Postoperative autotransfusion in primary knee replacement surgery

OBJECTIVE: To assess the efficacy of postoperative autologous transfusion to reduce homologous blood transfusion needs in primary knee replacement surgery. PATIENTS AND METHODS: A prospective study was carried out in 33 consecutive patients with diagnoses of arthrosis scheduled for primary knee replacement surgery with postoperative autotransfusion using a CBCII Constavac-Stryker (Stryker Instruments, Michigan, USA) recovery system from June through October 2002. We analyzed patient age, sex, preoperative and postoperative (24 hours) hemoglobin and hematocrit values, autologous blood reinfused and homologous blood transfusion incidence rate (if hematocrit was below 25%). RESULTS: Of the 33 patients receiving postoperative autotransfusion, one also needed homologous blood transfusion (3%). The mean volume of filtered whole blood reinfused was 538.63+/-261.23 mL, 1100 mL being the largest volume reinfused. We observed no complications related to use of autotransfusion devices during the perioperative period. CONCLUSIONS: Postoperative autotransfusion as the only blood salvage technique in primary knee prosthesis surgery nearly eliminates homologous transfusion needs. In addition, it is a safe, simple procedure and has replaced our hospital's preoperative autologous transfusion procedure.