Blood transfusion incidence in primary Total Knee Arthroplasty of Unilateral vs Bilateral group

Original Article

Background: Blood transfusion is one of the major concerns following Total Knee Arthroplasty. We assessed the incidence rate of blood transfusion (packed red cells) in our geographical group based on age, gender, preoperative Haemoglobin and following both unilateral and bilateral primary TKA done either in single-stage or sequentially after a week. Materials and Methods: This was a retrospective observational study that included 200 patients who underwent primary TKA unilateral, bilateral done in single-stage and sequential from June 2015 to May 2016. Two doses of parenteral Tranexamic acid and periarticular cocktail injection was given. Transfusion was indicated with postoperative Hgb below 8 g/dl associated with or without clinical signs of tissue hypoperfusion. Results: The study group was 200 patients with the age group of 50-81 years, of which 154 (77%) were female and 46 (23%) were male and had a mean preoperative Hgb level of 12.6 g/dl. 88 (44%) unilateral, 40 (20%) bilateral and 72 (36%) sequential TKA were performed and 7 (7.95%), 12 (30%) and 26 (36%) patients received blood transfusion respectively. Among the transfused 45 patients, 38 patients were bilateral group, of which 30 (66.6%) patients had a preoperative Hgb level of 10–12 g/dl, indicating a high incidence of transfusion in bilateral cases compared to unilateral and with preoperative Hgb levels of 10–12g/dl which was statistically significant with p-value <0.05. Conclusion: In our study, age and gender were not the major factors for blood transfusion, but low preoperative Hgb levels and bilateral single stage and sequential TKA showed a significantly higher incidence of blood transfusion. Keywords: total knee arthroplasty, blood transfusion, preoperative Hgb