Autotransfusion of drained blood after total knee arthroplasty

Osteoarthritic knees were treated by cemented (20 knees) or uncemented (five knees) total knee arthroplasty. The drained blood of the first six postoperative hours was collected, filtered and autotransfused. The blood loss of 20 first postoperative hours averaged 970 ml in the cemented and 1360 ml in the uncemented arthroplasties. An average of 60% of the shed blood was returned to the patients. Transient fever reaction took place during the autotransfusion of three patients, all in the cemented arthroplasty subgroup. No other complications were recorded. The amount of drained blood and transfused blood was compared with a similar series of 16 arthroplasties, treated without autotransfusion. Autotransfusion of filtered blood appears safe and useful in arthroplasty of the knee. Marked reduction of foreign blood transfusion but no direct financial benefit was attained by autotransfusion in these cases. Autotransfusion after uncemented arthroplasty of the knee appears advisable, because of the lack of side-effects, possibly caused by acrylic monomers and because the bleeding (and collection of shed blood) was more extensive than after cemented arthroplasty.