Intraoperative Red Blood-Cell Salvage in Revision Hip Surgery. A Case-Matched Study -- Bridgens et al. 89 (2): 270 -- Journal of Bone and Joint Surgery
Intraoperative Red Blood-Cell Salvage in Revision Hip Surgery
A Case-Matched Study
J.P. Bridgens, MRCS1, C.R. Evans, FRCS(Tr&Orth)2, P.M.S. Dobson, FRCA1 and A.J. Hamer, MD, FRCS(Orth)1 1 Department of Trauma and Orthopaedics, Northern General Hospital, Herries Road, Sheffield S5 7AU, United Kingdom. E-mail address for J.P. Bridgens: jpbridgens@doctors.org.uk
2 Department of Trauma and Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire SY10 7AG, United Kingdom
Background: Revision hip arthroplasty is commonly associated
with substantial blood loss and the subsequent need for transfusion.
This leads to an increased risk of blood-borne infection and
hemolytic reactions. The purpose of this study was to demonstrate
whether the use of intraoperative red blood-cell salvage in
revision hip arthroplasty reduces the overall rate of allogeneic
transfusion.
Methods: Forty-seven patients who had undergone revision hip arthroplasty
with the use of intraoperative cell salvage were identified.
A computer database was used to individually match these patients,
for age, sex, and eleven operative variables, to control patients
who had undergone revision hip arthroplasty in the same unit
without intraoperative cell salvage. Data gathered included
the total allogeneic transfusion requirement for each patient,
preoperative and postoperative hemoglobin levels, and operative time.
Results: The total allogeneic transfusion requirement was significantly
lower in the group that had intraoperative cell salvage than
in the control group (median, 2 compared with 6 U of packed
red blood cells, p = 0.0006), with a median reduction in allogeneic
transfusion of 4 U. There was no significant difference in preoperative
or postoperative hemoglobin levels between the groups.
Conclusions: The use of intraoperative cell salvage significantly lowered
the allogeneic transfusion requirement, which can lead to substantial cost
savings. To our knowledge, this is the first study in which
the use of intraoperative red blood-cell salvage in revision
hip arthroplasty was evaluated by matching patients on the basis
of age, sex, and operative variables.
Level of Evidence: Therapeutic
Level III. See Instructions to
Authors for a complete description of levels of evidence.
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