A RANDOMISED PROSPECTIVE STUDY OF POST OPERATIVE BLOOD SALVAGE WITH AUTOLOGOUS RETRANSFUSION IN PRIMARY TOTAL HIP REPLACEMENT

Abstract

Homologous blood transfusion (HBT) following primary total hip replacement (THR) is not without risk. Postoperative blood salvage (POS) with autologous blood transfusion may minimize the necessity for HBT but the clinical, haematological and economic benefits have yet to be clearly demonstrated for primary THR.

The aim of this randomized prospective study was to determine if the use of POS affects postoperative haemoglobin levels, haematocrit and HBT requirement. Secondary outcomes included length of stay and patient satisfaction. A cost analysis was conducted on the basis of the results. The patients were randomized at the point of reduction of the primary THR to receive either two vacuum drains (82 patients) or an autologous retransfusion system (76 patients).

Haemoglobin and haematocrit values were not significantly different between groups but significantly fewer patients with the autologous system had a postoperative haemoglobin value < 9.0 gdL⁻¹ (8% vs. 20%, p = 0.035). Significantly fewer patients with the autologous system required HBT (8% vs. 21%, p = 0.022). There was an overall cost saving in this group.

This study has shown that use of an autologous retransfusion system for primary THR reduces the necessity for HBT and is cost effective.