Abstract:

Total hip arthroplasty is increasing in incidence due to our aging population. However, this procedure has a high potential for increased blood loss, with allogeneic blood transfusions commonly used. However, due to potential transfusion-related risks such as immunosuppression or infections, attempts have been made to reduce the amount of blood loss and minimize transfusions. Therefore, our aim was to provide a broad overview of the widely used methods for reducing post-operative blood loss after total hip arthroplasty. These include antifibrinolytic agents, autologous blood transfusion drains, avoiding the use of drains, and modifications in drainage techniques. In addition, lowering the transfusion threshold is another method used to decrease the rates of allogeneic blood transfusion. Current evidence suggests that the use of some of these strategies—either alone, or in combination—may reduce the amount of blood loss and the need for allogeneic transfusions. However, further research is needed to create new, more standardized guidelines.

Authors:

Julio J. Jauregui, MD, Research fellow, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, Kimona Issa MD, Research fellow , Seton Hall University School of Health , and Medical Sciences , Department of Orthopaedic Surgery , South Orange Village, New Jersey, Bhaveen H. Kapadia, MD, Research fellow, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, Samik Banerjee, MD, Research fellow, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, Steven F. Harwin, MD, Chief of joint reconstruction, Beth Israel Medical Center, Adult Reconstruction and Total Joint Replacement Service, New York, NY, Michael A. Mont, MD, Director of Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD

PMID:  24347484

For Direct IP Access please click this link