Optimising the use of cell salvage in revision hip arthroplasty

Background:Intraoperative cell salvage is an established method to reduce the requirement for and the volume of allogenic blood transfusion but adds to the financial cost of performing surgery. Aims:The primary aim of this study was to determine which patients and what type of revision hip surgery benefit most from intraoperative cell salvage. Methods:This observational study included patients who underwent revision hip surgery performed by the senior author at a single orthopaedic unit. The cohort was divided into single and two-component revision groups; then, the transfusion requirement combined with analysis of patient factors was used to create a decision-making protocol. Findings:The two-component group had a significantly higher number of cases using cell salvage and a higher total transfusion volume. Patients who required postoperative allogenic blood transfusions had a higher mean age, were less likely to have received tranexamic acid and had a lower preoperative haemoglobin level. Conclusion:Based on these results, a decision-making protocol was developed for when to use cell salvage in revision hip surgery.