Efficacy of intraoperative autotransfusion in primary total hip arthroplasty

The role of intraoperative autotransfusion in diminishing perioperative transfusion requirements was studied in 64 patients undergoing primary total hip arthroplasty. The total transfusions administered in a 3-day perioperative period were tabulated for the study group (in which intraoperative autotransfusion was utilized) and compared to that of the control group. Despite the use of the Cell Saver autotransfusion device, no significant difference was noted between the total units of blood transfused perioperatively in the two groups. Moreover, calculations of mean perioperative blood loss (intra- and postoperative) were not significantly different, nor was there any difference in mean hemoglobin concentrations between the two groups on the third postoperative day. All 64 patients received 4 units or less of banked blood in the perioperative period. The authors conclude that this modality of blood conservation is not necessary in primary hip arthroplasty and that a well planned autologous prebanking program should be sufficient in the vast majority of cases to avoid the use of banked homologous blood.