An economic justification for autologous blood re-infusion in primary total knee replacement surgery.

INTRODUCTION: To justify economically the use of autologous blood re-infusion after total knee replacement surgery compared with vacuum drains. To determine if the patients using autologous re-infusion units have a reduced allogenic blood transfusion requirement and hospital stay. PATIENTS AND METHODS: Prospectively, 50 patients undergoing primary unilateral total knee replacements with autologous re-infusion units were studied. They were matched for age, sex, type of prosthesis and the month in which surgery took place to a second group undergoing the same surgery with vacuum drains. The results for the second group were obtained retrospectively from the notes. The outcome measures were the need for allogenic blood transfusion and length of postoperative hospital stay. RESULTS: The use of re-infusion units reduced the need for postoperative allogenic blood transfusion from 28% to 4% in total knee replacement surgery. The cost of using re-infusion units was the same as vacuum drains. Overall, the autologous re-infusion patients were discharged 2 days earlier (99% confidence interval). CONCLUSIONS: Re-infusion units are no more expensive than vacuum drains. In addition, autologous blood has many clinical benefits compared to allogenic blood. Re-infusion may shorten the hospital stay for patients undergoing total knee replacement surgery.