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Review
. 2016 Sep;28(3):179-87.
doi: 10.5792/ksrr.2016.28.3.179. Epub 2016 Aug 25.

Blood Management Strategies in Total Knee Arthroplasty

David Liu  1 , Michael Dan  2 , Sara Martinez Martos  1 , Elaine Beller  3
Affiliations
Review

Blood Management Strategies in Total Knee Arthroplasty

David Liu et al. Knee Surg Relat Res. 2016 Sep.

Abstract

A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim. Multiple blood conservation strategies are available in the preoperative, intraoperative and postoperative periods and can be employed in various combinations. Recent literature has highlighted the importance of preoperative Hb optimization, minimizing blood loss and evidence-based transfusion guidelines. Given TKA is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal.

Keywords: Arthroplasty; Blood; Conservation strategies; Knee.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Blood conservation algorithm used in our unit for total knee arthroplasty. Hb: hemoglobin.
See this image and copyright information in PMC

References

    1. Eubanks JD. Antifibrinolytics in major orthopaedic surgery. J Am Acad Orthop Surg. 2010;18:132–138. - PubMed
    1. Noticewala MS, Nyce JD, Wang W, Geller JA, Macaulay W. Predicting need for allogeneic transfusion after total knee arthroplasty. J Arthroplasty. 2012;27:961–967. - PubMed
    1. Shortt J, Polizzotto MN, Waters N, Borosak M, Moran M, Comande M, Devine A, Jolley DJ, Wood EM. Assessment of the urgency and deferability of transfusion to inform emergency blood planning and triage: the Bloodhound prospective audit of red blood cell use. Transfusion. 2009;49:2296–2303. - PubMed
    1. Goodnough LT, Shuck JM. Risks, options, and informed consent for blood transfusion in elective surgery. Am J Surg. 1990;159:602–609. - PubMed
    1. Newman ET, Watters TS, Lewis JS, Jennings JM, Wellman SS, Attarian DE, Grant SA, Green CL, Vail TP, Bolognesi MP. Impact of perioperative allogeneic and autologous blood transfusion on acute wound infection following total knee and total hip arthroplasty. J Bone Joint Surg Am. 2014;96:279–284. - PubMed

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