J Knee Surg 2005; 18(2): 102-107
DOI: 10.1055/s-0030-1248166
Original Article

© 2005 Thieme Medical Publishers

Blood Loss and Transfusion Rates in Bilateral Total Knee Arthroplasty

Fred D. Cushner1, 2 , W. Norman Scott2 , Giles Scuderi2 , Kala Hill3 , John N. Insall4
  • 1The Department of Surgery, Division of Orthopedic Surgery, Albert Einstein College of Medicine of Yeshiva University, New York, NY
  • 2The Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, New York, NY
  • 3Ortho Biotech Clinical Affairs, LLC, Bridgewater, NJ
  • 4Deceased
Further Information

Publication History

Publication Date:
27 January 2010 (online)


From 1994 to 1998, we performed 170 bilateral total knee arthroplasties (TKAs) with cemented, posterior cruciate-substituting prostheses. Blood management included preoperative autologous donation, symptom-based transfusion, and autoreinfusion devices. Perioperative allogeneic transfusion rates for patients who donated 0, 1, 2, 3, or 4 units of blood were 40.00%, 0.00%, 3.70%, 0.00%, and 3.23%, respectively. Preoperative autologous donation >2 units also resulted in lower preoperative hemoglobin levels. For bilateral TKA, a protocol of 2 preoperative autologous donation units and reinfusion of postoperative drainage reduces anemia during the preoperative and postoperative periods.