Insights & Injuries:

A blog by Dr. Dolf R. Ichtertz, Nebraska Hand & Shoulder Institute

The Dr.
Who Needs Autologous Blood Donation?2 January, 2014
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“Who needs autologous blood donation in joint replacement?” by Parvizi, M.D., et al, Journal of Knee Surgery, 2011.

Surgeons retrospectively reviewed 409 patients undergoing total knee and 513 patients undergoing total hip replacement to determine if patients donating their own blood before surgery were benefiting from doing so.  This study is an eye opener.  The results support it for a total hip replacement but not for total knee replacement.  
This study is an eye opener from the standpoint that total hip replacement patients typically lose a lot more blood and would therefore be expected to need more blood when, in fact, it turned out to be the opposite on this large group of patients.  

They determined in the total knee patients that 21% that donated their own blood needed blood bank blood vs. 27% of those who had not donated.  In the total hip replacement crew 16% of the patients donating blood for themselves still needed bank blood while 34% of the patients who did not donate on their own behalf required bank blood.  They felt that these results supported continued autologous blood donation for total hip arthroplasty, i.e. a person donating for themselves, while it did not support one donating their own blood for a total knee arthroplasty.

This important information will help doctors and patients alike and can cut down the potential for a lot of wasted time and money in autologous blood donation for knee replacement patients while continuing to support the practice for hip replacement patients and helping cut down on transfusion reaction, hepatitis B or C, or HIV transmission with transfusion.  It is also very important to note that almost no patient ever undergoing a unicompartmental knee replacement, i.e. partial knee replacement, ever needs a blood transfusion for that surgery while at least ¼ of the people undergoing total knee replacement do require transfusion.  

Patient Satisfaction with treatments for Dupuytren's Disease

Collagenase rather than Surgery - that is the question

Computers and CTS - Is there an association?

Review of a recent study on the use of computers and the development of carpal tunnel syndrome.

Nebraska Hand and Shoulder Institute, P.C.

Nebraska Hand and Shoulder Institute, P.C.
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