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Komnos, George A., Manrique, Jorge, Foltz, Carol, Klement, Mitchell, Restrepo, Camilo, Parvizi, JavadJ. (1400). Transfusion Rates in Total Hip Arthroplasty Are lower in Patients with Direct Anterior Approach. , 9(6), 659-664. doi: 10.22038/abjs.2021.50237.2497
George A. Komnos; Jorge Manrique; Carol Foltz; Mitchell R. Klement; Camilo Restrepo; JavadJ Parvizi. "Transfusion Rates in Total Hip Arthroplasty Are lower in Patients with Direct Anterior Approach". , 9, 6, 1400, 659-664. doi: 10.22038/abjs.2021.50237.2497
Komnos, George A., Manrique, Jorge, Foltz, Carol, Klement, Mitchell, Restrepo, Camilo, Parvizi, JavadJ. (1400). 'Transfusion Rates in Total Hip Arthroplasty Are lower in Patients with Direct Anterior Approach', , 9(6), pp. 659-664. doi: 10.22038/abjs.2021.50237.2497
Komnos, George A., Manrique, Jorge, Foltz, Carol, Klement, Mitchell, Restrepo, Camilo, Parvizi, JavadJ. Transfusion Rates in Total Hip Arthroplasty Are lower in Patients with Direct Anterior Approach. , 1400; 9(6): 659-664. doi: 10.22038/abjs.2021.50237.2497

Transfusion Rates in Total Hip Arthroplasty Are lower in Patients with Direct Anterior Approach

The Archives of Bone and Joint Surgery
مقاله 7، دوره 9، شماره 6، بهمن 2021، صفحه 659-664    اصل مقاله (627.49 K)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 10.22038/abjs.2021.50237.2497
نویسندگان
George A. Komnos1؛ Jorge Manrique* 2؛ Carol Foltz1؛ Mitchell R. Klement1؛ Camilo Restrepo1؛ JavadJ Parvizi1
1Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
21 Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA 2 Cleveland Clinic Florida, Weston, FL, USA
چکیده
Background: Blood conservation and reduction in the need for allogeneic blood transfusion (ABT) has been a subject of importance in total hip arthroplasty. There are a number of well-recognized parameters that influence blood loss during total hip arthroplasty (THA). The role of surgical approach on blood loss and the rate of ABT during THA is not well studied. The hypothesis of this study was that blood loss and the need for ABT is lower with direct anterior (DA) approach. Methods: In a case-control retrospective cohort study, we analyzed 1,524 primary THAs performed at a single institution by seven fellowship-trained surgeons between January 2015 to March 2017. All patients received THA using either the modified direct lateral (DL) or direct anterior (DA) approach using a standard operating table. The overall ABT rate was 10.2% (155/1,524) in the cohort. Demographic, surgical, and postoperative data were extracted and analyzed. Logistic regression was used to identify independent risk factors for transfusion. Results: Higher preoperative hemoglobin (p<0.001), use of DA approach (p<0.016) and administration of tranexamic acid TXA, (p=0.024) were identified as independent factors which reduced the odds of ABT. Operative time (p<0.001) was associated with an increased odd of ABT, while age, BMI and type of anesthesia were not statistically significant. Conclusion: Based on the findings of this study, direct anterior approach for THA appears to be protective against blood loss and reduced ABT rate, when controlling for confounding variables. Level of evidence: III
کلیدواژه‌ها
Total Hip Arthroplasty؛ Allogeneic Blood Transfusion؛ Blood Loss؛ Direct Anterior؛ Direct Lateral
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