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Methods - A retrospective review of 104 patients with simultaneous bilateral total kneearthroplasty done between 2006-2009 was performed. Patients donated two units of blood, 4weeks prior to surgery and also received Erythropoetin injections( 40 k units 3weeks,2 weeksand 1 week prior to surgery). Intra- operative Blood Management included symptom-basedtransfusions, blood salvage devices, local epinephrine injections and fibrin spray. Pre-donationblood levels , peri-operative hemoglobin and hematocrit levels along with transfusion recordswere assessed.Results- The mean pre-donation hemoglobin was 13.1 g/dL. After 2 units of autologous blooddonation and procrit injection, the mean hemoglobin was 13.0 g/dL. The mean hemoglobindropped to a nadir of 9.8 g/dL on postoperative day 3. The mean drop in hemoglobin frompreadmission testing was 3.3g/dl. Overall, 28 % patients required autologous blood transfusionand no patients required allogeneic transfusion if the protocol was followed. 6 patients (5.8%)did require allogeneic transfusions but all 6 were protocol violations and did not follow theproposed treatment regiment.Conclusion- This multi-modal protocol was effective in not only avoiding allogeneictransfusions following Bilateral TKA but also resulted in high blood levels at the time ofdischarge. This protocol was effective in eliminating allogeneic transfusions and maintainingblood levels.Saturday, October 9, 2010, 11:15-11:50Session B19: Hip MechanicsManagement of Severe CDH With THA and Derotating/shorteningOsteotomy: Our 20 Years Experience Results*Gianluca Cusma' Guatteri - HUMANITAS CLINICAL INSTITUTE - Rozzano, ITALY*Email: g.cdg@libero.itIntroduction: The anatomic abnormalities associated with the dysplastic hip increase thecomplexity of hip arthroplasty, in addition previous femural osteotomy can deformate proximalfemur. Despite the fact that uncemented cup and stems are specifically designed for dysplasia torecover the true acetabular region in Crowe IV and sometimes Crowe III additional surgicalprocedure are required. Purpose of the study is to verify surgical procedures and explorereconstruction options on severe hip dysplasia.Materials and methods: In last 25 years, 2308 arthroplasties were performed in dysplastic hips(565 cases had a previous femoral osteotomy). In 128 cases was required a correction offemoral side deformity: in 64 cases was performed a greater trochanter osteotomy (in 12 ofthese a proximal femoral shortening was associated), 55 cases were treated by a shorteningsubtrochanteric osteotomy (that allows corrections in any plane) and in 9 cases was performed adistal femur osteotomy.Discussion: Long-term results in these patients are steadily inferior to those obtained in generalpopulation (70% survival rate at 15 years). On femoral side early failures reflect learning curvefile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]