Postoperative Thrombotic Thrombocytopenic Purpura after Total Hip Arthroplasty: A Case Report and Review of the Literature.

Thrombotic thrombocytopenic purpura (TTP) is an uncommon and potentially lethal microangiopathy that carries a >90% mortality rate if not treated urgently and appropriately. Postoperative TTP after orthopaedic procedures is particularly rare with only four case reports existing in the literature. We present the case of postoperative TTP in a 57-year-old female who underwent elective total hip arthroplasty. We believe this case adds to the limited literature surrounding the topic. While rare, TTP after orthopaedic procedures poses a real and potentially fatal condition if not managed appropriately. Therefore, it is essential for orthopaedic surgeons to be cognizant of postoperative TTP for timely diagnosis and treatment.

Decreased infection rates following total joint arthroplasty in a large county run teaching hospital: a single surgeon's experience and possible solution.

Total joint arthroplasty is a common orthopaedic procedure producing valuable improvements in patient's quality of life. A dreaded complication of this procedure is deep seated, periprosthetic infection. This complication can lead to multiple reoperations and upwards of $100,000 of increased cost burden. At one 900 bed county run teaching hospital, with a historically high infection rate in total joints, the total joint service was closed and restarted using a new protocol, dropping infection rates from 12.9% to 1.9% (P = 0.007).