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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 4, 451-454.
doi: 10.1302/0301-620X.90B4.20044  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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A prospective randomised controlled trial of autologous retransfusion in total knee replacement

A. Amin, MRCS(Eng), Specialist Registrar Trauma and Orthopaedics (Percival Pott Rotation)1; A. Watson, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon2; J. Mangwani, MRCS, Specialist Registrar Trauma and Orthopaedics1; D. Nawabi, MA, MRCS(Eng), Specialist Registrar Trauma and Orthopaedics (Percival Pott Rotation)1; R. Ahluwalia, MRCS, Specialist Registrar Trauma and Orthopaedics1; and M. Loeffler, FRCS, Consultant Orthopaedic Surgeon1

1 Department of Trauma and Orthopaedics Colchester General Hospital, Turner Road, Colchester CO4 5JL, UK.
2 Department of Trauma & Orthopaedics Prince Alexandra Hospital, Hamstel Road, Harlow CM20 1QX, UK.

Correspondence should be sent to Mr A. Amin at 30 Church Drive, North Harrow, Middlesex HA2 7NR, UK; e-mail: amitamin{at}doctors.org.uk

We undertook a prospective randomised controlled trial to investigate the efficacy of autologous retransfusion drains in reducing the need for allogenic blood requirement after unilateral total knee replacement. We also monitored the incidence of post-operative complications. There were 86 patients in the control group, receiving standard care with a vacuum drain, and 92 who received an autologous drain and were retransfused postoperatively. Following serial haemoglobin measurements at 24, 48 and 72 hours, we found no difference in the need for allogenic blood between the two groups (control group 15.1%, retransfusion group 13% (p = 0.439)). The incidence of post-operative complications, such as wound infection, deep-vein thrombosis and chest infection, was also comparable between the groups. There were no adverse reactions associated with the retransfusion of autologous blood.

Based on this study, the cost-effectiveness and continued use of autologous drains in total knee replacement should be questioned.




eLetters:

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Autologous transfusion does reduce allogenic blood transfusion in total knee replacement
Santoshkumar Hakkalamani, et al.
J Bone Joint Surg Br Online, 8 May 2008 [Full text]
Authors' reply:
Amit AMIN, et al.
J Bone Joint Surg Br Online, 23 May 2008 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General