Effects Of Reinfusion Systems On Transfusion Needs After Total Knee Arthroplasty

Abstract

Background: Total Joint arthroplasty can lead to significant blood loss. This loss often requires replacement with banked allogenic or pre-donated antologous blood. Both forms of replacement involve substantial financial cost and can be associated with significant complications to the patient. The purpose of this study was to evaluate the effect that reinfusion of postoperative drained blood has on the transfusion requirements following total knee arthroplasty(TKA) using the ConstaVac re-infusion system. Methods: A retrospective analysis of 91 consecutive TKA performed at one institution was carried out. 22 cases were excluded. The remaining 69 cases formed the basis of the study. The ConstaVac reinfusion system was used in 43 of these cases and a standard Bellovac drainage system was used in the remaining 26 cases. Data was collected on patient\'s age, side affected, operative duration, tourniquet use, volumes drained and reinfused, transfusion requirements and preand post-operative as well as post transfusion haemoglobin levels. Results: Transfusion of packed red cells was required in 50% of cases in which the standard drainage system was used compared with 19% of cases in which the re-infusion system was used. This result was statistically significant using chi-squared analysis. (p< 0.05) Conclusion: We recommend that a postoperative reinfusion system should be used to decrease the transfusion requirements following TKA.