Abstract
Purpose: In order to determine the incidence of allogenic blood transfusion in patients undergoing primary total knee arthroplasty (TKA) at our centre, we performed a retrospective analysis of prospectively collected data for all patients who underwent TKA between 1 April 2006 and 31 March 2008.
Methods and Results: In 2006/2007 there were 650 primary TKA patients (group 1) and in 2007/2008 this increased to 841 (group 2). Allogenic blood transfusions were administered according to hospital policy. The transfusion threshold was haemoglobin of 8g/dl or less or a symptomatic patient. For transfused patients data were collected for haemoglobin levels (pre-operative, post-operative and pre-discharge), duration of operation, ASA grade, number of transfusions, use of tranexamic acid and suction drains, and relevant clinical data including post-operative medical and surgical complications.
In group 1 27 patients were transfused (group 1T) and in group 2 10 patients were transfused (group 2T). This was a significant reduction in allogenic blood transfusions (4.5% vs. 1.2%, p < 0.001). The two transfused groups were similar with respect to age, gender, ASA, BMI, duration of operation, pre- and post-operative haemoglobin and tranexamic acid usage. In group 1T, the usage of suction drains was greater than in group 2T (48% vs. 20%) although this was not statistically significant (p = 0.27).
Conclusion: This study indicates that a low rate of allogenic blood transfusion can be achieved by using tranexamic acid and minimising insertion of suction drains. To the best of our knowledge, we report the lowest rate of allogenic blood transfusion for primary TKA. Our data have important implications in the management of patients undergoing TKA, particularly with respect to the need to cross-match all patients.
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
