Bilateral Total Hip Arthroplasty in a Jehovah??s Witness With Chronic Anemia

Rab, George T.; Gorin, Linda; Eisele, John H.

doi:10.1097/00003086-198203000-00019

Cited by 4 publications

(6 citation statements)

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“…Although the current authors also observed similar outcomes to those reported in the literature following aseptic revisions in healthy, optimized patients, the risks of surgery must be carefully considered. 9,10,12,39 The current authors believe that their comprehensive blood optimization and management program contributed to their excellent outcomes.…”

Section: Discussionmentioning

confidence: 86%

“…In the approximately 7 decades since the adoption of this doctrine, published case reports regarding surgical outcomes and blood management strategies in the medical literature have spanned nearly every intervening decade. [5][6][7][8][9][10][11][12][13] However, few reports have been published regarding revision THA in this subset of patients, and even fewer have systematically and objectively measured postoperative clinical outcomes. Because of the risks associated with perioperative blood loss resulting in postoperative anemia, physicians must be able to counsel their patients on expected outcomes using evidence-based data.…”

Section: Revision Total Hip Arthroplasty In Jehovah's Witnessesmentioning

confidence: 99%

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Revision Total Hip Arthroplasty in Jehovah’s Witnesses

Harwin¹,

Pivec²,

Johnson³

et al. 2012

Orthopedics

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Revision total hip arthroplasty (THA) is associated with greater blood loss than primary THA. Jehovah's Witnesses will not accept transfusions of blood or blood products and are thus at an increased risk for complications due to perioperative anemia. The purpose of this study was to report the clinical outcomes, radiographic outcomes, morbidity, and mortality of Jehovah's Witnesses who were medically optimized and underwent revision THA. Databases from 2 institutions were reviewed to identify 10 patients (11 THAs) who were Jehovah's Witnesses undergoing revision THA with a minimum 24-month follow-up. At most recent follow-up, all patients were doing well clinically, with Harris Hip Scores greater than 80 points. Radiographic evaluation demonstrated well-positioned components and no progressive radioluciencies. No major perioperative medical or surgical complications occurred in patients undergoing THA. Revision THA for aseptic causes results in good clinical outcomes in patients who are preoperatively optimized before undergoing surgery.

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Section: Discussionmentioning

confidence: 86%

Section: Revision Total Hip Arthroplasty In Jehovah's Witnessesmentioning

confidence: 99%

Revision Total Hip Arthroplasty in Jehovah’s Witnesses

Harwin¹,

Pivec²,

Johnson³

et al. 2012

Orthopedics

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“…35,36 In addition, the published reports about these patients in orthopaedic joint arthroplasty are mainly limited to the perioperative period with minimal to no follow-up evaluations. 15,16,18,[29][30][31] In this study, we assessed revision total knee arthroplasties in these patients who underwent our established blood management and found 100% implant survivorship over a mean follow-up of 62 months with excellent clinical and radiographic outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[26][27][28] A large number of orthopaedic procedures such as joint arthroplasties are performed on this patient population, however, clinical outcomes of such operations have only been reported in a limited number of studies which are mainly limited to the peri-operative period with minimal to no follow-up evaluations. 15,16,18,[29][30][31] To the best of our knowledge, after a thorough search of the English-language literature, there has been no study evaluating clinical outcomes of revision total knee arthroplasty (TKA) in Jehovah's Witness patients. Due to this lack of such reported data, we undertook this study to assess the clinical outcomes in these patients who underwent a special blood management strategy.…”

mentioning

confidence: 99%

Excellent Results of Revision TKA in Jehovah's Witness Patients

et al. 2012

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Revision total knee arthroplasty (TKA) can be quite challenging in Jehovah's Witness patients because blood transfusion is often needed, however, these patients do not accept allogeneic or autologous blood due to religious convictions. We reported our clinical experiences with a special blood management protocol for Jehovah's Witnesses who underwent a revision TKA. There were 12 self-reported Jehovah's Witness patients (12 total knee arthroplasties) who had a mean age of 69 years (range: 55 to 79 years) and who underwent revision TKA between 1998 and 2009. All revision surgeries were due to aseptic component failure. Implant survivorship was 100% over a mean follow-up of 62 months (range: 24 to 120 months). The Knee Society objective and function scores improved to a mean of 83 and 82 points, respectively. The authors believe that the use of this blood management protocol was responsible for the excellent clinical outcomes.

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“…Methods that have been described in the literature include pre-treatment with erythropoietin (18), preoperative haemodilution with intraoperative blood salvage (16), surgical techniques such as gentle soft tissue handling and meticulous haemostasis (7), bipolar sealers (19, 20), intravascular occlusion (21), haemostatic agents (22), and early removal of drains (8, 23). However, the preponderance of the literature investigating clinical outcomes of THA in Jehovah's Witnesses was published over two decades ago, and the few studies that enrolled large numbers of patients focused on the perioperative period rather than long-term follow-up (9, 18, 21, 24–25–26–27–28). To the best of our knowledge, there is no study of this patient population that has investigated implant survivorship, mid-term clinical outcomes, and mortality following primary THA in the setting of a comprehensive blood management strategy.…”

Section: Introductionmentioning

confidence: 99%

Is total hip arthroplasty a successful and safe procedure in Jehovah's Witnesses? Mean five-year results

et al. 2013

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Total hip arthroplasty (THA) can be challenging in Jehovah's Witnesses because of the potential for blood loss. Because these patients will not accept blood transfusions, multiple strategies to prevent blood loss have been developed. The purpose of this study was to report implant survivorship, clinical outcomes, radiographic outcomes, morbidity, and mortality of Jehovah's Witnesses undergoing primary THA. Databases from two institutions were reviewed to identify 53 patients (55 hips) who were Jehovah's Witnesses and had a primary total hip arthroplasty. There were 27 women and 26 men who had a mean age of 63 years (range 35-94 years), and a mean follow-up of 63 months (range 24-120 months). All Jehovah's Witnesses had a comprehensive perioperative blood management strategy employed by a coordinated medical and surgical team. Mean post-operative Harris Hip Scores were 86 points, and implant survivorship was 97%. There were two aseptic revisions for osteolysis and component loosening. There were no mortalities, and three minor surgical and two minor medical complications occurred during the study. Excellent clinical outcomes were found for Jehovah's Witness undergoing total hip arthroplasty using a comprehensive blood management protocol. We believe that the use of a specialised blood management protocol involving a team approach to preoperative evaluation, appropriate anaesthesia, and surgical and postoperative management was responsible for minimising complications. Total hip arthroplasty is safe and efficacious in this patient group if proper preoperative safeguards are utilised.

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Bilateral Total Hip Arthroplasty in a Jehovah??s Witness With Chronic Anemia

Cited by 4 publications

References 0 publications

Revision Total Hip Arthroplasty in Jehovah’s Witnesses

Revision Total Hip Arthroplasty in Jehovah’s Witnesses

Excellent Results of Revision TKA in Jehovah's Witness Patients

Is total hip arthroplasty a successful and safe procedure in Jehovah's Witnesses? Mean five-year results

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