title: Bipolar sealing in revision total hip arthroplasty for infection: efficacy and cost analysis.
abstract: Saline-coupled bipolar sealing has shown mixed results in primary arthroplasty. However, this technology has not been studied in infected revision total hip arthroplasty (THA), where morbidity is higher and conventional methods of blood management, such as cell salvage, often cannot be used. This case-matched study of 76 consecutive revision THA for infection included an experimental bipolar sealing group and a control group of conventional electrocautery. Groups were matched for gender, body mass index, American Society of Anesthesiologists classification, and surgery type. Total blood loss, intraoperative blood loss, and perioperative hemoglobin drop were significantly less in the experimental group. In addition, operative time was significantly shorter in the experimental group, which translated into gross savings approximately equal to the cost of the device. The decreases in total blood loss and perioperative hemoglobin decline, along with financial savings, may support the use of bipolar sealing in infected revision THA.
authors.affiliation: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: R Carter
authors.initials: RC
authors.lastname: Clement
authors.forename: Atul F
authors.initials: AF
authors.lastname: Kamath
authors.forename: Peter B
authors.initials: PB
authors.lastname: Derman
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Garino
authors.forename: Gwo-Chin
authors.initials: GC
authors.lastname: Lee
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D004564:Electrocoagulation / Q000191:economics; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000191:economics* / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000097:blood / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D006454:Hemoglobins