Bloodless Total Hip Arthroplasty in Jehovah's Witness Patients: Contemporary Strategies and Outcomes.

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Abstract

[Indexed for MEDLINE] 3. BMC Musculoskelet Disord. 2022 Dec 9;23(1):1079. doi: 10.1186/s12891-022-05955-w. Special orthopaedic geriatrics (SOG) - a new multiprofessional care model for elderly patients in elective orthopaedic surgery: a study protocol for a prospective randomized controlled trial of a multimodal intervention in frail patients with hip and knee replacement. Kappenschneider T(1), Maderbacher G(2), Weber M(3), Greimel F(2), Holzapfel D(2), Parik L(2), Schwarz T(2), Leiss F(2), Knebl M(2), Reinhard J(2), Schraag AD(2), Thieme M(2), Turn A(2), Götz J(2), Zborilova M(2), Pulido LC(2), Azar F(2), Spörrer JF(2), Oblinger B(2), Pfalzgraf F(2), Sundmacher L(4), Iashchenko I(4), Franke S(4), Trabold B(5), Michalk K(2), Grifka J(2), Meyer M(2). Author information: (1)Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany. t.kappenschneider@asklepios.com. (2)Department of Orthopaedic Surgery, Regensburg University Medical Center, Bad Abbach, Germany. (3)Department of Orthopaedic and Trauma Surgery, Hospital Barmherzige Brüder Regensburg, Regensburg, Germany. (4)Department of Health Economics, Technical University of Munich, Munich, Germany. (5)Department of Anaesthesiology, Asklepios Klinikum Bad Abbach, Bad Abbach, Germany. BACKGROUND: Due to demographic change, the number of older people in Germany and worldwide will continue to rise in the coming decades. As a result, the number of elderly and frail patients undergoing total hip and knee arthroplasty is projected to increase significantly in the coming years. In order to reduce risk of complications and improve postoperative outcome, it can be beneficial to optimally prepare geriatric patients before orthopaedic surgery and to provide perioperative care by a multiprofessional orthogeriatric team. The aim of this comprehensive interventional study is to assess wether multimorbid patients can benefit from the new care model of special orthopaedic geriatrics (SOG) in elective total hip and knee arthroplasty. METHODS: The SOG study is a registered, monocentric, prospective, randomized controlled trial (RCT) funded by the German Federal Joint Committee (GBA). This parallel group RCT with a total of 310 patients is intended to investigate the specially developed multimodal care model for orthogeriatric patients with total hip and knee arthroplasty (intervention group), which already begins preoperatively, in comparison to the usual orthopaedic care without orthogeriatric co-management (control group). Patients ≥70 years of age with multimorbidity or generally patients ≥80 years of age due to increased vulnerability with indication for elective primary total hip and knee arthroplasty can be included in the study. Exclusion criteria are age