Blood management strategies for total knee arthroplasty.

Perioperative blood loss during total knee arthroplasty can be significant, with magnitudes typically ranging from 300 mL to 1 L, with occasional reports of up to 2 L. The resultant anemia can lead to severe complications, such as higher rates of postoperative infection, slower physical recovery, increased length of hospital stay, and increased morbidity and mortality. Although blood transfusions are now screened to a greater extent than in the past, they still carry the inherent risks of clerical error, infection, and immunologic reactions, all of which drive the need to develop alternative blood management strategies. Thorough patient evaluation is essential to individualize care through dedicated blood management and conservation pathways in order to maximize efficacy and avoid associated complications. Interventions may be implemented preoperatively, intraoperatively, and postoperatively. Copyright 2014 by the American Academy of Orthopaedic Surgeons.