title: Prospective, Randomized Trial to Evaluate Efficacy of a Bipolar Sealer in Direct Anterior Approach Total Hip Arthroplasty.
abstract: Total hip arthroplasty can be associated with substantial blood loss requiring allogenic transfusions. Intraoperative blood loss patterns in DAA differ from other approaches. This study evaluated the hemostatic efficacy of a bipolar sealer in DAA THA on surgical blood loss and transfusion requirements. 118 patients were enrolled in this prospective, randomized, double-blinded trial. Primary outcome measure was transfusion rate, while secondary measures included calculated blood loss. A lower transfusion rate was found in the treatment group (3.5 % vs 16.4%, P=.03). There were differences in Hemoglobin-drop (P=.04), calculated blood loss (P=.02), and hidden blood loss (P=.02), favoring the treatment group. The use of a bipolar sealer decreased intraoperative blood loss and transfusion requirements in the study population.
authors.affiliation: Cleveland Clinic Florida, Department of Orthopedic Surgery, Weston, Florida.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Suarez
authors.affiliation: Orthopaedic Associates of Reading, Reading Hospital, West Reading, Pennsylvania.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Slotkin
authors.affiliation: Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio.
authors.forename: Caleb R
authors.initials: CR
authors.lastname: Szubski
authors.affiliation: Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, Ohio.
authors.forename: Wael K
authors.initials: WK
authors.lastname: Barsoum
authors.affiliation: Cleveland Clinic Florida, Department of Orthopedic Surgery, Weston, Florida.
authors.forename: Preetesh D
authors.initials: PD
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000706:statistics & numerical data; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: blood management; direct anterior approach; hemostasis; primary hip; transfusion rates