Blood Management and Orthopaedic Surgery

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Subspecialty Theme Collection - January

Blood loss in orthopaedic surgery can be substantial, resulting in acute anaemia with serious consequences.

Documented complications of perioperative anaemia include tachycardia, hypotension, and increased risk of perioperative myocardial infarction.

Patients with acute anaemia often require allogeneic blood transfusion. Transmission of viral pathogens, anaphylaxis, acute lung injury, and septic reaction to bacterial toxins are known adverse events associated with allogeneic blood transfusions.

Recent studies have also demonstrated higher rates of deep joint arthroplasty infections following transfusions of allogeneic blood.

To avoid such complications, efforts have been made to reduce perioperative anaemia and to decrease the need for an allogeneic blood transfusion. The articles in January's Subspecialty Theme Collection, reprinted with permission from the Summer 2011 issue of COA Bulletin, provide an update on blood management techniques in orthopaedic surgery by experts in the field:

  • Dr. Fiona Ralley and Donna Berta discuss the assessment of anaemia in the elective orthopaedic surgical patient.
  • Dr. Tom Turgeon focuses on the use of erythropoiesis-stimulating agents.
  • Drs. Peter Lewkonia and Zhi Wang address the role of autologous blood donation.
  • Drs. Prasad Antapur, Rajiv Gandhi, and Nizar Mahomed examine topical and intra-articular tranexamic acid.
  • Drs. James Howard and Douglas Naudie discuss their experience with intravenous tranexamic acid use in elective total joint arthroplasty.
  • Drs. Wade Gofton and Steven Papp address blood management in the orthopaedic trauma patient.
Note

Articles in the Blood Management and Orthopaedic Surgery series will be available according to the schedule below, with one or more articles released each week during the month.