No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls

J Arthroplasty. 2017 Jan;32(1):177-182. doi: 10.1016/j.arth.2016.06.037. Epub 2016 Jul 1.

Abstract

Background: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA.

Methods: In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet. Twenty-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group.

Results: No significant differences were found neither for calculated blood loss, with 1397 (standard deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up.

Conclusion: The use of a bipolar sealer in a TKA revision setting without the use of a tourniquet did not reduce blood loss or blood transfusion rates.

Keywords: Aquamantys; bipolar sealer; blood loss; blood transfusion; revision knee arthroplasty.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Arthroplasty, Replacement, Knee / statistics & numerical data
  • Blood Loss, Surgical / prevention & control*
  • Blood Loss, Surgical / statistics & numerical data
  • Blood Transfusion / statistics & numerical data*
  • Electrocoagulation
  • Female
  • Hemostasis, Surgical / instrumentation*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Prospective Studies
  • Reoperation / statistics & numerical data*
  • Retrospective Studies
  • Tourniquets