Postoperative blood retrieval and transfusion in cementless total knee arthroplasty

Postoperative wound drainage was aspirated, collected, and transfused in 197 patients undergoing unilateral or bilateral cementless knee arthroplasty using the Solcotrans or the Constavac Blood Conservation blood-retrieval devices. Operative technique, method of hemostasis, and postoperative management were identical in all patients. Drainage-tube suction pressure was minimized, and the duration of drainage collection was less than 8 hours in all patients. In the 153 patients who underwent unilateral total knee arthroplasty (TKA), the amount of blood retrieved and transfused averaged 829 cm3 (59% of total blood lost). For the 44 patients who underwent bilateral procedures, 1,131 cm3 of blood was salvaged (56% of total blood lost). Transfused banked blood averaged 1.7 units (25% homologous) in unilateral cases, while bilateral procedures required 3.0 units (35% homologous). Complications (4%) included wound hematomata in five patients and deep venous thrombosis in two. Transient chills, fever, or tachycardia were seen in four patients at the time of transfusion. Transfusion requirements of banked blood appeared to be significantly reduced, especially in simultaneous bilateral knee arthroplasty, when compared to previous experience in patients who did not undergo postoperative blood retrieval.