The Journal of arthroplasty
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Tranexamic acid (TA) has been reported to reduce blood loss after total joint arthroplasty; however, the literature is sparse in evaluating its efficacy in simultaneous bilateral total knee arthroplasty (TKA). In this retrospective study of consecutive patients, TA use in bilateral TKA was associated with a significant reduction in perioperative serum hemoglobin drop, as well as allogeneic blood transfusion needs from 50% to 11% of patients. ⋯ There were no venous thromboembolic events reported. Implementation of a systematic intravenous TA protocol in simultaneous bilateral TKA appears highly effective in reducing transfusion requirements, potentially reducing healthcare resource utilization as well as the morbidity and complications associated with allogeneic blood transfusions.
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Despite advances in surgical techniques and instrumentation, optimal cup positioning in total hip arthroplasty (THA) is challenging with a limited accuracy. We evaluated whether a learning curve exists for the optimal cup positioning, using the LC-CUSUM test (Learning curve cumulative summation test). We evaluated the first 100 consecutive THA performed by two surgeons, who had a year of fellowship training in the same teaching hospital. ⋯ There was no significant difference of numbers of outlier between two surgeons (P = 0.079). Both surgeons completed the learning curve of optimal cup positioning before 50 procedures, and maintained competence. A substantial learning period is necessary in the optimal positioning of an acetabular cup.