ABSTRACT
Following total hip arthroplasty (THA) and total knee arthroplasty (TKR) only the 'visible' measured blood loss is usually known. This underestimates the 'true' total loss, as some loss is 'hidden'. Correct management of blood loss should take hidden loss into account. We studied 101 THAs and 101 TKAs (with re-infusion of drained blood). Following THA, the mean total loss was 1510 ml and the hidden loss 471 ml (26%). Following TKA, the mean total loss was 1498 ml. The hidden loss was 765 ml (49%). Obesity made no difference with either operation. THA involves a small hidden loss, the total loss being 1.3 times that measured. However, following TKA, there may be substantial hidden blood loss due to bleeding into the tissues and residual blood in the joint. The true total loss can be determined by doubling the measured loss.
Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Knee/adverse effects , Blood Loss, Surgical , Aged , Blood Transfusion, Autologous , Female , Hemoglobins/metabolism , Hemostasis, Surgical , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
A hospital radiology reports database was used to determine the prevalence of non-union of scaphoid fractures. Radiographs taken for any indication were used. By using a large number of radiographs, variations attributable to bias were minimised. There was a 0.14% prevalence of established scaphoid fracture non-union in the general population, indicating that unrecognised scaphoid non-union is rare.
