An Efficient Algorithm for Minimizing Perioperative Blood Loss During Minimally Invasive Total Knee Arthroplasty Utilizing Erythropoietin, Epinepherine, a Bipolar Sealer, and a Reinfusion Drain

Blood loss during the perioperative period of total joint arthroplasty has been well described in the literature. Despite numerous advances, allogeneic transfusion rates are still reported as high as 50%. Often the literature focuses on one area or mechanism of blood loss prevention but this article focuses on a multimodal approach to blood loss prevention including preoperative optimization, intraoperative technique, and postoperative management. Hemoglobin drop and transfusion rates were retrospectively reviewed for 134 control patients undergoing total knee arthroplasty (TKA) in three groups. Group 1 included low risk patients (Hb >14 g/dl), Group 2 included intermediate risk patients (Hb 13-14 g/dl) utilizing reinfusion drain and preoperative autologous blood donation, and Group 3 included high risk (Hgb