Abstract
BackgroundRevision total hip replacement (THR) is associated with increased blood loss and extended hospitalization.Materials and methodsWe reviewed 146 patients who underwent revision THR to identify predictors of blood loss, transfusion requirements, and length of hospitalization.ResultsBlood loss was greater with increasing age and in men. Femoral and dual-component revision and revision of cemented hip components were also associated with greater blood loss. Transfusion requirements were greater in patients who had lower preoperative hemoglobin concentration and in patients undergoing dual-component revision. Length of hospitalization was significantly increased in patients who received transfusion but less in patients who underwent isolated acetabular-component hip revision.ConclusionsThis study shows significantly greater blood loss in men, older patients, revision surgery of cemented implants, and dual-component revisions. More complex revision surgery and preoperative anemia are clearly associated with increased transfusion requirements and length of hospitalization. Identification and treatment of patients at higher risk of transfusion may guide likely transfusion requirements, shorten the length of hospitalization, and reduce the overall cost of treatment.
Highlights
Revision total hip replacement (THR) is associated with increased blood loss and extended hospitalization
Femoral and dual-component revision and revision of cemented hip components were associated with greater blood loss
Transfusion requirements were greater in patients who had lower preoperative hemoglobin concentration and in patients undergoing dual-component revision
Summary
A retrospective analysis was conducted on 146 patients who underwent elective revision total hip arthroplasty (THA) in our unit over a 5-year period. J Orthopaed Traumatol (2010) 11:159–165 look into the modes of implant failure and excluded cases of revision THA for infection or fractures as well as early revisions for dislocations secondary to implant malposition. Data were grouped according to the type of THR component that was revised (acetabular, femoral, or dual components). The electronic database was searched, and variables such as pre- and postoperative hemoglobin concentrations, patient demographics such as age and gender, type of revision surgery, transfusion rates, and length of hospitalization were recorded. Blood loss was estimated by measurement of pre- and postoperative hemoglobin concentrations (24 h after surgery); the difference between concentrations was recorded in each case. Anemia was defined as hemoglobin levels \12 g/dl in women and \13 g/dl in men [4]
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