| pubmed-article:9927115 | pubmed:abstractText | A common assumption among orthopedic surgeons is that cemented/hybrid total hip arthroplasty (THA) results in lower transfusion requirements than noncemented THA. The hypothesized mechanism to account for transfusion differences is that cement application, after polymerization, decreases perioperative blood loss. To evaluate this theory, a retrospective matched-pair study was performed to quantify perioperative, intraoperative, postoperative blood loss, and transfusion requirements among patients undergoing cemented/hybrid and noncemented THA. Twenty-five THA procedures were either cemented or hybrid and 25 were noncemented. Patients were matched with respect to age, gender, weight, and diagnosis. Six patients in the noncemented group and 10 in the cemented/hybrid group received autologous blood in the Post Anesthesia Care Unit. Among this subgroup, those in the cemented/hybrid group received a significantly greater volume of transfused blood (519.20 mL, versus 291.67 mL in the noncemented group, P < .017). After stratifying patients by gender, additional analysis revealed a greater total blood loss in the male population than in females (1848 mL versus 1464 mL, P < .004). Males also had a greater drain volume (548 mL versus 414 mL, P < .02). The female population utilizing hormone replacement therapy (HRT) was found to have a lesser blood loss (810 mL versus 1209 mL, P < .0107) and received a smaller amount of transfused blood (1164 mL versus 1377 mL) than those who were not on HRT. Other significant findings included a shorter length of stay in the cemented/hybrid group (6.85 versus 7.56 days, P < .012). Based on this matched-pair retrospective analysis of blood requirements, there is no indication that cemented/hybrid and noncemented THA procedures result in different blood requirements. However, differences were found in several areas when the population was stratified by gender. The information obtained from this study is important in its ability to solidify a foundation from which blood management decisions can be made. | lld:pubmed |
