Introduction: We performed a retrospective case control study in 80 patients who under went revision hip surgery at our unit.

Methodology: Group A (40 patients), received tranexamic acid and intra-operative cell salvage. Group B (40 patients) a matched control did not receive these treatments. Each group was divided into 4 sub groups; revision of both components, revision of components + bone grafting, revision acetabular component +/− bone grafting and revision femoral component +/− bone graft.

Results: In group A the total number of units transfused was 139 compared to 52 in group B. This represents a reduction in blood usage of 37%. The mean amount of blood transfused from cell salvage in each group was 858mls, 477mls, 228mls and 464mls. There was a significant difference in the amount of blood returned between the groups (p< 0.0001). In the control group 37 patients needed transfusion, in the study group 22 (p< 0.0001). At our unit a cost analysis calculation has shown total revenue saving of £88,000 and a potential saving throughout the trust of £316,688 per year.

Discussion: To our knowledge this is the first study to examine the use of cell salvage and tranexamic acid in revision hip surgery. Our results show that a significant reduction in blood transfusion can be made using this technique. It is vital that blood conserving strategies are developed so that future revision surgery can continue.

We carried out a retrospective case-control study in 80 patients who underwent a revision total hip replacement. Group A (40 patients) received tranexamic acid and intra-operative cell salvage. Group B (40 patients) was a matched control group and did not receive this management. Each group was divided into four subgroups: revision of both components, revision of both components with bone grafting, revision of the acetabular component with or without bone graft, and revision of the femoral component with or without bone graft.

In group A the total number of units transfused was 52, compared with 139 in group B, representing a reduction in blood usage of 62.5%. The mean amount of blood transfused from cell salvage in each group was 858 ml (113 to 2100), 477 ml (0 to 2680), 228 ml (75 to 315) and 464 ml (120 to 1125), respectively. There was a significant difference in the amount of blood returned between the groups (p < 0.0001).

In group A, 22 patients needed transfusion and in group B, 37 (p < 0.0001). A cost analysis calculation showed a total revenue saving of £70 000 and a potential saving throughout our facility of £318 288 per year.

Our results show that a significant reduction in blood transfusion can be made using combined cell salvage and tranexamic acid in revision surgery of the hip.