Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern Protocol
Background: Transfusion is a known risk of total hip arthroplasty (THA). It has been associated with a multitude of medical complications and increased cost. Prior studies report transfusion rates associated with THA, with wide variation, but most cannot differentiate the surgical approach utilize...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Joint Implant Surgery & Research Foundation
2021-02-01
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| Series: | Reconstructive Review |
| Subjects: | |
| Online Access: | https://reconstructivereview.org/ojs/index.php/rr/article/view/247 |
| _version_ | 1818393883764064256 |
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| author | Joseph Gondusky Benjamin Campbell Christian Coulson |
| author_facet | Joseph Gondusky Benjamin Campbell Christian Coulson |
| author_sort | Joseph Gondusky |
| collection | DOAJ |
| description | Background: Transfusion is a known risk of total hip arthroplasty (THA). It has been associated with a multitude of medical complications and increased cost. Prior studies report transfusion rates associated with THA, with wide variation, but most cannot differentiate the surgical approach utilized. The anterior approach (AA) for THA has been associated with increased operative time, complications, and blood loss, but little data exists regarding the actual transfusion rate associated with the approach.
Methods: We performed a retrospective review of 390 consecutive, elective, primary unilateral AA THA procedures. Patient demographic, clinical and perioperative data was analyzed.
A modern perioperative pathway, including a simple protocol to limit blood loss, is defined.
Results: The group consisted of a typical inpatient arthroplasty population, with wide ranges of age, body mass index (BMI), and health status. The average age was 64.05 years (+ 10.67, range 27-94). BMI averaged 29.76 kg/m2 (+ 5.98, range 16-47). The majority of patients were American Society of Anesthesiologists (ASA) class 2 (45.6%) or 3 (50.3%), with 10 patients ASA 4 (2.6%). Average preoperative hemoglobin was 13.48 g/dL (+ 1.47, range 9.1-18.2). Operative time averaged 91.22 minutes (+ 14.2). 83.3% of patients received a spinal anesthetic. Most patients were discharged on postoperative day one (93.1%) to home (99%). Estimated blood loss averaged 264mL (+ 95.19, range 100-1000). No patient required perioperative transfusion or readmission for symptomatic anemia within 30 days postoperative.
Conclusion: A modern protocol we utilize and define is capable of limiting blood loss and transfusion risk in anterior approach total hip arthroplasty. |
| first_indexed | 2024-12-14T05:52:24Z |
| format | Article |
| id | doaj.art-f3e869cc75b340afbb696b2b9a34e5ae |
| institution | Directory Open Access Journal |
| issn | 2331-2262 2331-2270 |
| language | English |
| last_indexed | 2024-12-14T05:52:24Z |
| publishDate | 2021-02-01 |
| publisher | Joint Implant Surgery & Research Foundation |
| record_format | Article |
| series | Reconstructive Review |
| spelling | doaj.art-f3e869cc75b340afbb696b2b9a34e5ae2022-12-21T23:14:41ZengJoint Implant Surgery & Research FoundationReconstructive Review2331-22622331-22702021-02-0111110.15438/rr.11.1.247Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern ProtocolJoseph Gondusky0Benjamin Campbell1Christian Coulson2Jordan-Young InstituteThomas Jefferson UniversityEastern Virginia Medical SchoolBackground: Transfusion is a known risk of total hip arthroplasty (THA). It has been associated with a multitude of medical complications and increased cost. Prior studies report transfusion rates associated with THA, with wide variation, but most cannot differentiate the surgical approach utilized. The anterior approach (AA) for THA has been associated with increased operative time, complications, and blood loss, but little data exists regarding the actual transfusion rate associated with the approach. Methods: We performed a retrospective review of 390 consecutive, elective, primary unilateral AA THA procedures. Patient demographic, clinical and perioperative data was analyzed. A modern perioperative pathway, including a simple protocol to limit blood loss, is defined. Results: The group consisted of a typical inpatient arthroplasty population, with wide ranges of age, body mass index (BMI), and health status. The average age was 64.05 years (+ 10.67, range 27-94). BMI averaged 29.76 kg/m2 (+ 5.98, range 16-47). The majority of patients were American Society of Anesthesiologists (ASA) class 2 (45.6%) or 3 (50.3%), with 10 patients ASA 4 (2.6%). Average preoperative hemoglobin was 13.48 g/dL (+ 1.47, range 9.1-18.2). Operative time averaged 91.22 minutes (+ 14.2). 83.3% of patients received a spinal anesthetic. Most patients were discharged on postoperative day one (93.1%) to home (99%). Estimated blood loss averaged 264mL (+ 95.19, range 100-1000). No patient required perioperative transfusion or readmission for symptomatic anemia within 30 days postoperative. Conclusion: A modern protocol we utilize and define is capable of limiting blood loss and transfusion risk in anterior approach total hip arthroplasty.https://reconstructivereview.org/ojs/index.php/rr/article/view/247anterior approachdirect anteriorprimary total hip arthroplastytotal hip arthroplastytransfusionblood loss |
| spellingShingle | Joseph Gondusky Benjamin Campbell Christian Coulson Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern Protocol Reconstructive Review anterior approach direct anterior primary total hip arthroplasty total hip arthroplasty transfusion blood loss |
| title | Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern Protocol |
| title_full | Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern Protocol |
| title_fullStr | Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern Protocol |
| title_full_unstemmed | Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern Protocol |
| title_short | Low Transfusion Rate Attainable in Anterior Approach Total Hip Arthroplasty Utilizing a Modern Protocol |
| title_sort | low transfusion rate attainable in anterior approach total hip arthroplasty utilizing a modern protocol |
| topic | anterior approach direct anterior primary total hip arthroplasty total hip arthroplasty transfusion blood loss |
| url | https://reconstructivereview.org/ojs/index.php/rr/article/view/247 |
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