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Intraoperative blood loss and haemoglobin drop in patients with developmental dysplasia of the hip in Jordan undergoing total hip arthroplasty

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A Letter to the Editor to this article was published on 02 August 2023

Abstract

Purpose

Developmental dysplasia of the hip is still a prevailing secondary cause of early hip osteoarthritis in Jordan. Dysplastic coxarthrosis can result in significant and disabling hip pain with impaired patient’s functionality. Due to this significant morbidity, patients ultimately need total hip arthroplasty, which offers the best functional outcome. Significant anatomical aberrances do exist in such hips as a result of old dysplasia; such pathoanatomical changes can complicate an already difficult surgery and lead to significant intraoperative blood loss and haemoglobin drop postoperatively. So, the aim of this research was to investigate on the intraoperative blood loos, and postoperative haemoglobin drop in these patients.

Methods

A cross-sectional study design was adopted, and 162 patients with advanced hip osteoarthrosis secondary to developmental dysplasia of the hip (DDH) were studied. We studied predictors of hemoglobin drop and blood loss and linked some variables to this outcome variable using different statistical tests.

Results

Our results showed a positive correlation between blood loss and BMI (r = 0.27, p = 0.73), haemoglobin drop and duration of surgery (r = 0.14, p = 0.07), length of hospital stay and duration of surgery (r = 0.25, p = 0.001). No significant differences between outcome measures (blood loss, haemoglobin drop, and duration of surgery) between males and females (p = 0.38, 0.93, 0.77 respectively). However, there was a statistically significant differences in haemoglobin drop among patients underwent general versus spinal anaesthesia (p = 0.03). additionally, there was a statistically significant association in length of hospital stay among smokers (p = 0.03), and patients who didn’t prescribed anxiolytic preoperatively (p = 0.008).

Conclusion

Haemoglobin drop and blood loss in patients with dysplastic coxarthrosis were linked to increased preoperative BMI. Use of preoperative anxiolytics, and being non-smoker decreased the length of hospital stays. General anaesthesia was associated with more haemoglobin drop as well.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available but may be made available from the corresponding author on reasonable request.

Code availability

Not applicable.

Abbreviations

DDH:

Developmental Dysplasia of the Hip

THA:

Total Hip Arthroplasty

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Acknowledgements

The authors appreciate the technical support of all the radiology staff.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Faculty of Medicine, Mutah University, Al-Karak, Jordan

    Moh’d S. Dawod

  2. Department of Orthopedics, Jordan University Hospital, P.O. Box: 13046, Amman, 11942, Jordan

    Mohammad N. Alswerki, Bassem I. Haddad & Jihad Alajlouni

  3. Jordan University Hospital, Amman, Jordan

    Mohammad A. Alshrouf, Saba Alnsour & Sohayla Dababseh

  4. Ministry of Health, Karak Governmental Hospital, Al-Karak, Jordan

    Mohammad A. Alsmairat

Authors
  1. Moh’d S. Dawod
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Contributions

All authors contributed to the study's conception and design. Material preparation, data collection, and analysis were performed by Saba AlNsours, Sohayla Dababseh, Mohammad A. Alsmairat. The first draft of the manuscript was written by Moh'd S. Dawod and all authors commented on previous versions of the manuscript. The analysis was done by Mohammed Alshrouf. The discussion section, the conclusion, and the abstract were done by Mohammad Alswerki. Bassem Haddad and Jihad Aljlouni revised the new manuscript, and Mohammad Alswerki made the revisions. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mohammad N. Alswerki.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Mutah University (IRB no. 912022).

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Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the results of this research.

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The authors have no relevant financial or non-financial interests to disclose.

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Level of Evidence: Level IV, Cross sectional descriptive study

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Dawod, M.S., Alswerki, M.N., Haddad, B.I. et al. Intraoperative blood loss and haemoglobin drop in patients with developmental dysplasia of the hip in Jordan undergoing total hip arthroplasty. International Orthopaedics (SICOT) 47, 2933–2940 (2023). https://doi.org/10.1007/s00264-023-05869-9

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