This study investigated blood loss and transfusion rates in patients undergoing two-stage exchange in infected total knee arthroplasty (TKA) using a bipolar sealer. The study was a propensity score-matched study comparing the effectiveness of the bipolar sealer (Hemodiss, Kylix) against standard electrocautery.
Key Points:
- Participants: Medical records of 82 patients with infected TKA who underwent two-stage exchange arthroplasty from 2021 to 2022 were reviewed.
- Groups: 24 patients were treated using the bipolar sealer, while a historical control group of 58 patients used standard electrocautery. Propensity score matching created two comparable groups of 24 patients each.
- Primary Outcome: Transfusion requirement.
- Secondary Outcomes: Estimated blood loss on postoperative day three and at the nadir of hemoglobin level.
Findings:
Demographic Data:
No significant differences between groups in age, gender, baseline hemoglobin, and hematocrit levels.
Blood Loss:
- Third-day calculated blood loss was significantly lower in the bipolar group (1180 ± 595 mL) compared to the control group (1620 ± 779 mL; p = 0.029).
- Blood loss at the nadir of hemoglobin was also lower in the bipolar group (1369 ± 567 mL) than the control group (1882 ± 713 mL; p = 0.044).
Transfusion Requirement:
Lower in the bipolar group (8%) compared to the control group (33%; p = 0.036).
Conclusion:
The bipolar sealer effectively supports hemostasis and reduces the need for transfusions after the first stage of a two-stage exchange for periprosthetic joint infection.
