This is a well-designed meta-analysis of six RCTs, selected after a meticulous literature search among 729 potentially relevant articles. It is claimed by the authors that this is the first meta-analysis to systematically compare the clinical results of postoperative autologous transfusion (PAT) with a control group in patients subjected to total hip or knee arthroplasty. Although the benefits of PAT have been documented previously, this study comes with the straightforward conclusion that PAT significantly reduces allogeneic blood transfusion requirements, as well as the length of hospital stay and the cost of hospitalization. There seems also to be a trend towards reduction of infection rates as well as venous thromboembolism, findings that should be verified by further RCTs. In my opinion, the results of this study justify the routine use of PAT in this type of orthopedic surgery.

– Constantine Vagianos