Findings and Conclusion To our knowledge , this is the first meta- analysis to compare the clinical results between PAT and a control in joint replacement patients .
This meta- analysis has proven that the use of a PAT reinfusion system reduced significantly the dem and for ABT , the number of patients who require ABT and the cost of hospitalization after total knee and hip arthroplasty .
This study , together with other previously published data , suggests that PAT drains are beneficial .
Background Total hip or knee arthroplasty is an elective procedure that is usually accompanied by substantial blood loss , which may lead to acute anemia .
As a result , almost half of total joint arthroplasty patients receive allogeneic blood transfusions ( ABT ) .
Many studies have shown that post-operative auto-transfusion ( PAT ) significantly reduces the need for  ABT  , but other studies have question ed the efficacy of this method .
The effectiveness of reinfusion after total knee replacement. A prospective randomised controlled study
The purpose of our study was to determine the effectiveness of a postoperative autologous blood reinfusion system as an alternative to homologous , banked blood transfusions in total knee arthroplasty . We carried out a prospect i ve r and omised controlled study on 60 patients having unilateral total knee replacements . In all these patients , the same surgical team applied the same surgical technique , and all patients followed the same rehabilitation program . In 30 of these patients ( group A ) , a reinfusion system of unwashed salvaged blood was applied , and they were supplemented postoperatively with banked blood transfusions when required . A control group of 30 patients ( group B ) , in whom st and ard suction drains were used , received one unit of homologous banked blood transfusion intraoperatively and additional blood transfusions postoperatively when required . The administration of banked blood transfusion was determined by the haemoglobin value ( < 9 mg/dl ) and /or clinical signs ( blood pressure , pulse , etc . ) . The values of haemoglobin , haematocrit and platelets were recorded preoperatively and the first , fifth and 15th postoperative days , respectively . Five patients of group A required nine units of homologous blood ( 0.3 units/patient ) postoperatively . Ten patients of group B required an additional 15 banked blood units postoperatively ( in total 45 banked blood units for group B ; 1.5 units/patient ) . In the study group , the total homologous blood requirements were reduced by 80 % , while the postoperative blood requirements were reduced by 50 % . There was no significant difference in the postoperative haematocrit and haemoglobin values between the two groups . The cost of the blood management in the study group was reduced by 36 % . The use of an autologous blood reinfusion system  reduces highly effectively the dem and s of homologous banked blood transfusion in total knee arthroplasty . RésuméLe but de cette étude était de déterminer l’efficacité d’un système de réinjection post-opératoire de sang autologue comme alternative à la transfusion homologue dans l’arthroplastie totale de genou . Nous avons fait une étude prospect i ve r and omisée sur 60 patients opérés d’une prothèse totale du genou unilatérale . Chez 30 patients ( groupe A ) un système de réinjection sans lavage du sang préservé était utilisé avec supplémentation post-opératoire par du sang de banque si nécessaire . Un groupe de contrôle de 30 patients ( groupe B ) , chez qui un drainage aspiratif classique était utilisé , recevait une unité de sang homologue pendant l’intervention et des transfusions post-opératoires si nécessaire . L’indication de transfusion homologue était posé sur un taux d’hémoglobine < 9mg/dL et/ou des signes cliniques . Les valeurs de l’hémoglobine , de l’hématocrite et des plaquettes étaient relevées avant l’intervention et les premier , cinquième et quinzième jours post-opératoires . 5 patients du groupe A eurent besoin après l’opération de 9 unités de sang homologue ( 0,3 unité par patient ) . 10 patients du groupe B eurent besoin de 15 unités supplémentaires de sang homologue après l’opération ( au total 45 unités de sang homologue pour le groupe B ; 1,5 unités par patient ) . Dans le groupe étudié la nécessité globale de sang homologue était réduite de 80 % et la nécessité de transfusion post-opératoire de 50 % . Le coût de la gestion du sang était réduite de 36 % dans le groupe étudié . l’utilisation d’un système de réinjection du sang autologue réduit significativement la nécessité de  transfusion homologue dans l’arthroplastie totale du genou
Findings and Conclusion To our knowledge , this is the first meta- analysis to compare the clinical results between PAT and a control in joint replacement patients .
This meta- analysis has proven that the use of a PAT reinfusion system reduced significantly the dem and for ABT , the number of patients who require ABT and the cost of hospitalization after total knee and hip arthroplasty .
This study , together with other previously published data , suggests that PAT drains are beneficial .
Background Total hip or knee arthroplasty is an elective procedure that is usually accompanied by substantial blood loss , which may lead to acute anemia .
As a result , almost half of total joint arthroplasty patients receive allogeneic blood transfusions ( ABT ) .
Many studies have shown that post-operative auto-transfusion ( PAT ) significantly reduces the need for  ABT  , but other studies have question ed the efficacy of this method .