Knee Surg Relat Res.  2016 Sep;28(3):179-187. 10.5792/ksrr.2016.28.3.179.

Blood Management Strategies in Total Knee Arthroplasty

• Liu D
• Dan M
• Martinez Martos S
• Beller E

• KMID: 2350094
• DOI: http://doi.org/10.5792/ksrr.2016.28.3.179

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.

Keyword

Knee; Arthroplasty; Blood; Conservation strategies

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Knee*
Blood Transfusion
Bloodless Medical and Surgical Procedures
Comorbidity
Humans
Knee
Patient Care
Postoperative Period
Risk Factors
Surgeons