Blood loss and transfusion rate in short stem hip arthroplasty. A comparative study

Hochreiter, Josef; Hejkrlik, Wilfried; Emmanuel, Katja; Hitzl, Wolfgang; Ortmaier, Reinhold

doi:10.1007/s00264-016-3365-2

Cited by 42 publications

(37 citation statements)

References 35 publications

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“…There are many different methods to calculate intraoperative blood loss, and most measurements are done by indirect calculations. Nevertheless, we could confirm previous findings about lower blood loss and decreased transfusion rates after short-stem THA with a minimally invasive approach in comparison to conventional stems, where transfusion rates of up to 70% are reported [19]. Besides the risk of transfusions, it is also a very important economic factor.…”

Section: Discussionsupporting

confidence: 87%

“…As can be seen in the perioperative parameters, our series can be well compared to other papers regarding short-stem prostheses (Table 3). Interestingly, blood loss seems to be higher after surgery in Europe in comparison to the rest of the world [19]. We tried to find a reason for this detail, but we were not able to identify a cause.…”

Section: Discussionmentioning

confidence: 98%

“…A similar functional outcome compared to conventional stem implants may be reached using the MiniMIS ® short stem. Pogliacomi et al [19] demonstrated a mean Harris Hip Score of 91 for the implantation of conventional stems using the direct anterior approach, and a score of 89 for the lateral approach at one-year follow-up. A study by Stadler et al [32], using the Nanos ® short stem, described postoperative Harris Hip Scores of 94.5 ± 8.8 at one-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prospective Short-Term and Return-to-Sports Results of a Novel Uncemented Short-Stem Hip Prosthesis with Metaphyseal Anchorage

Breuer

Fiala²,

Schrenk

et al. 2020

JCM

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Short-stem hip prostheses were developed to treat active patients requiring total hip arthroplasty (THA). This study provides short-term data about a short-stem total hip arthroplasty system. Functional and radiological outcomes as well as return to sports and activity level were assessed. A series of 55 patients was primarily included. Data were available for 47 patients at an average follow-up of 38 ± 4.6 months. The back-to-sports analysis showed a 98% return-to-sports rate (46/47 patients). The average time for return to sports was 13 weeks (± 8) postoperatively. Five patients (10.6%) were more active postoperatively. The Harris Hip Score (HHS) improved from 34.8 (±9.4) preoperatively to 94.7 (±8.4, p ≤ 0.001) and the University of California, Los Angeles (UCLA) score improved from 4.5 (±1.8) to 6.9 (±1.9) (p ≤ 0.001). The High Activity Arthroplasty Score (HAAS) was 12 (±3.6) at 3-year follow-up. Pre- and postoperative UCLA and postoperative HHS and HAAS scores had a positive influence on the return-to-sports rate (p ≤ 0.05). The collection of radiographic data during all postoperative follow-ups showed no signs of radiolucent lines or bone fissures. The complication rate was at 5%. Short-stem systems are equaling conventional prostheses and offer benefits regarding soft tissue and bone stock preservation. Fast recovery and return to sports can be achieved.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Prospective Short-Term and Return-to-Sports Results of a Novel Uncemented Short-Stem Hip Prosthesis with Metaphyseal Anchorage

Breuer

Fiala²,

Schrenk

et al. 2020

JCM

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“…This minimised the effects on the postoperative outcome of the surgical technique or the surgeonʼs experience. Recent studies indicate that minimally invasive techniques and short stems give better early postoperative results than with conventional accesses and implants [23,24]. The present study confirms that intra-operative blood loss is extremely low, due to the short operating time, together with the lack of damage to soft tissue during surgery and perioperative medicationas in the concept [25].…”

Section: Discussionsupporting

confidence: 81%

Outcome of an “Enhanced Recovery” Program in Contemporary Total Hip Arthroplasty in Germany

et al. 2019

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Background An inpatient hospital stay of up to 10 days after total hip arthroplasty (THA) is still common in Germany, mostly followed by inpatient rehabilitation. Internationally already widespread concepts for enhanced recovery are increasingly gaining popularity in Germany. Objectives The presentation of content and results of a newly implemented enhanced recovery concept in THA. Materials and Methods In this single-center, prospective observational study of a consecutive patient collective of a single surgeon, between January 2016 and July 2016, 103 short-stem THA patients were enrolled and treated using a newly introduced enhanced recovery concept. After 6 weeks and 6 months clinical examination was performed regarding function, pain, satisfaction and possible complications. Results The goal of discharge on day 4 after operation was reached in 61.2% of the patients with a mean postoperative inpatient stay of 4.9 days. After 6 weeks and 6 months respectively, excellent clinical results were achieved with high patient satisfaction. The complication rate was found to be low. Mean hemoglobin concentration decreased by 2.1 g/dl. A fissure of the femur below the implant healed conservatively applying no weight bearing for a total of 6 weeks. A pulmonary embolism that occurred during rehabilitation was also successfully treated. After 6 months one case showed a bursitis trochanterica. Conclusions Inpatient length of stay can be reduced by enhanced recovery concepts without increasing the risks to patients. Thus, in Germany these concepts will be applied increasingly.

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“…A review of the literature indicated that no study has yet compared the screw and no-screw groups with regard to volume of blood loss and operation time. Studies have reported that blood loss in THA ranges between 600 and 1800 mL[ 21 , 22 ]. The mean blood loss in our study was 983.3 mL in the screw group and 983 mL in the no-screw group, with the difference being statistically non-significant.…”

Section: Discussionmentioning

confidence: 99%

Acetabular components with or without screws in total hip arthroplasty

Pepe

Kocadal

Erener

et al. 2017

WJO

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AIMTo compare the operation time, blood loss, and early outcomes of acetabular components with and without the screw.METHODSThirty patients who underwent cementless acetabular component with or without screw and whose follow-up exceeded one year period in total hip arthroplasty were evaluated. A posterior approach was used in all surgical procedures by one experienced surgeon. Demographic data, operation time, intra- and postoperative blood loss volume, follow-up clinical score, cup migration, and osteolysis were recorded. The Kolmogorov-Smirnov test was performed for testing the normality of study data. Mann-Whitney U test was used to analyze the inter-group differences. A P-value of ≤ 0.05 was considered statistically significant.RESULTSAcetabular components were used in 16 (53.3%) patients with screw and 14 (46.7%) without screw. After one year of follow-up, an osteolytic lesion of 3 mm was found in only one patient in the screw group. No cup migration was encountered. Intra-group mean Harris hip score significantly increased, but there was no significant inter-group difference. While the mean operation time of the screw group was 121.8 min (range; 95-140), it was 102.7 min (range; 80-120) in the no-screw group, and this difference was statistically significant (P = 0.002). The mean intraoperative/postoperative, and total blood loss were 556.6 mL (range: 350-800)/423.3 mL (range: 250-600), and 983.3 mL (range: 600-1350), respectively in the screw group; and 527 mL (range: 400-700)/456 mL (range: 230-600), and 983 mL (range: 630-1250), respectively in the no-screw group. The blood loss difference between the two groups was not significant. In the screw group, the operation time was 19.1 min longer than the no-screw group, and this difference was statistically significant.CONCLUSIONAcetabular components with or without screw have similar results, but the use of screw increases the operation time significantly, while not changing the blood loss volume.

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Blood loss and transfusion rate in short stem hip arthroplasty. A comparative study

Cited by 42 publications

References 35 publications

Prospective Short-Term and Return-to-Sports Results of a Novel Uncemented Short-Stem Hip Prosthesis with Metaphyseal Anchorage

Prospective Short-Term and Return-to-Sports Results of a Novel Uncemented Short-Stem Hip Prosthesis with Metaphyseal Anchorage

Outcome of an “Enhanced Recovery” Program in Contemporary Total Hip Arthroplasty in Germany

Acetabular components with or without screws in total hip arthroplasty

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