Population and clinical characteristics of studies included in our review and meta-analysis
| Study | Population/system | Design | Level of evidence/DB score | Findings |
|---|---|---|---|---|
| TKA | ||||
| Thomas et al. (2001)14 | Primary TKA Cell Saver | Single-centre RCT salvage with and without reinfusion (control) 231 patients | Level-1 evidence DB = 25/31 | Transfusion rates Salvage: 7% Control: 28% (p < 0.001) Fewer readmits and GP visits |
| Sinclair et al. (2009)15 | Primary TKA OrthoPAT | Retrospective cohort Salvage/PAD/control 229 patients | Level-3 evidence DB = 22/31 | Transfusion rates Salvage: 25% PAD: 18% Control: 52% High-risk and low-risk sub-analysis |
| Blatsoukas et al. (2010)16 | Primary TKA Dideco Compact Advanced | Prospective cohort Salvage (intraop and postop)/salvage (postop)/control 248 patients | Level-2 evidence DB = 23/31 | Transfusion rates/mean units Salvage: (intra- and postop) 62%/0.81 Salvage: (postop) 59%/0.91 Control: 79%/1.74; (p < 0.001) |
| THA | ||||
| del Trujillo et al. (2008)6 | Primary THA OrthoPAT | Prospective cohort Salvage/control 108 patients | Level-2 evidence DB = 26/31 | Transfusion rate/LOS Salvage: 15% / 9.6 days Control: 48% / 13.6 days (p < 0.001) Subanalysis: high/low preop Hgb Postop infection rates trended toward sign reduction (2% v. 10%; p = 0.09) |
| Revision | ||||
| Bridgens et al. (2007)4 | Revision THA Cell Saver | Prospective cohort Salvage/control 94 patients | Level-3 evidence DB = 22/31 | Mean transfusion units Salvage: 2.6 Control: 6.4 (p < 0.001) |
| Garvin et al. (2005)17 | Revision THA OrthoPAT and Cell Saver | Retrospective case series Salvage/no salvage 147 patients | Level-4 evidence DB = 19/31 | Transfusion volume 31% incremental transfusion volume when salvage used No difference between salvage systems Inappropriate control group |
| TKA, THA and revision | ||||
| Clark et al. (2006)9 | Primary and revision TKA and THA OrthoPAT | Prospective cohort Salvage/control 310 patients | Level-2 evidence DB = 18/31 | Transfusion rate THA 73% less likely to use allogenic blood TKA 76% less likely to have allogenic transfusion |
| Abstracts | ||||
| Morgenschweis et al. (2011)18 | Primary THA and TKA Dideco Electa | Prospective cohort Salvage/control 379 patients | Level-2 evidence DB = n/a | Transfusion rates THA salvage: 9.5 THA control: 4.3% (p = 0.16) TKA salvage: 13.3 TKA control: 14.0% (p = 0.89) |
| White et al. (2011)19 | Primary THA and TKA OrthoPAT | Prospective cohort Salvage/control 268 patients | Level-2 evidence DB = n/a | Transfusion rates 48% reduction in allogenic transfusion rate with salvage |
| Paskova (2011)20 | Primary and revision TKA and THA OrthoPAT and Cell Saver | Retrospective cohort study Salvage/control 443 patients | Level-3 evidence DB = n/a | Transfusion rates
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DB = Downs and Black; GP = general practitioner; n/a = not available; LOS = length of stay in hospital; PAD = preoperative autogenic donation; THA = total hip arthroplasty; TKA = total knee arthroplasty; RCT = randomized controlled trial.