We performed a retrospective examination of the anteroposterior pelvic CT scout views of 419 randomly selected patients between April 2004 and August 2009 in order to determine the prevalence of cam-type femoroacetabular deformity in the asymptomatic population. The CT scans had all been undertaken for conditions unrelated to disorders of the hip. The frequency of cam-type femoroacetabular deformity was assessed by measuring the α-angle of each hip on the anteroposterior images. The α-angles were classified according to the Copenhagen Osteoarthritis Study. Among 215 male hips (108 patients) the mean α-angle was 59.12° (37.75° to 103.50°). Of these, a total of 30 hips (13.95%) were defined as pathological, 32 (14.88%) as borderline and 153 (71.16%) as normal. Among 540 female hips (272 patients) the mean α-angle was 45.47° (34.75° to 87.00°), with 30 hips (5.56%) defined as pathological, 33 (6.11%) as borderline and 477 (88.33%) as normal. It appears that the cam-type femoroacetabular deformity is not rare among the asymptomatic population. These anatomical abnormalities, as determined by an increased α-angle, appear to be twice as frequent in men as in women. Although an association between osteoarthritis and femoroacetabular impingement is believed to exist, a long-term epidemiological study is needed to determine the natural history of these anatomical abnormalities.

Perioperative blood loss during total knee arthroplasty can be significant, with magnitudes typically ranging from 300 mL to 1 L, with occasional reports of up to 2 L. The resultant anemia can lead to severe complications, such as higher rates of postoperative infection, slower physical recovery, increased length of hospital stay, and increased morbidity and mortality. Although blood transfusions are now screened to a greater extent than in the past, they still carry the inherent risks of clerical error, infection, and immunologic reactions, all of which drive the need to develop alternative blood management strategies. Thorough patient evaluation is essential to individualize care through dedicated blood management and conservation pathways in order to maximize efficacy and avoid associated complications. Interventions may be implemented preoperatively, intraoperatively, and postoperatively.