FP1.2 Intraoperative Cell Salvage Reduces Transfusion Rates and Hospital Stay in Periacetabular Osteotomy

Abstract ICLB01 - The Instability Masterclass: Correcting Bone, Biology, and Bad Outcomes, Session Room 6 (BMCC Level 3), October 8, 2026, 10:30 - 12:30 Background Periacetabular osteotomy (PAO) is the treatment of choice for symptomatic acetabular dysplasia and provides good long-term outcomes. However, PAO is associated with considerable intraoperative blood loss, and blood transfusion is frequently required, which may increase complication rates and length of hospital stay. Intraoperative cell salvage (ICS) systems are widely used in several surgical specialties to reduce the need for allogeneic blood transfusion, but evidence regarding their use in PAO remains limited. Purpose To evaluate the effect of intraoperative cell salvage on transfusion requirements and hospital length of stay in patients undergoing PAO. Methods A comparative case–control study was performed including patients undergoing PAO performed by a single surgeon using the Ganz technique through an oblique inguinal incision. Patients were divided into two groups according to the use of intraoperative cell salvage. The Cell Saver® Elite®+ system (Haemonetics Corporation, MA, USA) was used in the ICS group. Collected variables included age, sex, pre- and postoperative hematocrit and hemoglobin levels, estimated blood loss, recovered blood volume, need for transfusion, and length of hospital stay. Descriptive statistics and Student’s t-test were used for analysis. Results A total of 128 patients were included: 64 in the ICS group and 64 controls. Mean age was 26 years, and 93% were female. In the ICS group, mean preoperative hematocrit/hemoglobin was 40.4%/13 g/dL and postoperative values were 30.4%/10.4 g/dL. In the control group, preoperative hematocrit/hemoglobin was 40.7%/13.6 g/dL and postoperative values were 27.4%/9.1 g/dL. Mean estimated blood loss was 740 mL, with a mean recovered volume of 251 mL in the ICS group. Transfusion was required in 4.5% of patients in the ICS group compared with 29.7% in controls. Median hospital stay was 3 days (range 2–5) in the ICS group and 4 days (range 2–7) in controls (p = 0.03). Statistically significant differences were observed in transfusion rates and length of stay. Conclusion The use of intraoperative cell salvage during periacetabular osteotomy significantly reduces the need for blood transfusion and shortens hospital stay. ICS represents a useful strategy to optimize perioperative management in PAO surgery.