A literature review assessing the perioperative efficacy and safety of tranexamic acid in elective total hip and knee arthroplasty in UK practice.

Hip and knee arthroplasty are frequently associated with significant blood loss, often necessitating blood transfusions. A variety of methods are employed to minimise blood loss and consequently mitigate the necessity for transfusions. This review explores the incidence of blood loss in hip and knee arthroplasty alongside perioperative strategies aimed at its reduction in UK practice. Given the increasing prevalence of tranexamic acid utilisation, we systematically examine the extant literature concerning its application in patients undergoing hip and knee arthroplasty. Our analysis discerns a prevailing consensus within published studies favouring the implementation of tranexamic acid as a safe and efficacious measure for reducing blood loss during hip and knee arthroplasty procedures.

Identification and optimisation of perioperative factors for patients with von Willebrand disease undergoing elective total hip and knee arthroplasty.

Von Willebrand disease stands as the most prevalent bleeding disorder seen in both medical and surgical practice. Due to recurrent bleeding episodes within the joints, many patients endure arthropathy, leading to substantial pain and restricted function. Total joint arthroplasty emerges as a final option for managing such cases. Nevertheless, the existence of von Willebrand disease presents several challenges in this regard. This review aims to explore the perioperative strategies tailored for patients with von Willebrand disease undergoing elective total joint arthroplasty.

Ultrasound scanning helped surgeons to locate the buried metal work: A case series.

Removal of metalwork in children can be a challenging procedure, particularly if the metalwork is deeply buried and not palpable. This article proposes a surgical tip to help locate the position of metalwork just before the operation using an ultrasound machine and methylene blue dye. The technique involves using the ultrasound machine to locate the position of metalwork and marking the tract by injection of methylene blue dye just before prepping and draping the skin. This allows the operation to be performed through a smaller wound with less trauma to the soft tissues and avoids radiation exposure to the patient and theatre personnel. Our experience in a case series of 5 patients have found this a useful technique for removing threaded wires following a Salters osteotomy, where the wires can end up being buried beneath the iliac apophysis. It could however, be used to aid removal of any metal work where difficulty finding it is anticipated. Study expanded to include case series of patients rather than just one example. We have tracked a further 4 patients who have had the same technique used to include them in the paper. Reviewer 2 wanted further examples.