Dislocation after primary total hip arthroplasty is a relatively common complication. The incidence is usually between 1% and 4%, although 0% to 10% has been reported in the literature. The posterior approach is by far the most popular by surgeons, but it reportedly has an increase risk of post-operative dislocation. The posterior approach causes disruption of the posterior capsule and the short external rotators. Studies have shown that repair of the posterior capsule and the short external rotators greatly reduce the dislocation rate.
There are no transfusion guidelines defined for Total knee arthroplasty (TKA), and each orthopaedic unit usually has its own protocol when it comes to transfusion. With the present climate of concern about non-autologous blood transfusions and transmission of infection, orthopaedic units are trying to keep their transfusion rates to a minimum and only transfuse when absolutely necessary.
Of the 150 patients reviewed after the change in transfusion trigger (Hct <
0.25), only 29% were transfused – 35% of females and 18% of males. 50% of patients with a pre-operative Hb of 12 g/dl or less were transfused.
Hb drop = Pre-op Hb – (Day 3 Hb + No. of units of blood received) (We assumed that one unit of blood equates to one gram increase in circulating haemoglobin).
Three (20%) of the fifteen patients diagnosed with DDH which were not referred via the Hip Screening Programme had an identifiable risk factor at birth, yet were not sent for orthopaedic review and ultrasound examination via the Screening Programme.