Huntley D, Walton T J, Whitehouse S L, Ross A D, Hubble M J W, Howell J R, Wilson M J, Davies J, Thomas E, Kassam A M
Exeter Hip Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon University Healthcare NHS Foundation Trust, Barrack Road, Exeter, UK.
Queensland University of Technology, Brisbane, Queensland, Australia.
JB JS Open Access. 2025 Sep 11;10(3). doi: 10.2106/JBJS.OA.24.00204. eCollection 2025 Jul-Sep.
Revision hip arthroplasty is associated with significant blood loss and a subsequent need for blood transfusion. Intraoperative cell salvage (ICS) is a method of recovering a patient's blood for autologous transfusion. This potentially reduces the need for allogenic blood transfusion (ABT), thus avoiding associated risk and expense. This study assessed the impact of the use of ICS on the need for ABT in revision hip arthroplasty in a tertiary referral center over a 24-year period.
Retrospective analysis of prospectively collected data of revision hip arthroplasties performed between November 1996 and May 2020 was undertaken. ABT and ICS use for each procedure was collated and analyzed.
Two thousand six hundred thirty-nine revision hip operations were included, of which 755 (28.6%) used ICS. Significantly less patients in the ICS group required ABT, 218 patients (28.9%) compared with 923 (49.0%) in the control group, p < 0.001, χ test. Patients who had ICS required significantly fewer units of ABT per person (ICS group: 0.73 units/person (554/755, SD 1.4); control group 1.36 units/person (2,574/1884, SD 1.9) (p < 0.001, -test)).
The use of ICS in revision hip surgery significantly reduces the risk of requiring postoperative ABT and reduces the volume of allogenic blood required. This reduces the known risks associated with ABT, with associated cost saving benefits of reduced transfusion rates and reduced use of the precious resource of allogenic blood. We advise the use of ICS in all patients undergoing revision hip surgery and, in particular, those patients with higher bleeding risks outlined in the study.
髋关节翻修术会导致大量失血，进而需要输血。术中血液回收（ICS）是一种回收患者自身血液用于自体输血的方法。这有可能减少异体输血（ABT）的需求，从而避免相关风险和费用。本研究评估了在一家三级转诊中心24年期间，使用ICS对髋关节翻修术中ABT需求的影响。
对1996年11月至2020年5月期间进行的髋关节翻修术的前瞻性收集数据进行回顾性分析。整理并分析了每个手术中ABT和ICS的使用情况。
纳入了2639例髋关节翻修手术，其中755例（28.6%）使用了ICS。ICS组中需要ABT的患者明显较少，为218例（28.9%），而对照组为923例（49.0%），p<0.001，χ检验。接受ICS的患者每人所需的ABT单位明显较少（ICS组：0.73单位/人（554/755，标准差1.4）；对照组1.36单位/人（2574/1884，标准差1.9）（p<0.001，t检验））。
在髋关节翻修手术中使用ICS可显著降低术后需要ABT的风险，并减少所需异体血的量。这降低了与ABT相关的已知风险，具有降低输血率和减少珍贵异体血资源使用的相关成本节约效益。我们建议在所有接受髋关节翻修手术的患者中使用ICS，特别是本研究中概述的那些出血风险较高的患者。
