The Journal of arthroplasty
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The study aim is to assess associations between chronic kidney disease (CKD) and blood transfusions during hospitalization for joint arthroplasty. Patients with Stage IV-V CKD who underwent elective total knee or hip arthroplasty from 2007 to 2010 were matched 2:1 with age, gender, and surgery type controls without kidney disease. ⋯ CKD was independently associated with increased odds of transfusions (2.88, 95% confidence interval 1.33-6.23, P=0.007). Preoperative optimization of CKD patients should be considered to reduce transfusion rates.
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Implants used for hip and knee arthroplasties have recently come under increased scrutiny. In England, a large variety of prostheses are currently being used. With the need for savings within the NHS of up to £20 billion over the next five years, we should be 'getting it right first time' by using the most reliable implants with proven survivorship. ⋯ This study demonstrates that the majority of implants did have long-term results but a small percentage had no published data. The cost of these implants was calculated to see if the implants provided best value for money based on survivorship. Implant choice was also correlated to revision rates published in the NJR report (2011) to help determine whether their continued use was justified.
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Metabolic syndrome (MetS)-a diagnostic grouping of diabetes, dyslipidemia, hypertension, and obesity-has been indicated as a risk factor for perioperative complications following total joint arthroplasty (TJA). This study investigates the impact of MetS on perioperative complications, specifically the importance of controlling MetS components. One hundred thirty-three patients undergoing TJA with all four components of MetS were identified. ⋯ The complication rates were 49%, 8%, and 8% for uncontrolled MetS, controlled MetS, and no MetS, respectively. Multivariate analysis confirmed independent associations between control of MetS components and both perioperative complications and length of stay. Both surgeons and patients should be aware of the substantial risk of dangerous complications following TJA in patients with uncontrolled metabolic syndrome.