HSS Journal

, 5:45 | Cite as

Efficiency of Autologous Blood Donation in Combination with a Cell Saver in Bilateral Total Knee Arthroplasty

  • Friedrich Boettner
  • Peter Sculco
  • Eric Altneu
  • Bülent Çapar
  • Thomas P. Sculco
 

Abstract

The increased blood loss and resulting need for allogenic blood has been a major concern of one-stage bilateral total knee arthroplasty (TKA). One hundred eighteen consecutive patients donating either 2 units (87 patients) or 3 units (31 patients) of autologous blood prior to one-stage bilateral TKA were retrospectively evaluated to determine: (1) how many patients received allogenic transfusion; (2) what percentage of autologous blood was wasted; and (3) whether donating 2 or 3 units of autologous blood before surgery is more cost-effective. Fifteen patients in the 2-units donation group (17.2%) and one patient in the 3-units donation group (3.2%) required allogenic blood transfusions. In the 2-units group, 37.9% of the patients wasted 21.8% of predonated autologous blood, and in the 3-units group, 64.5% of the patients wasted 32.3% of predonated autologous blood. The estimated cost for patients donating 2 or 3 units of blood was $1,814.17 and $1,996.10, respectively. Donating 2 units of autologous blood is more cost-effective; however, patients donating 3 units of blood required less allogenic blood.

Keywords

autologous blood cell saver allogenic blood transfusion bilateral total knee arthroplasty 

References

  1. 1.
    Dorr LD, Udomkiat P, Szenohradszky J, Chorn R, Raya J, Udomkiat P, Szenohradszky J, Chorn R, Raya J (2002) Intraoperative monitoring for safety of bilateral total knee replacement. Clin Orthop Relat Res 396:142–151PubMedCrossRefGoogle Scholar
  2. 2.
    Kim YH (2001) Incidence of fat embolism syndrome after cemented or cementless bilateral simultaneous and unilateral total knee arthroplasty. J Arthroplasty 16(6):730–739PubMedCrossRefGoogle Scholar
  3. 3.
    Leonard L, Williamson DM, Ivory JP, Jennison C (2003) An evaluation of the safety and efficacy of simultaneous bilateral total knee arthroplasty. J Arthroplasty 18(8):972–978PubMedCrossRefGoogle Scholar
  4. 4.
    Lombardi AV, Mallory TH, Fada RA, Hartman JF, Capps SG, Kefauver CA, Dodds K, Adams JB (2001) Simultaneous bilateral total knee arthroplasties: who decides? Clin Orthop Relat Res 392:319–329PubMedCrossRefGoogle Scholar
  5. 5.
    Lynch NM, Trousdale RT, Ilstrup DM (1997) Complications after concomitant bilateral total knee arthroplasty in elderly patients. Mayo Clin Proc 72:799–805PubMedCrossRefGoogle Scholar
  6. 6.
    Pavone V, Johnson T, Saulog PS, Sculco TP, Boettner F (2004) Perioperative morbidity in bilateral one-stage total knee replacements. Clin Orthop Relat Res 421:155–161PubMedCrossRefGoogle Scholar
  7. 7.
    Ritter MA, Harty LD, Davis KE, Meding JB, Berend M (2003) Simultaneous bilateral, staged bilateral, and unilateral total knee arthroplasty. A survival analysis. J Bone Joint Surg Am 85:1532–1537PubMedGoogle Scholar
  8. 8.
    Ritter MA, Harty LD (2004) Debate: simultaneous bilateral knee replacements: the outcomes justify its use. Clin Orthop Relat Res(428):84–86PubMedCrossRefGoogle Scholar
  9. 9.
    Bullock DP, Sporer SM, Shirreffs TG Jr (2003) Comparison of simultaneous bilateral with unilateral total knee arthroplasty in terms of perioperative complications. J Bone Joint Surg Am 85-A(10):1981–1986PubMedGoogle Scholar
  10. 10.
    Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB (1999) An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am 81(1):2–10PubMedGoogle Scholar
  11. 11.
    Bould M, Freeman BJ, Pullyblank A, Newman JH (1998) Blood loss in sequential bilateral total knee arthroplasty. J Arthroplasty 13(1):77–79PubMedCrossRefGoogle Scholar
  12. 12.
    Bottner F, Pavone V, Johnson T, Heitkemper S, Sculco TP (2003) Blood management after bilateral total knee arthroplasty. Clin Orthop Relat Res 410:254–261PubMedCrossRefGoogle Scholar
  13. 13.
    Boettner F, Sculco TP (2004) Letters to the editor: blood management after bilateral total knee arthroplasties. Clin Orthop Relat Res 422:270–284Google Scholar
  14. 14.
    Etchason J, Petz L, Keeler E, Calhoun L, Kleinman S, Snider C, Fink A, Brook R (1995) The cost effectiveness of preoperative autologous blood donations. N Engl J Med 332:719–724PubMedCrossRefGoogle Scholar
  15. 15.
    Breakwell LM, Getty CJ, Dobson P (2000) The efficacy of autologous blood transfusion in bilateral total knee arthroplasty. Knee 7(3):145–147, JulPubMedCrossRefGoogle Scholar
  16. 16.
    Lane GJ, Hozack WJ, Shah S, Rothman RH, Booth RE, Eng K, Smith P (1997) Simultaneous bilateral versus unilateral total knee arthroplasty. Outcomes analysis. Clin Orthop 345:106–112PubMedGoogle Scholar

Copyright information

© Hospital for Special Surgery 2008

Authors and Affiliations

  • Friedrich Boettner
    • 1
  • Peter Sculco
    • 1
  • Eric Altneu
    • 1
  • Bülent Çapar
    • 2
  • Thomas P. Sculco
    • 1
  1. 1.Hospital for Special SurgeryNew YorkUSA
  2. 2.Hisar International HospitalIstanbulTurkey

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