Knee Replacement Procedures

Reducing Blood Loss in Knee Replacement Surgery

If you’ve been scheduled by your doctor for knee replacement surgery, you’re probably interested in learning more about what will happen during the procedure and how it may affect your health and rehabilitation. The information presented here is designed to help patients and their families better understand the value of blood preservation and the importance of controlling blood loss during joint replacement surgery.

Medtronic Advanced Energy is a medical device company founded on the idea that reducing and preventing blood loss during surgery has huge benefits for surgeons and patients. In recent years, Medtronic has teamed up with surgeons and hospitals to help provide a way to reduce the need for blood transfusions during surgery.

What Causes Blood Loss During Surgery

Before replacing your knee joint, your surgeon must first get to it by cutting through tissue from the skin down into the joint space. This tissue contains many small vessels that can bleed when they are cut. Your surgeon will try to stop the bleeding using surgical instruments, but it is difficult to stop all bleeding, especially in the small vessels of the muscle and soft tissue.

Although bleeding and blood loss are common during all types of surgery, studies have shown that orthopaedic procedures in particular – including knee replacements – may cause a large amount of bleeding.¹

The Aquamantys^® System is Medtronic Advanced Energy's signature product line and is commonly used in many different types of surgery, including knee and hip replacements, spine surgery, and orthopedic trauma cases. The Aquamantys System uses patented Transcollation^® technology – a combination of radio frequency (RF) energy (a form of electrical energy used in medical applications) and saline (salt and sterile water) – to stop the flow of blood during surgery. The technical term for this process is called haemostatic sealing, and it can help prevent further blood loss during the procedure. Medtronic's technology is focused on decreasing blood loss and pain during and after joint replacement.^*,2

Why Decreasing Blood Loss Is Important

Keeping the proper amount of blood inside your body is very important. One of the primary functions of blood is to carry oxygen to all parts of the body. Oxygen gives you the energy to perform physical activities like walking, lifting objects, and exercising. It also gives your internal organs the energy to perform tasks like digesting food, breathing, healing, and thinking.

If you lose a lot of blood during surgery, it can lead to a condition called anemia– a reduction in the red blood cells, which are a component of blood and carry oxygen to all parts of the body. Anemia can make you feel tired and weak. It can also cause chest pain, dizziness and problems concentrating. The effects caused by anemia often add to the length of hospital stays for patients after their surgery. For patients who may already be anemic before surgery decreasing blood loss during and after joint replacement is even more important.

Internal bleeding can also occur after the surgery in the area where your joint was replaced. This type of bleeding can cause swelling and pain. Continued blood loss after surgery is normal, but if the amount of blood loss is excessive, it may delay how quickly you heal, feel better, and get back to your normal routine.

If the surgeon uses the Aquamantys System it may reduce the symptoms of post-surgical bleeding, such as pain and swelling around the area of the replaced joint.^*,2 This may decrease the length of your hospital stay and the amount of time it takes to get back to the things you could do before surgery.^**,3

Some doctors have patients donate their own blood before surgery to be given back if anemia occurs. This is called autologous donation. In contrast, most of the blood products utilized after surgery are from a local blood bank and are donated from eligible individuals in the community.

About Blood Transfusions

To replenish the blood lost during surgery, you may need to receive a blood transfusion. A blood transfusion is a procedure in which blood is introduced into your body through an intravenous (IV) line. Although they are common and often saves lives, it is important to understand that blood transfusions carry some risks. Some of the more common risks include fever, allergic reaction and in rare cases a virus or infectious disease. Transfusions have also been shown to potentially lengthen hospital stays for patients after a joint replacement.^**,3

For many surgeons, using the Aquamantys System during their cases has reduced the need for blood transfusions.^*,4 In instances where a transfusion is still needed, the Aquamantys System may reduce the number of blood units required.⁵

If you’ve been scheduled for a knee replacement, it’s important to know how your surgeon manages blood loss during the procedure. Check with your surgeon for more information about blood transfusions or how blood loss is managed during surgery.

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

To locate a surgeon currently using the Aquamantys System, use our Surgeon Locator.

1. Callaghan JJ, Spitzer A. Blood management and patient specific transfusion options in total joint replacement surgery. Iowa Orthop J. 2000; 20:36-45.

2. Rosenberg AG. Reducing blood loss in total joint surgery with a saline-coupled bipolar sealing technology. J Arthroplasty 2007; 22:82-85

3. Covance report; 2008 MedPAR database based on ICD-9-CM Codes for 100% of Medicare beneficiaries. Data on file.

4. Arndt S, Patney M. Efficacy of a bipolarsealer in reducing post-operative transfusion rates in total joint arthroplasty. 2009 Abstract at EOA (Eastern Orthopedic Association)

5. Marulanda G, Krebs V et al. Hemostasis using a bipolar sealer in primary total knee arthroplasty. Am J Ortho 2009; 38:E179-183

* Performance has not been established in all surgical procedures.
** Covance, MedPAR Report, length of stay has not been specifically correlated with the Aquamantys System