Instructional course lectures
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Blood management during total hip arthroplasty is a critical component of successful patient care, and an overall strategy is necessary. Multiple options for blood management are available, including the use of predeposited autologous blood, perioperative blood salvage, hemodilution techniques, erythropoietic agents, hemostatic agents, and allogeneic blood. Rather than relying on automatic so-called transfusion triggers, the surgeon should identify patient-specific risk factors such as the anticipated difficulty of the procedure, preoperative hemoglobin level, comorbidities, and a plan for blood management.
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Lumbar spinal stenosis associated with adult scoliosis is being increasingly recognized and studied. Degenerative changes leading to spinal stenosis can precede a spinal deformity resulting in de novo scoliosis. Conversely, degenerative changes leading to spinal stenosis can occur in a preexisting deformity. ⋯ The optimal surgical procedure depends on a careful evaluation of involved segments and patient comorbidities. Positive sagittal imbalance is associated with significant morbidity and should be corrected when feasible. Data that continue to be collected in this patient population will guide future efforts in treating this complicated disease.