Transfusion Rates in Total Hip Arthroplasty Are lower in Patients with Direct Anterior Approach
محل انتشار: مجله استخوان و جراحی عمومی، دوره: 9، شماره: 6
سال انتشار: 1400
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 215
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شناسه ملی سند علمی:
JR_TABO-9-6_007
تاریخ نمایه سازی: 23 آبان 1400
چکیده مقاله:
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 ۱,۵۲۴ primary THAs performed at a single institution by seven fellowship-trained surgeons between January ۲۰۱۵ to March ۲۰۱۷. 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 ۱۰.۲% (۱۵۵/۱,۵۲۴) 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<۰.۰۰۱), use of DA approach (p<۰.۰۱۶) and administration of tranexamic acid TXA, (p=۰.۰۲۴) were identified as independent factors which reduced the odds of ABT. Operative time (p<۰.۰۰۱) 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
کلیدواژه ها:
نویسندگان
George A. Komnos
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
Jorge Manrique
۱ Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA ۲ Cleveland Clinic Florida, Weston, FL, USA
Carol Foltz
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
Mitchell Klement
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
Camilo Restrepo
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
JavadJ Parvizi
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA