MA (2004) Clinical efficacy of postoperative autologous transfusion of filtered shed blood in hip and knee arthroplasty. Transfusion 44:1567–1571CrossRefPubMed Strümper D, Weber EWG, Gielen-Wijffels S, van Drumpt R, Bulstra S, Slappendel R, Durieux ME, Marcus MA (2004) Clinical efficacy of postoperative autologous transfusion of filtered shed blood in hip and knee arthroplasty. Transfusion 44:1567–1571CrossRefPubMed
32.
go back to reference Thomas D, Wareham K, Cohen D, Hutching H (2001) Autologous blood transfusion in total knee replacement surgery. Br J Anaesth 86:669–673CrossRefPubMed Thomas D, Wareham K, Cohen D, Hutching H (2001) Autologous blood transfusion in total knee replacement surgery. Br J Anaesth 86:669–673CrossRefPubMed
33.
go back to reference Boralessa H, Boralessa H, Contreras M, Lang-Stevenson A, Desilva A (2001) Effectiveness of a protocol to improve transfuion practice in knee replacement surgery. Vox Sang 81:248–253CrossRefPubMed Boralessa H, Boralessa H, Contreras M, Lang-Stevenson A, Desilva A (2001) Effectiveness of a protocol to improve transfuion practice in knee replacement surgery. Vox Sang 81:248–253CrossRefPubMed
34.
go back to reference Slappendel R, Horstmann W, Dirksen R (2006) Safety of retransfusion of filtered shed blood in 1,830 patients undergoing total hip or total knee arthroplasty implantation. Transf Altern Transf Med 8(Suppl 1):76 Slappendel R, Horstmann W, Dirksen R (2006) Safety of retransfusion of filtered shed blood in 1,830 patients undergoing total hip or total knee arthroplasty implantation. Transf Altern Transf Med 8(Suppl 1):76
35.
go back to reference Engelfriet CP, Reesink HW (2006) Perioperative blood salvage. Vox Sang 91:185–192CrossRef Engelfriet CP, Reesink HW (2006) Perioperative blood salvage. Vox Sang 91:185–192CrossRef
36.
go back to reference Wakankar HM, Nicholl JE, Koka R, D’Arcy JC (1999) The tourniquet in total knee arthroplasty. A prospective, randomised study. J Bone Joint Surg [Br] 81-B:30–33CrossRef Wakankar HM, Nicholl JE, Koka R, D’Arcy JC (1999) The tourniquet in total knee arthroplasty. A prospective, randomised study. J Bone Joint Surg [Br] 81-B:30–33CrossRef
37.
go back to reference Aglietti P, Baldini A, Vena LM, Abbate R, Fedi S, Falclani M (2000) Effect of tourniquet use on activation of coagulation in total knee replacement. Clin Orthop Relat Res 371:169–177CrossRefPubMed Aglietti P, Baldini A, Vena LM, Abbate R, Fedi S, Falclani M (2000) Effect of tourniquet use on activation of coagulation in total knee replacement. Clin Orthop Relat Res 371:169–177CrossRefPubMed
38.
go back to reference Fukuda A, Hasegawa M, Kato K, Shi D, Sudo A, Uchida A (2007) Effect of tourniquet application on deep vein thrombosis after total knee arthroplasty. Arch Orthop Trauma Surg 127:671–675CrossRefPubMed Fukuda A, Hasegawa M, Kato K, Shi D, Sudo A, Uchida A (2007) Effect of tourniquet application on deep vein thrombosis after total knee arthroplasty. Arch Orthop Trauma Surg 127:671–675CrossRefPubMed
39.
go back to reference Wakai A, Winter DC, Street JT, Redmond PH (2001) Pneumatic tourniquets in extremity surgery. J Am Acad Orthop Surg 9:345–351PubMed Wakai A, Winter DC, Street JT, Redmond PH (2001) Pneumatic tourniquets in extremity surgery. J Am Acad Orthop Surg 9:345–351PubMed
40.
go back to reference Smith TO, Hing CB (2009) Is a tourniquet beneficial in total knee replacement surgery? A meta-analysis and systematic review. Knee Jul 17, (Epub ahead of print) Smith TO, Hing CB (2009) Is a tourniquet beneficial in total knee replacement surgery? A meta-analysis and systematic review. Knee Jul 17, (Epub ahead of print)
Metadata
Title
Prospective comparative study of two different autotransfusion methods versus control group in total knee replacement
Authors
Konstantinos S. Blatsoukas
Georgios I. Drosos
Konstantinos Kazakos
Miltiadis Papaioakim
Theodora Gioka
Pelagia Chloropoulou
Dionisios-Alexandros Verettas
Publication date
01-06-2010
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 6/2010
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-010-1062-y

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