The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Mar 1986
Comparative StudyTotal hip arthroplasty in Jehovah's Witnesses without blood transfusion.
One hundred patients who were Jehovah's Witnesses underwent total hip replacement without transfusion, of which eighty-nine procedures were performed under hypotensive anesthesia. Of these eighty-nine patients, sixty-five had not had previous hip surgery and sustained an average intraoperative blood loss of 450 milliliters. This was a 43 per cent reduction in blood loss as compared with a control group of patients, who were not Jehovah's Witnesses and who had total hip replacement under normotensive anesthesia. ⋯ Eleven Jehovah's Witnesses who were not candidates for hypotensive anesthesia had a total hip replacement under normotensive techniques. Factors other than hypotensive anesthesia that aided in reducing blood loss were careful surgical technique, meticulous hemostasis, and well planned surgery. There were six complications, one of which was possibly related to hypotensive anesthesia, and no deaths.
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J Bone Joint Surg Am · Mar 1986
Biomechanical study of the ligamentous system of the acromioclavicular joint.
The ligamentous structures of the acromioclavicular joint were studied by gross examination and quantitative measurement in twelve human cadaver specimens. Distances between insertions at various extreme positions of the clavicle were studied with the biplane radiographic technique. Ligamentous contributions to joint constraint under displacements were determined by performing load-displacement tests along with sequential sectioning of the ligaments. ⋯ The trapezoid ligament contributed less constraint to movement of the clavicle in both the horizontal and the vertical plane except when the clavicle moved in axial compression toward the acromion process. The various contributions of different ligaments to constraint changed not only with the direction of joint displacement but also with the amount of loading and displacement. For many directions of displacement, the acromioclavicular joint contributed a greater amount to constraint at smaller degrees of displacement, while the coracoclavicular ligaments, primarily the conoid ligament, contributed a greater amount of constraint with larger amounts of displacement.