EFFECT OF PREOPERATIVE DONATION OF AUTOLOGOUS BLOOD ON DEEP-VEIN THROMBOSIS FOLLOWING TOTAL JOINT ARTHROPLASTY OF THE HIP OR KNEE

The effect of preoperative donation of autologous blood on postoperati ve deep-vein thrombosis was retrospectively studied in men who had bee n managed consecutively with elective total joint replacement of the h ip or knee because of osteoarthrosis. The patients had, on the average , two of nine considered risk factors for deep-vein thrombosis. Two hu ndred and thirty-seven patients were evaluated postoperatively with as cending venography, and they form the basis of this study. Fifty-four patients had venographic evidence of deep-vein thrombosis of the lower extremity: with most having asymptomatic clots distal to the knee. Th e prevalence of deep-vein thrombosis was nineteen (16 per cent) of 116 after total hip arthroplasty, compared with thirty-five (29 per cent) of 121 after total knee arthroplasty (chi square = 4.6, p = 0.03), De ep-vein thrombosis developed in twenty-eight (17 per cent) of the 161 patients who had donated blood preoperatively, compared with twenty-si x (34 per cent) of the seventy-sis patients who had not donated blood preoperatively (chi square = 7.7, p = 0.006). Through logistic regress ion analysis, the donation of autologous blood was shown to reduce sig nificantly the development of postoperative deep-vein thrombosis for p atients managed with total knee arthroplasty (p < 0.01) but not for pa tients managed with total hip arthroplasty, Additional neural network analysis showed the donation of autologous blood to be the most import ant prognostic factor in predicting the absence of postoperative deep- vein thrombosis. In addition to diminishing the need for transfusion o f homologous blood after total joint arthroplasty, preoperative donati on of autologous blood appears to protect against postoperative deep-v ein thrombosis after total knee arthroplasty.