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No benefit of autologous transfusion drains in total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose and Hypothesis

Autologous blood transfusion drains are commonly used to reduce allogeneic blood transfusion rate after total knee arthroplasty. There is conflicting evidence as to whether autologous transfusion drains (ABT drains) were effective when restrictive transfusion triggers were used. The aim of our study was to ascertain where, as a part of a blood management protocol, autologous blood transfusion drains reduce the allogeneic blood transfusion rate after total knee arthroplasty.

Methods

Two-hundred total knee arthroplasty patients were included in the prospective randomized controlled study. After implantation, a Redon drain without vacuum assistance (control, n = 100) or an autologous blood transfusion drain (ABT group, n = 100) was used. Demographic and operative data were collected. The blood loss, total blood loss, blood values and transfusion rate were documented.

Results

The blood loss in the drains was significantly increased for the ABT group (409 vs. 297 ml, p < 0.001). There was a non-significant trend towards a higher total blood loss for ABT patients (1844 vs. 1685 ml, n.s.). The allogeneic blood transfusion rate was similar for both groups (8 vs. 9%, n.s.). Similarly, the number of transfused blood units was comparable between both groups (0.2U/patient vs. 0.17U/patient n.s.).

Conclusion

In combination with restrictive blood transfusion triggers, ABT drains had no positive effect on the allogeneic blood transfusion rate. The blood loss in ABT drains was higher. As a consequence, the use of ABT drains was discontinued.

Level of Evidence

I.

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Authors and Affiliations

  1. Clinic of Orthopedic Surgery, St. Vinzenz Hospital Düsseldorf, Schloßstr. 85, 40477, Düsseldorf, Germany

    Christoph Schnurr & Ioannis Giannakopoulos

  2. Clinic of Orthopedic Surgery, Klinikum Dortmund, Beurhausstraße 40, 44137, Dortmund, Germany

    Dariusch Arbab

  3. Clinic for Orthopedic Surgery and Traumatology, University of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany

    Jens Dargel & Peer Eysel

  4. Department for Endoprosthetics Lower Extremity, Sportklinik Stuttgart, Taubenheimstr. 8, 70372, Stuttgart, Germany

    Johannes Beckmann

Authors
  1. Christoph Schnurr
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  2. Ioannis Giannakopoulos
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  3. Dariusch Arbab
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  4. Jens Dargel
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Correspondence to Christoph Schnurr.

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The authors declare that they have no conflict of interest.

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No funding was received for this study.

Ethical approval

All authors certify that this investigation was performed in conformity with ethical principles of research. Institutional review board approval was obtained prior to the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Schnurr, C., Giannakopoulos, I., Arbab, D. et al. No benefit of autologous transfusion drains in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 26, 1557–1563 (2018). https://doi.org/10.1007/s00167-017-4585-8

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  • DOI: https://doi.org/10.1007/s00167-017-4585-8

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