Acta orthopaedica Scandinavica
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Comparative Study Clinical Trial Controlled Clinical Trial
Postoperative blood salvage in hip and knee arthroplasty. A prospective study on cost effectiveness in 161 patients.
We conducted a prospective controlled study on 161 patients who underwent primary or revision total hip or knee arthroplasty to assess the efficacy and limitations of postoperative blood salvage. The actual quantity of blood salvaged after washing, the theoretical increase in hemoglobin concentration caused by its reinfusion and the cost of this procedure were studied. ⋯ One third of the devices used were discarded as not effective enough and, in order to obtain an increase of 1 g/dL in the hemoglobin concentration, an average of 3.4 postoperative Solcotrans Plus Orthopaedic devices were used. To obtain the same increase in hemoglobin concentration as that given by an allogeneic blood transfusion, the overall cost of materials alone was more than five times the price of a single blood unit transfusion.
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The epidemiology of ankle fractures is changing. Increasing longevity has resulted in the highest age-specific incidence of ankle fractures being in women between 75 and 84 years of age. ⋯ Isolated malleolar fractures accounted for two thirds of the series, with bimalleolar fractures occurring in one fourth of the patients and trimalleolar fractures in the remaining 7%. Open fractures occurred in 2%.