DOI: 10.1093/bjs/znad258.686 ISSN:

952 The Use of Cell-Salvage in Periprosthetic Femur Fractures: A Cheaper and Safer Alternative?

L Kapuge, R Brunt, S Crosswell
  • Surgery



Periprosthetic femur fractures (PFF) are becoming increasingly frequent due to an ageing population and growing number of arthroplasties. PFF revision surgery is associated with significant peri-operative blood loss and higher transfusion requirements. There are few strategies to reduce rates of transfusion. One of which is the use of cell-salvage. The aim of this study was to determine whether cell salvage should be routinely implemented during PFF revision surgeries.


All admission with PFF were retrospectively reviewed over a period of 18 months. Data points including patient demographics, admission/operation dates, fracture site, anticoagulation status, pre/post-op Hb and number of transfusions were collected.


There were a total of 38 PFF. Average age was 83.4 years with admission Hb 11.65g/dl. Mean time for operation was 2.9 days. 56% of total hip replacement PFF received a blood transfusion post-operatively with an average of 2.6 units per patient. 100% of total knee replacement PFF received a post-operative transfusion with an average of 1.6 units per patient. Of note there was no increased transfusion requirements for patient on anticoagulation (Warfarin/DOAC).


We identified that >50% of PFF required a post-op transfusion. The cost of 1 unit of RBC locally was found to be £145.99. The average cost of a cell salvage filter is £100 per patient. Considering the above and the well-known risk of allogenic red blood cell transfusion, it was concluded that the routine use of cell salvage could be a cheaper and safer alternative to allogenic red blood cell transfusion.

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