Despite the lack of data regarding the diagnostic validity of synovial aspiration in Girdlestone hips a Girdlestone-aspiration is often performed before reimplantation to detect a possible persistence of infection during two staged revision total hip arthroplasty (THA). The aim of this study was to assess the diagnostic performance of the synovial aspiration in Girdlestone hips, without a PMMA-Spacer, for the detection of infection persistence prior to THA reimplantation. Seventy four patients undergoing a two staged revision THA surgery between 2006 and 2013 were included in this retrospective cohort study. Both synovial cultures and CRP values were acquired before explantation of the THA and of the Girdlestone hip before reimplantation. An antibiotic holiday of 14 days was observed prior to synovial aspiration. A PJI was defined according to the following criteria: intraarticular presence of pus or a sinus tract, a periprosthetic membrane indicative of infection in the histological analysis, or a positive microbiological isolation in a minimum of two samples.Introduction
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The efficacy of tranexamic acid (TXA) to reduce blood loss in various surgical procedures has been proven. However, there is little data about the effect of TXA on blood loss, rate of blood transfusion and thromboembolic events during periacetabular osteotomy (PAO). The reduction of blood loss during PAO promotes postoperative mobilization and reduces the risk of complications, associated with blood transfusions. The aim of the following study was to determine, if TXA can reduce both blood loss and the rate of blood transfusions. In addition we analyzed whether TXA was associated with an increased risk of thromboembolic events. A consecutive series of 96 PAO procedures was reviewed to compare the groups immediately prior to and following the routine implementation of TXA. The TXA group received a continuous infusion of TXA with a rate of 10mg/kg/h. The outcome was blood transfusion rate, total blood loss, length of hospital stay, and thromboembolic events.INTRODUCTION
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