Comparison of Autologous Drainage Blood Reinfusion or No Drain in Primary Total Knee Replacements

Han, Hyuk Soo; Kang, Seung Baik; Yoon, Kang Sup; Lee, Ji Ho; Lee, Jae Hyup; Jo, Hyunchul; Rhee, Seunghwan; Kim, Tae Woo

Abstract

PURPOSE
Primary total knee arthroplasty is associated with considerable blood loss, and allergenic blood transfusions are frequently necessary. Because of the cost and risks of allogenic blood transfusions, the autologous drainage blood reinfusion technique has been developed as an alternative transfusion technique. A number of studies have compared the reinfusion techniques with standard suction drainage, but few reports have compared the reinfusion technique with the technique that uses no drain. We analyzed the early results after primary total knee arthroplasty with using autologous drainage blood reinfusion and no drain.
MATERIALS AND METHODS
We selected 30 patients who underwent primary total knee arthroplasty with using no drain between November 2005 and March 2006 and they were matched for age and gender with 30 patients who underwent primary total knee arthroplasty with using the autologous drainage blood reinfusion technique between January 2003 and October 2005. All the operations were done under a pneumatic tourniquet and meticulous hemostasis was performed after deflation of the tourniquet. We have retrospectively reviewed the preoperative data (age, gender, the body mass index, the diagnosis, a history of knee surgery, infection and/or anticoagulant therapy, and the medical cormorbidities) and the postoperative data (the hemoglobin level, the hematocrit and the platelet count during hospitalization, the amount of allogenic blood transfusion and narcotics, the complications, the rehabilitation process and the clinical scores).
RESULTS
The amount of allogenic blood transfusion in the autologous drainage blood reinfusion group was greater than that of the no drain group, but the difference was not statistically significant. The hemoglobin level and hematocrit during hospitalization were higher in the autologous drainage blood reinfusion group, which was significant at the postoperative second and seventh days. There was a case of deep infection in the no drain group.
CONCLUSION
The autologous drainage blood reinfusion method when performing primary total knee arthroplasty did not show any significant clinical benefit over the no-drain method with regards to allogenic blood transfusions, the amount of narcotic used, the rehabilitation processes and the clinical scores. However, the incidences of wound complication and infection were higher in the no drain group.