title: Post-operative blood management strategies for total hip arthroplasty.
abstract: Total hip arthroplasty is increasing in incidence due to our aging population. However, this procedure has a high potential for increased blood loss, with allogeneic blood transfusions commonly used. However, due to potential transfusion-related risks such as immunosuppression or infections, attempts have been made to reduce the amount of blood loss and minimize transfusions. Therefore, our aim was to provide a broad overview of the widely used methods for reducing post-operative blood loss after total hip arthroplasty. These include antifibrinolytic agents, autologous blood transfusion drains, avoiding the use of drains, and modifications in drainage techniques. In addition, lowering the transfusion threshold is another method used to decrease the rates of allogeneic blood transfusion. Current evidence suggests that the use of some of these strategies-either alone, or in combination-may reduce the amount of blood loss and the need for allogeneic transfusions. However, further research is needed to create new, more standardized guidelines.
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement Sinai Hospital of Baltimore Baltimore, MD.
authors.forename: Julio J
authors.initials: JJ
authors.lastname: Jauregui
authors.affiliation: Seton Hall University School of Health and Medical Sciences Department of Orthopaedic Surgery South Orange Village, New Jersey.
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement Sinai Hospital of Baltimore Baltimore, MD.
authors.forename: Bhaveen H
authors.initials: BH
authors.lastname: Kapadia
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement Sinai Hospital of Baltimore Baltimore, MD.
authors.forename: Samik
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: Beth Israel Medical Center Adult Reconstruction and Total Joint Replacement Service New York, NY.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Harwin
authors.affiliation: Sinai Hospital of Baltimore Baltimore, MD.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001804:Blood Transfusion, Autologous; D004322:Drainage; D006801:Humans; D019106:Postoperative Hemorrhage / Q000517:prevention & control / Q000628:therapy; D014148:Tranexamic Acid; D014184:Transplantation, Homologous
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid