• Steven F Harwin, Robert Pivec, Qais Naziri, Kimona Issa, and Michael A Mont.
• Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland - USA.
• Hip Int. 2014 Jan 1;24(1):69-76.

AbstractTotal hip arthroplasty (THA) can be challenging in Jehovah's Witnesses because of the potential for blood loss. Because these patients will not accept blood transfusions, multiple strategies to prevent blood loss have been developed. The purpose of this study was to report implant survivorship, clinical outcomes, radiographic outcomes, morbidity, and mortality of Jehovah's Witnesses undergoing primary THA. Databases from two institutions were reviewed to identify 53 patients (55 hips) who were Jehovah's Witnesses and had a primary total hip arthroplasty. There were 27 women and 26 men who had a mean age of 63 years (range 35-94 years), and a mean follow-up of 63 months (range 24-120 months). All Jehovah's Witnesses had a comprehensive perioperative blood management strategy employed by a coordinated medical and surgical team. Mean post-operative Harris Hip Scores were 86 points, and implant survivorship was 97%. There were two aseptic revisions for osteolysis and component loosening. There were no mortalities, and three minor surgical and two minor medical complications occurred during the study. Excellent clinical outcomes were found for Jehovah's Witness undergoing total hip arthroplasty using a comprehensive blood management protocol. We believe that the use of a specialised blood management protocol involving a team approach to preoperative evaluation, appropriate anaesthesia, and surgical and postoperative management was responsible for minimising complications. Total hip arthroplasty is safe and efficacious in this patient group if proper preoperative safeguards are utilised.

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