The Efficacy of Unilateral Use of a Blood Reinfusion Device in One-Stage Bilateral Total Knee Arthroplasty

Geon-Hyeong Kim,Jong-Ho Kim,Yong In,Se-Wook Park

doi:10.5792/ksrr.2014.26.1.7

Abstract

PurposeTo assess the efficacy of unilateral use of a blood reinfusion device in one-stage bilateral total knee arthroplasty (TKA).Materials and MethodsWe carried out a retrospective cohort study on 100 patients having one-stage bilateral TKA. In 50 of these patients (study group), a blood reinfusion device was applied on one knee and a standard suction drain on the other, and they were compared with 50 matched controls who received bilateral suction drains (control group). The hemoglobin (Hb) level, the hematocrit (Hct) and the platelet count were checked preoperatively, immediately postoperatively, and the third and seventh days postoperatively. The total drain output and the amount of allogeneic blood transfusion were also compared.ResultsThere were no significant differences in the total drain output and required amount of allogeneic blood transfusions between groups (p>0.05). However, the study group had significantly lower Hb and Hct values by the first day postoperatively and significantly lower platelet count values by the third day postoperatively than the control group (p<0.05).ConclusionsCompared with use of bilateral suction drains, unilateral use of reinfusion device was not advantageous in reducing allogeneic transfusion in one-stage bilateral TKA.

Highlights

Osteoarthritis (OA) of the knee is often bilateral, there have been controversies about performing bilateral total knee arthroplasty (TKA) in a single stage[1,2,3])
There were no significant differences in the preoperative values of complete blood count tests, Prothrombin time (PT), activated partial thromboplastin time (APTT) and PT/INR
The average postoperative drainage through a standard suction drain was measured as 692 mL for bilateral TKA and 442 mL for unilateral TKA, and they reported a high prevalence of allogeneic blood transfusion in the bilateral TKA group

Summary

Introduction

Osteoarthritis (OA) of the knee is often bilateral, there have been controversies about performing bilateral total knee arthroplasty (TKA) in a single stage[1,2,3]). Because of complications and the cost of allogeneic blood transfusions, an alternative method of using an autologous blood reinfusion device has been developed[6,7,8]). Breakwell et al.4) reported that bilateral use of blood reinfusion devices in simultaneous bilateral TKA was safe and effective for reducing allogeneic blood transfusion requirements.

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