Autologous bone plugs in unilateral total knee arthroplasty

BACKGROUND: The purpose of this study was to compare blood loss, declines in hemoglobin (HgB) and hematocrit (HcT) levels, and required homologous transfusions for patients who either had the femoral intramedullary defect left open or filled with an autologous bone plug during total knee arthroplasty (TKA). We hereby present our results of autologous bone plugs in unilateral TKA. MATERIALS AND METHODS: A retrospective chart review was performed on 55 patients diagnosed with osteoarthritis (OA) who had undergone unilateral TKA. Twenty six patients had the femoral defect filled with an autologous bone plug and 29 did not. Lateral releases and patella replacements were not performed. Drained blood was reinfused when appropriate. RESULTS: Mean blood loss and mean blood reinfused were similar for the plugged (loss: 960.8 ± 417.3 ml; reinfused: 466.7 ± 435.9 mL) and unplugged groups (loss: 1065.9 ± 633.5 ml, P = 0.38; reinfused: 528.4 ± 464.8 ml, P = 0.61). Preoperative HgB (14.3 ± 1.4 g/dL, P = 0.93) and HcT levels (42.2 ± 4.6%, P = 0.85) were similar across plug conditions. HgB and HcT levels declined similarly for the plugged (2.7 ± 1.2 g/dl and 7.9 ± 4.0%) and unplugged groups (3.0 ± 0.9 g/dl, P = 0.16 and 9.0 ± 2.6%, P = 0.16), respectively. Of patients, one in the plugged group and none in the unplugged group required homologous transfusions (P = 0.5). CONCLUSION: The autologous bone plug does not appear to reduce the need for homologous blood transfusions following unilateral TKA.