Effect of re‐transfusion systems on physiotherapy participation and transfusion in total knee joint arthroplasty

Background Total knee joint arthroplasty is associated with significant blood loss. We hypothesized that re‐transfusion drains would be associated with a lesser requirement for allogeneic blood transfusion and result in earlier physiotherapy participation and decreased length of hospital stay. Methods We performed a retrospective analysis of 303 patients with a mean age of 68.3 years (44–91) who underwent unilateral primary total knee joint arthroplasty within a single orthopaedic unit. A re‐transfusion drain, deep drain, superficial drain or no drain was placed at the time of surgery. Blood tests were taken pre‐ and post‐operatively, and blood transfusions were given based on the haemoglobin and clinical symptoms. Medical records data were used to determine the day patients sat out of bed, mobilized more than 10 m and were discharged from hospital. Results Patients with a re‐transfusion drain were able to sit out of bed ( P = 0.006), mobilize more than 10 m ( P = 0.006) and were ready for discharge earlier ( P = 0.013) than those without a re‐transfusion drain. The use of a re‐transfusion drain showed no effect on allogenic blood transfusion requirement; however, it was associated with decreased haemoglobin drop when compared with other drain types ( P = 0.003). Conclusion Our results suggest that the use of a re‐transfusion system following total knee arthroplasty has beneficial physiotherapy outcomes and a decreased length of stay.