Perioperative strategies to reduce transfusion rates in one-stage bilateral total hip arthroplasty via direct anterior approach

John Attenello; Samantha Andrews; Scott Nishioka; Kristin Mathews; Cass Nakasone

doi:10.1016/j.jor.2020.12.030

Perioperative strategies to reduce transfusion rates in one-stage bilateral total hip arthroplasty via direct anterior approach

J Orthop. 2020 Dec 29:23:118-122. doi: 10.1016/j.jor.2020.12.030. eCollection 2021 Jan-Feb.

Authors

John Attenello¹, Samantha Andrews^{1

2}, Scott Nishioka², Kristin Mathews², Cass Nakasone^{1

2}

Affiliations

¹ University of Hawai'i, Department of Surgery, Honolulu, HI, USA.
² Straub Medical Center, Bone and Joint Center, Honolulu, HI, USA.

Abstract

Despite several blood management strategies available, blood transfusion rates following total hip arthroplasty remain high. Therefore, this study evaluated transfusion rates following bilateral hip arthroplasty via direct anterior approach using a multimodal blood loss management approach for 213 consecutive patients. All patients received standard surgical and post-operative procedures, with allogenic transfusion performed if hemoglobin was less than 8.0 g/dL with persistent clinical symptoms. Thirty-two patients (15%) required transfusion, with those patients significantly older and had lower pre-operative hemoglobin compared to non-transfusion patients. This transfusion rate was much lower than previous literature and could be an appropriate, multimodal blood loss management strategy.

Keywords: Blood loss management; Direct anterior approach; One-stage bilateral total hip arthroplasty; Transfusion.