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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

01.06.2010 | Orthopaedic Surgery

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

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

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 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.

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

Keating EM, Meding JB, Faris PM, Ritter MA (1998) Predictors of transfusion risk in elective knee surgery. Clin Orthop Relat Res 357:50–59CrossRefPubMed

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

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

Williamson LM, Lowe S (1999) Serious hazards of transfusion (SHOT) initiative: analysis of the two annual reports. Br Med J 319:16–19

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

Keating EM, Ritter MA (2002) Transfusion options in total joint arthroplasty. J Arthroplasty 17(4 Suppl 1):125–128CrossRefPubMed

Spence RK (2004) Current concepts and issues in blood management. Orthopedics 27(6 Suppl):s643–s651PubMed

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.

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.

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.

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.

Newman JH, Bowers M, Murphy J (1997) The clinical advantages of autologous transfusion. J Bone Joint Surg [Br] 79-B:630–632CrossRef

14.

Han CD, Shin DE (1997) Postoperative blood salvage and reinfusion after total joint arthroplasty. J Arthroplasty 12:511–516CrossRefPubMed

15.

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.

Henderson MS, Newman JH, Hand GC (1999) Blood loss following knee replacement surgery, use it don’t lose it. Knee 6:125–129CrossRef

17.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Grimaldi NA, Sicuranza M, Eck JC (2006) Perioperative autotransfusion systems in TKA are not necessary. Orthopedics 29:1027–1029PubMed

28.

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.

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.

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.

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.

Thomas D, Wareham K, Cohen D, Hutching H (2001) Autologous blood transfusion in total knee replacement surgery. Br J Anaesth 86:669–673CrossRefPubMed

33.

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.

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.

Engelfriet CP, Reesink HW (2006) Perioperative blood salvage. Vox Sang 91:185–192CrossRef

36.

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.

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.

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.

Wakai A, Winter DC, Street JT, Redmond PH (2001) Pneumatic tourniquets in extremity surgery. J Am Acad Orthop Surg 9:345–351PubMed

40.

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)

Titel: Prospective comparative study of two different autotransfusion methods versus control group in total knee replacement
verfasst von: Konstantinos S. Blatsoukas
Georgios I. Drosos
Konstantinos Kazakos
Miltiadis Papaioakim
Theodora Gioka
Pelagia Chloropoulou
Dionisios-Alexandros Verettas
Publikationsdatum: 01.06.2010
Verlag: Springer-Verlag
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 6/2010
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-010-1062-y

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