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Anaemia and preoperative and joint arthroplasty

Holger Haas, Christian D Weber
Background A thorough pre-operative evaluation is required prior to total joint arthroplasty (TJA). The objective of screening is to identify patient- and procedure-related risk constellations. Pre-operative diagnostic measures are vital in order to anticipate, reduce or even eliminate threats to patient safety. Furthermore, the clinical and radiographical workup may confirm the indication and type of surgical procedure, but this is not the subject of this article. Objective An overview of the current literature on pre-operative diagnostic principles is presented...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
Olivier Borens, Éric Thein, Christophe Tissot, Anne-Sophie Brunel
Total joint replacement comes with a high success rate and has been shown to have a very positive impact on our patients suffering from arthritis. Against all efforts about 2 % of our patients will suffer an implant related infection. As the treatment of infected arthroplasties is difficult and expensive the knowledge of risk factors is becoming more and more important for the treatment team in order to improve our preventive measures. Prevention must be performed pre-, intra- and postoperatively. Preoperative optimization of blood sugar levels, nutritional status and correction of general anaemia for example are paramount and the general practitioner as well as the surgeon should be aware of these and other modifiable risk factors in order to operate on the patient in the best possible conditions...
December 14, 2016: Revue Médicale Suisse
R Kasivisvanathan, V Ramesh, R Rao Baikady, S Nadaraja
OBJECTIVES: To estimate the prevalence of preoperative World Health Organization (WHO) defined anaemia in patients presenting for revision hip and knee arthroplasty and its association with transfusion of allogeneic packed red blood cells (PRBC). BACKGROUND: Studies have mainly investigated the prevalence of preoperative anaemia in primary and not revision hip and knee joint arthroplasty. METHODS: An analysis of a prospectively collected patient data for 5387 patients having revision hip or knee arthroplasty over a 10-year period at a single high volume centre was conducted...
August 2016: Transfusion Medicine
B Kearney, J To, K Southam, D Howie, B To
BACKGROUND: An anaemia clinic was established to improve the preoperative management of elective orthopaedic patients scheduled for arthroplasty. This paper is a report on the first 100 patients assessed. AIM: To assess the incidence and causes of anaemia in patients on a waiting list for elective arthroplasty in a public hospital and to assess the impact of anaemia detection in this patient population. METHODS: Patients attending an Anaemia Clinic for elective orthopaedic surgical patients, during March 2010 to June 2013 were studied...
January 2016: Internal Medicine Journal
Andrew Cook, Steven Cook, Ian Smith, Patrick Weinrauch
It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical grounds. We therefore question the necessity and clinical value of routine perioperative blood testing about the time of hip resurfacing arthroplasty...
2014: Advances in Orthopedics
Angela Graves, Piers Yates, Axel O Hofmann, Shannon Farmer, Paolo Ferrari
BACKGROUND: Lower preoperative haemoglobin and older age pose a risk for perioperative allogeneic blood transfusions (ABT). The presence of chronic kidney disease (CKD) is associated with low haemoglobin, greater bleeding and ABT utilization. STUDY DESIGN AND METHODS: The interaction between estimated glomerular filtration rate (eGFR) and haemoglobin on perioperative ABT, length-of-stay and mortality was assessed in 86 patients with CKD stage 3 or higher undergoing elective total knee or hip arthroplasty compared with 294 without CKD...
July 2014: Nephrology
E Saleh, D B L McClelland, A Hay, D Semple, T S Walsh
BACKGROUND: Preoperative investigation and treatment of anaemia is recommended before orthopaedic surgery. We measured the prevalence of anaemia among admissions presenting for elective major joint arthroplasty (MJA), assessed their transfusion requirements, and investigated factors associated with perioperative blood transfusion. METHODS: All admissions to a dedicated elective orthopaedic hospital during 2000-2001 were studied. The patients' database was merged with the haematology and transfusion databases...
December 2007: British Journal of Anaesthesia
P M Sutton, T Cresswell, J P Livesey, K Speed, T Bagga
After total hip and knee replacement arthroplasty, patients may become anaemic and may be prescribed oral iron. There is, however, no published evidence that this is of benefit when used postoperatively. We treated 72 patients who were anaemic after primary total hip and knee arthroplasty by randomly allocating them to receive six weeks of either oral ferrous sulphate (35 patients) or a placebo (37 patients). Both groups of patients were similar in all aspects except for the treatment given. There was no statistically significant difference in the change of haemoglobin levels between the two groups...
January 2004: Journal of Bone and Joint Surgery. British Volume
B Borghi, A Casati
The efficacy of an integrated autotransfusion regimen, including pre-donation and perioperative salvage of autologous blood, was prospectively evaluated in 2884 patients undergoing total hip (n = 2016) or knee arthroplasty (n = 480), and hip revision (n = 388) with either balanced general, regional, or integrated epidural/general anaesthesia. Allogenic concentrated red blood cells were transfused in the presence of symptomatic anaemia or when haemoglobin concentration was < 6 g dL-1 (10 g dL-1 in patients affected by cerebrovascular or coronary artery disease) after all salvaged and pre-donated autologous blood had been transfused...
July 2000: European Journal of Anaesthesiology
N Tanaka, K Ito, S Ishii, I Yamazaki
The aim of this study was to determine the conditions under which a sufficient preoperative amount of autologous blood could be obtained with administration of rHuEPO (recombinant human erythropoietin) in anaemic patients with rheumatoid arthritis (RA). Thirty-one patients (29 female, two male) with RA who were unable to donate any autologous blood owing to a haemoglobin level of less than 11 g/dl were recruited for this study. Their mean age at the time of operation was 59.3 years. The study protocol for preoperative autologous blood donations started 2...
1999: Clinical Rheumatology
C M Andrews, D W Lane, J G Bradley
Patients undergoing total hip or knee replacement frequently receive blood transfusion. Homologous blood transfusion carries appreciable risks and should therefore be reduced to a minimum. We have investigated the use of preoperative oral iron supplements to optimize haemoglobin concentration and iron stores prior to surgery. All patients attending a preadmission clinic 4 weeks prior to primary hip or knee replacement had a haemoglobin measurement. If the haemoglobin concentration (Hb) was less than 12 g dL-1 they were given a four week course of ferrous sulphate...
December 1997: Transfusion Medicine
A Quoss, S Paululat
The management and the resulting effectiveness of a four-step autotransfusion concept, consisting of preoperative autologous blood predeposit, isovolaemic haemodilution, preoperative plasmapheresis and intraoperative autotransfusion in rheumatic patients undergoing planned operations associated with considerable blood loss, are presented. In just one case out of 117 primary total joint replacements of the hip or knee that were retrospectively studied in rheumatic patients suffering from chronic anaemia did a homologous erythrocyte concentrate have to be transfused...
1997: Anaesthesiologie und Reanimation
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