Aims. Tranexamic acid (TXA) has been shown to reduce
Aims. The purpose of this study was to examine the efficacy and safety of carbazochrome sodium sulfonate (CSS) combined with tranexamic acid (TXA) on
Tranexamic acid (TXA), an inhibitor of fibrinolysis,
reduces
Aims. A typical pattern of
Aims. Cementless primary total hip arthroplasty (THA) is associated with risks of bleeding and thromboembolism. Anticoagulants are effective as venous thromboprophylaxis, but with an increased risk of bleeding. Tranexamic acid (TXA) is an efficient antifibrinolytic agent, but the mode and timing of its administration remain controversial. This study aimed to determine whether two intravenous (IV) TXA regimens (a three-hour two-dose (short-TXA) and 11-hour four-dose (long-TXA)) were more effective than placebo in reducing perioperative real
Aims. We chose unstable extra-capsular hip fractures as our study group
because these types of fractures suffer the largest
Background. 91% of
Aims. The aim of this study was to examine the efficacy and safety
of multiple boluses of intravenous (IV) tranexamic acid (TXA) on
the hidden
Autologous retransfusion and no-drainage are
both blood-saving measures in total hip replacement (THR). A new combined
intra- and post-operative autotransfusion filter system has been
developed especially for primary THR, and we conducted a randomised
controlled blinded study comparing this with no-drainage. A total of 204 THR patients were randomised to autologous blood
transfusion (ABT)
(n = 102) or no-drainage (n = 102). In the ABT group, a mean of
488 ml (. sd. 252) of blood was retransfused. The mean lowest
post-operative haemoglobin level during the hospital stay was higher
in the autotransfusion group (10.6 g/dl (7.8 to 13.9) vs 10.2 g/dl
(7.5 to 13.3);
p = 0.01). The mean haemoglobin levels for the ABT and no-drainage
groups were not significantly different on the first day (11.3 g/dl
(7.8 to 13.9) vs 11.0 g/dl (8.1 to 13.4);
p = 0.07), the second day (11.1 g/dl (8.2 to 13.8) vs 10.8 g/dl
(7.5 to 13.3); p = 0.09) or the third day (10.8 g/dl (8.0 to 13.0) vs 10.6 g/dl
(7.5 to 14.1); p = 0.15). The mean total peri-operative net blood
loss was 1464 ml (. sd. 505) in the ABT group and 1654 ml
(. sd. 553) in the no-drainage group (p = 0.01). Homologous
blood transfusions were needed in four patients (3.9%) in the ABT
group and nine (8.8%) in the no-drainage group (p = 0.15). No statistically
significant difference in adverse events was found between the groups. The use of a new intra- and post-operative autologous blood transfusion
filter system results in less total
Aims. It is not known whether preservation of the capsule of the hip positively affects patient-reported outcome measures (PROMs) in total hip arthroplasty using the direct anterior approach (DAA-THA). A recent randomized controlled trial found no clinically significant difference at one year postoperatively. This study aimed to determine whether preservation of the anterolateral capsule and anatomical closure improve the outcome and revision rate, when compared with resection of the anterolateral capsule, at two years postoperatively. Methods. Two consecutive groups of patients whose operations were performed by the senior author were compared. The anterolateral capsule was resected in the first group of 430 patients between January 2012 and December 2014, and preserved and anatomically closed in the second group of 450 patients between July 2015 and December 2017. There were no other technical changes between the two groups. Patient characteristics, the Charlson Comorbidity Index (CCI), and surgical data were collected from our database. PROM questionnaires, consisting of the Oxford Hip Score (OHS) and Core Outcome Measures Index (COMI-Hip), were collected two years postoperatively. Data were analyzed with generalized multiple regression analysis. Results. The characteristics, CCI, operating time, and length of stay were similar in both groups. There was significantly less
We have investigated the effect of using tranexamic
acid (TXA) during peri-acetabular osteotomy (PAO) on peri-operative
blood
Preoperative anaemia and intraoperative
The benefits of cell salvage autotransfusion are well reported. There is a common non-evidenced belief amongst revision arthroplasty surgeons that auto-transfusion is potentially contraindicated in infected revisions. The aim is to study the immediate and delayed outcomes of using cell saver on patients undergoing PJI surgery. Prospective cohort service evaluation registered with the local audit department. 20 PJI cases in 18 patients where cell saver was used over a period of 4 years. Intraoperative fluid and tissue samples were taken for culture. Blood culture from salvaged blood pre and post leucodepletion filter were sent for microbiological analysis. Data on type of surgery,
The current evidence favors replacement for the treatment of displaced femoral neck fractures in the older patients. Controversies remain whether total hip replacement (THR), or hemiarthroplasty (HA) would result in better outcomes. The purpose of this study is to compare the outcomes, and the complications in patients who underwent THR or HA for displaced femoral neck fractures. There were 345 consecutive patients who had undergone either a THR or HA at a single institution. THR was done in 137, and HA was done in 208 patients, respectively. Standard peri-operative data were collected. The mean values for the data in the THR group are: age 69 years, ASA 2.7, OR time was 99 minutes, estimated
Aims. There is evidence that morbidly obese patients have more intra- and postoperative complications and poorer outcomes when undergoing total hip arthroplasty (THA) with the direct anterior approach (DAA). The aim of this study was to determine the efficacy of DAA for THA, and compare the complications and outcomes of morbidly obese patients with nonobese patients. Methods. Morbidly obese patients (n = 86), with BMI ≥ 40 kg/m. 2. who underwent DAA THA at our institution between September 2010 and December 2017, were matched to 172 patients with BMI < 30 kg/m. 2. Data regarding demographics, set-up and operating time,
The purposes of this study were to evaluate the accuracy and feasibility of a robotic preparation for acetabular metal augments in patients with developmental dysplasia of the hip (DDH). Mako robotic arm reaming was used in 7 DDH to prepare the bony cavities for both Trident PSL cups and Tritanium acetabular wedge augments in six hips with Crowe 2 or 3 DDH. In CT-based planning, a properly sized cup was placed in the original acetabulum, and the same sized cup was also placed to fit the superolateral acetabular defect. The coordinates of the planned positions of cup and augment were recorded to manage the robotic arm reaming. After registration of the patient's pelvis, robotic reaming was performed first for the augment, then, for the cup by changing the target position of reaming as planned. The accuracy of the cup and augment placement was assessed on postoperative CT. To evaluate the feasibility of the robotic procedure, the OR time and
Thru purpose of this study was to evaluate the clinical outcomes of a consecutive series of conversion total hip arthroplasty (cTHA) following previous hip fractures. A retrospective chart review of patients who underwent cTHAs from 2008–2017 at an urban academic teaching institution was performed. Eighty-eight patients were included in this study. The mean age at the cTHA was 66 years (range 27 to 89). 67% of the patients wre women. The mean BMI was 28 kg/m. 2. (range 17 to 41). The mean Charlson Comorbidity Index was 3 (range 0 to 9). The mean follow-up was 49 months (range 24 to 131). The mean duration from the hip fracture fixation to the cTHA was 51 months (range 10 to 144). The mean operating time was 188 minutes, (range 71 to 423) with a mean estimated
Background. Tranexamic acid (TXA) decreases
Over 62,000 total hip arthroplasty (THA) cases are performed each year in Canada, with an estimated annual healthcare system cost of $1.4 billion and resulting in 4 billion tonnes of waste annually (6,600 tonnes per day). The aims of this study were 1) Assess satisfaction of current/standard set-up amongst different stakeholders. 2) Assess energy, economic and waste cost of current set up and apply lean methodology to improve efficiency 3. Design and test SLIM setup based on lean principles and its ability to be safely implemented into everyday practice. A Needs Assessment Survey was circulated to OR nursing staff to assess the need for change in the current THA OR setup at an academic tertiary referral hospital. Through feedback, surgeon input, and careful analysis of current instrumentation, the “SLIM setup” was created. Standard instrument tray numbers for elective THA were reduced from 9 to 3 trays. Eighty patients were then randomised to either the standard or SLIM setup. Four staff arthroplasty surgeons each randomised 20 patients to either standard or SLIM setup. OR time,
Extracapsular Hip Fractures (EHF's) are a significant health burden on healthcare services. Optimal treatment is controversial with conflicting evidence being reported. Currently treatment is undertaken with Intramedullary Nail (IMN) or Dynamic Hip Screw (DHS) constructs with a recent increase in IMN use (1). This study aims to conduct a systematic review of Randomised Control Trials published between 2020 and 2023 with particular focus on patient demographics and holistic patient outcomes. Using a unified search-protocol, RCT's published between 2020 and 2023 were collected from CENTRAL, PubMed, MEDLINE and EMBASE. Rayyan software screened duplicates. Using the CASP and Cochrane Risk of Bias Tool papers were critically examined twice, and