INTRODUCTION: Patients undergoing total knee arthroplasty may experience significant blood loss and are at risk of receiving blood transfusions. A bipolar sealing device designed to reduce intraoperative and postoperative blood loss, was compared to conventional electrocautery to determine its efficacy in maintaining hemoglobin levels and reducing transfusions in minimally invasive unilateral total knee arthroplasty.

METHODS: A retrospective, matched control review of one hundred patients undergoing primary total knee arthroplasty by a single surgeon. Conventional electrocautery was used for hemostasis in 50 patients and bipolar sealing technology used in another 50 patients.

RESULTS: Patients in the bipolar sealing group had a significantly lower mean decline in hemoglobin compared to the control group (3.3 ± 1.1 g/dL vs. 3.9 ± 1.2 g/dL; p = 0.0085). The prevalence of autologous transfusion was significantly lower for the bipolar sealing group (16%) compared to the controls (44%) (p < 0.001). The prevalence of allogeneic transfusion was also significantly lower for the bipolar sealing group (8%) compared to control group (22%) (p < 0.001). The prevalence of transfusion as a whole was significantly reduced by 64 percent (p < 0.001). While not statistically significant the break through allogeneic transfusion rate was reduced by 75 percent (4 controls compared to 1 treatment).

DISCUSSION/CONCLUSION: The use of bipolar sealing technology in patients undergoing minimally invasive primary unilateral total knee arthroplasty is associated with a significant reduction in blood loss and transfusion rates compared to the use of conventional electrocautery.

No funds were received in support of this study.