Subject(s)
Anemia , Orthopedic Procedures , Orthopedics , Humans , Anemia/etiology , Anemia/therapy , Orthopedic Procedures/adverse effectsABSTRACT
Anaemia is common before major surgery and increases complications. A new guideline aims to help with early diagnosis of the type and cause of anaemia and initiate effective treatment. The guideline includes clear education for all staff and patients about the biology of iron homeostasis and patient blood management.
Subject(s)
Anemia , Perioperative Care , Humans , Anemia/diagnosis , Anemia/therapyABSTRACT
Complications following surgery are common, predictable and often preventable. New preoperative assessment and optimisation guidance recommends clear pathways with triggers for interventions, patient involvement, shared decision making and team education, to help both patients and service efficiency.
Subject(s)
Pandemics , Patient Participation , Decision Making , Decision Making, Shared , HumansSubject(s)
Emigration and Immigration/statistics & numerical data , Medicine/statistics & numerical data , Personnel Selection/statistics & numerical data , Physicians, Women/statistics & numerical data , Specialization , Emigration and Immigration/trends , Female , Forecasting , Foreign Medical Graduates/statistics & numerical data , Foreign Medical Graduates/trends , Humans , Male , Medicine/trends , Personnel Selection/standards , Personnel Selection/trends , Physicians, Women/trends , Sex FactorsABSTRACT
Over a 3-year period, nine hemiarthroplasties were revised to total hip arthroplasty. The hemiarthroplasties were all performed for an original diagnosis of subcapital fracture, and the revisions were for a variety of indications including instability, loosening and acetabular erosion. Four of the revised prostheses subsequently dislocated, and one has recurrent subluxation. This dislocation rate of 50% is higher than previously reported. Factors contributing to this are discussed. These include: previous strokes, advanced age, difficulty complying with instructions, and a hip capsule not contracted by osteoarthritis. Preventative factors are discussed. It is imperative to treat this group of patients differently from those having other hip arthroplasties, and to consider prophylactic bracing post-operatively. The capsule or pseudo-capsule should be preserved wherever possible.
