Acta Orthop Belg
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Comparative Study Observational Study
Comparison of intra-operative regimes of tranexamic acid administration in primary total hip replacement.
The administration of tranexamic acid to decrease blood loss in primary total hip replacement is established. In this observational study three different regimes of tranexamic acid were used to investigate the effects of combined intravenous and topical administration of tranexamic acid to a single intravenous bolus given at induction or closure. Group 1 (n = 50) received 1 g tranexamic acid intravenously at induction and 500 mg tranexamic acid topically during closure. ⋯ The mean haemoglobin loss was 2.83 g/dL (95% Confidence interval [CI] 2.51 to 3.15 g/dL) in Group 1, 2.92 g/dL (95% CI 2.65 to 3.19 g/dL) in Group 2 and 3.36 g/dL (95% CI 2.94 to 3.77 g/dL) in Group 3. No significant difference in mean haemoglobin loss was found (p = 0.123). In this observational, non-randomised study we found no additional advantage to giving topical tranexamic acid at closure in addition to intravenous tranexamic acid given at induction.
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Comparative Study
Three metal-on-metal hip replacement devices from the same manufacturer--a short- to mid-term survival.
The aim of this retrospective study was to evaluate short- to mid-term results of three different metal-on-metal hip devices from the same manufacturer. A total of 329 hip operations were performed in a single academic unit between 2004 and 2010 using either Birmingham hip resurfacing or Synergy--Birmingham and Synergy--R3 total hip arthroplasty. The overall survival rate at the end of the follow-up time for Birmingham hip resurfacing was 88%, for Synergy--Birmingham total hip arthroplasty 95%, and for Synergy--R3 total hip arthroplasty 81% (p = 0.036). ⋯ Head sizes > 50 mm had lower revision rates compared to smaller ones. Synergy--R3 had a poor survival already at short-term. The mid-term survival of Birmingham hip resurfacing arthroplasty was inferior compared to previous studies.
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This study assessed the readability and quality of websites related to; total hip replacement, total knee replacement and anterior cruciate ligament reconstruction using validated instruments. 225 websites were analyzed from Google, Yahoo and Bing. Readability was assessed using the Flesch Reading Ease Score and Flesch-Kincaid grade level. ⋯ There was a wide variation in quality scores between websites and the information relating to the three procedures was inconsistent and generally of poor quality. Given the deficit in information it is important Orthopaedic surgeons provide patients with high quality, readable information or direct them to an appropriate source.