NoBlood - View Single Post - Blood Transfusion For Total Joint Replacement?

Jan B. Wade · #1 (**permalink**) 01-21-2004, 12:30 PM

The following is taken from the website of Dr H.D. Huddleston:

"ARTHRITIS OF THE KNEE JOINT

BLOOD TRANSFUSION FOR TOTAL JOINT REPLACEMENT
We do everything we can to minimize blood loss during surgery. Your blood pressure is lowered during the operation to cut down on bleeding, and cut blood vessels are zealously cauterized, and we use the smallest incision possible. Even so, almost all knee replacement patients need to be transfused after the operation because of oozing from cut surfaces, much of it occurring after the operation is over.

First time knee replacements require a 1 to 2 unit transfusion of blood. Revision knee replacements needs 2 to 3 units or more."

A broad sweeping statement based on what? The individual patients condition? Hardly.

In commenting on the article, "Preoperative Hemogloblin Levels and the Need for Transfusion After Prosthetic Hip and Knee Surgery.
Analysis of Predictive Factors" By Jose A. Salido, MD et al., Christopher R. Ferrante, MD*, and Paul A. Lotke, MD*,
Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA state:

"The conclusions of the article are intuitive and confirm those of prior reports, adding to the evidence that the preoperative hemoglobin level can be effectively used to predict the need for transfusion and/or alternative strategies of blood management. Currently the most common of these strategies include the use of predonated autologous blood1,3,4, treatment with human recombinant erythropoetin2, and postoperative blood salvage5. Use of predonated autologous blood is the most common method of blood management in patients who have undergone a total joint replacement."

Each patient should be examined as a unique case and presurgical hemoglobin levels should be considered and bolstered when necessary in order to lower the use of banked blood products