Optimising the use of cell salvage in revision hip arthroplasty.

Abstract

Intraoperative cell salvage is an established method to reduce the requirement for and the volume of allogenic blood transfusion but adds to the financial cost of performing surgery. The primary aim of this study was to determine which patients and what type of revision hip surgery benefit most from intraoperative cell salvage. This observational study included patients who underwent revision hip surgery performed by the senior author at a single orthopaedic unit. The cohort was divided into single and two-component revision groups; then, the transfusion requirement combined with analysis of patient factors was used to create a decision-making protocol. The two-component group had a significantly higher number of cases using cell salvage and a higher total transfusion volume. Patients who required postoperative allogenic blood transfusions had a higher mean age, were less likely to have received tranexamic acid and had a lower preoperative haemoglobin level. Based on these results, a decision-making protocol was developed for when to use cell salvage in revision hip surgery.