Postoperative Hemorrhage in Cementless Total Knee Replacement and its Countermeasures-Use of CBC Consta VAC.

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Despite its high usefulness, cementless total knee replacement (TKR) has a disadvantage of large-volume postoperative hemorrhage. In 122 cases (170 knees) of cementless TKR with Miller-Galante prosthese performed during the past six years, factors contributing to postoperative hemorrhage were investigated. No significant differences were found in dependence on the underlying disease (rheumatoid arthritis vs osteoarthrosis) and the implant used (M/G vs MGII) . The subjects were classified into three groups for analysis. The severer the preoperative deformity and contracture the knee showed, the larger the volume of postoperative hemorrhage, with a significant difference.<BR>Homologous blood transfusion could be avoided in 13.8% of the patients before CBC ConstaVAC was introduced, whereas the number increased to 39.8% with the use of CBC. The results indicate that CBC is of high value in cementless TKR provided that sufficient precautions are taken in its use. Particulary for the patients with severe knee deformity and/or contracture, or those who will have bilateral simultaneous operation, CBC may help to prevent homologous blood transfusion especially when preoperative storage of autologous blood is made with the use of an erythropoietin agent.
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