Blood conservation in revision total hip arthroplasty

Blood loss from major orthopedic procedures such as spine and revision total joint arthroplasty often necessitates perioperative blood transfusion. The risk of infectious disease transmission associated with homologous blood transfusion, particularly hepatitis and acquired immune deficiency syndrome, mandates use of blood conservation techniques. Methods available to the orthopedic surgeon include preoperative autologous donation, intraoperative and postoperative blood salvage, hemodilution, and other selective anesthetic techniques such as hypotensive anesthesia and epidural or spinal anesthesia. The safest blood patients can receive is their own. With full use of these blood conservation methods, the need for homologous blood transfusion for elective orthopedic procedures should be minimal.