Up to 2% of total hip arthroplasties (THA) are still complicated by infection. This leads to dissatisfied patients with poor function, and has far-reaching social and economic consequences. The challenge in these cases is the eradication of infection, the restoration of full function and the prevention of recurrence. We report the outcome of early aggressive debridement in the acutely infected THA. We studied 28 consecutive patients referred with acutely infected THA (18 primaries, 10 revisions) which occurred within 6 weeks of the index operation or of haematogenous spread between 1999 and 2006. Microbiology confirmed bacterial colonisation in all cases with 20 early post-operative infections and 8 cases of acute haematogenous spread. Patients with a cemented THA underwent aggressive open debridement, a thorough synovectomy and exchange of all mobile parts. Uncemented THA were treated as a single stage revision with removal of all implants, aggressive debridement and re-implantation of new prosthesis. Antibiotics were continued in all cases until inflammatory markers and the plasma albumin concentration returned to within normal limits.Introduction
Methods
Total knee replacements (TKR) are among the commonest operations performed in orthopaedic practice. Literature review showed that 10-30% of patients who underwent TKR needed 1-3 units of blood. Tranexamic acid (TXA) has been popularised as an effective way to reduce blood loss and subsequent blood transfusion. Our aim was to investigate the value of TXA in reducing blood loss and blood transfusion after TKR and other clinical outcomes such as deep venous thrombosis (DVT), pulmonary embolism (PE), ischaemic heart diseases and mortality. A systematic review and meta-analysis of published randomised and quasi-randomised trials which used TXA to reduce blood loss in knee arthroplasty were conducted.Introduction
Patients and Methods
