Prospective comparative study of two different autotransfusion methods versus control group in total knee replacement

Area of Science:

• Orthopedic Surgery
• Transfusion Medicine
• Anesthesiology

Background:

• Total knee replacement (TKR) often necessitates blood transfusions, posing risks and increasing costs.
• Allogeneic blood transfusion (ABT) is a common practice, but alternatives like autotransfusion are explored to mitigate risks.
• Minimizing ABT in TKR is crucial, especially in procedures performed without tourniquets.

Purpose of the Study:

• To compare the efficacy of two autotransfusion methods versus standard ABT in TKR without tourniquets.
• To determine if autotransfusion can reduce the requirement for allogeneic blood transfusions post-TKR.
• To evaluate the impact of autotransfusion timing (intraoperative/postoperative vs. postoperative only) on ABT needs.

Main Methods:

• A randomized comparative study involving 248 patients with knee osteoarthritis undergoing TKR without tourniquets.
• Patients were divided into three groups: control (ABT only), Group 1 (intraoperative and postoperative autotransfusion), and Group 2 (postoperative autotransfusion only).
• Postoperative ABT was administered based on predefined criteria.

Main Results:

• Autotransfusion significantly reduced the need for postoperative ABT compared to the control group (p < 0.001).
• Both autotransfusion methods (Group 1 and Group 2) were effective in reducing ABT requirements.
• No significant difference in ABT reduction was observed between intraoperative/postoperative and postoperative-only autotransfusion groups.

Conclusions:

• Autotransfusion is an effective strategy to decrease allogeneic blood transfusion (ABT) requirements in total knee replacement (TKR) performed without tourniquets.
• Both evaluated autotransfusion protocols demonstrate a significant reduction in the need for ABT.
• Autotransfusion offers a viable alternative to minimize allogeneic blood use in TKR procedures.