Purpose

To evaluate the effectiveness of the perioperative erythropoietin administration, as an alternative to homologous banked blood transfusions, in total hip arthroplasty.

Purpose

To evaluate the long term results of the use of a postoperative autologous blood reinfusion system in total knee arthroplasty.

Purpose: To determine the effectiveness of a postoperative autologous blood reinfusion system, as an alternative to homologous, banked blood transfusions in total hip arthroplasty.

Material and Methods: We have carried out a prospective randomized, controlled study on 60 patients having unilateral total hip replacement. In all these patients the same surgical team applied the same surgical technique (hybrid THA) and they follow the same rehabilitation program. All the patients received intraoperatively one or two units of homologous banked blood transfusion (average 1.7 units/patient) according to the volume of blood collected in the suction device and to the anaesthesiologist’s estimation. In 30 of these patients (group A) a reinfusion system of unwashed blood salvaged was applied and they supplemented postoperatively with banked blood transfusions when required. A control group of 30 patients (group B), in whom standard suction drains were used, received also additional blood transfusions when required. The admission of banked blood transfusions determined by haemoglobin value (< 9mg/dL) and/or clinical signs (blood pressure, pulses, etc). The value of haemoglobin, haematocrite and platelets recorded preoperatively and the 1st, 5th and 15th day after operation.

Results: 13 patients of group A required postoperatively 13 units of homologous blood (0.43 units/patient) (total amount for group A 64 banked blood units or 2.14 units/patient). 21 patients of group B required additional 28 banked blood units postoperatively (totally 79 units for group B or 2.63 units/patient). In the study group the total homologous blood requirements reduced by 20%, while the postoperative blood requirements reduced by 54% and the number of patients required additional blood transfusion reduced by 38%. There was no significant difference in the postoperative haematocrite and haemoglobin values between the two groups. None of the patients developed any adverse reactions after reinfusion.

Conclusions: The use of an autologous blood reinfusion system reduces effectively the postoperative demands of homologous banked blood transfusion in total hip arthroplasty.

Purpose: The purpose of our study, is to determine the role of erythropoetin administration, as an alternative to homologous banked blood transfusions in total hip arthroplasty.

Material and Methods: We have carried out a prospective randomized, controlled study on 60 patients having unilateral total hip replacement. In all the above patients, the same surgical team applied the same surgical technique (hybrid THA) and they followed the same rehabilitation program. We examined 2 groups of patients. In group A, all the patients received intraoperatively one unit of homologous blood transfusion (average 1 unit/patient), according to the volume of blood collected in the suction device and to the anaesthesiologist’s estimation. We also administered 40,000 units of erythropoetin subcutaneously one day before the operation followed by 40,000 units (sc) every 3 days in a total scheme of 4 doses. A control group of 30 patients (group B), in whom standard suction drains were used, received intraoperatively one or two units of homologous blood transfusion (average 1,7 units/patient), and also additional blood transfusions when required. The admission of banked blood transfusion was determined by the Haemoglobin value (< 9mg/dl) and/or clinical signs (blood pressure, pulse etc.). The values of Haemoglobin, Haematocrit and Platelets were recorded preoperatively and the 1st, 5th, and 15th day postoperatively.

Results: 5 patients of group A required postoperatively 7 units of homologous blood (0,23 unit/patient) (total amount for group A 37 banked blood units 1,12 units/patient). 21 patients of group B required additional 28 banked blood units postoperatively (totally 79 banked blood units, or 2,63 units/patient). In the group A (study group), the total homologous blood requirements were reduced by 53%, the postoperative blood requirements were reduced by 75% and the number of patients that required additional blood transfusion was reduced by 67%. There was no significant difference noticed in the postoperative values of Haematocrit and Haemoglobin.

Conclusions: The use of erythropoetin reduces effectively the postoperative demands of homologous banked blood transfusion in total hip arthroplasty.