TY  - BOOK
AU  - Keeling, Laura
AU  - Mottla, Jay L
TI  - Role of arthroplasty in the Jehovah's Witness population
SN  - 1633-8065
PY  - 2021///
KW  - *Arthroplasty, Replacement, Knee
KW  - *Jehovah's Witnesses
KW  - Arthroplasty, Replacement, Knee/ae [Adverse Effects]
KW  - Blood Transfusion
KW  - Humans
KW  - Quality of Life
KW  - Retrospective Studies
KW  - MedStar Washington Hospital Center
KW  - Orthopedic Surgery
KW  - Surgery/Orthopaedic Surgery
KW  - Journal Article
N2  - BACKGROUND: Total joint arthroplasties aim to improve quality of life from joint-related pain. Jehovah's Witnesses refuse blood products due to their religious beliefs. Surgeons may be reluctant to perform arthroplasty procedures on these patients for fear of uncontrolled bleeding. However, we hypothesize that through preoperative optimization, arthroplasty can be performed safely; CONCLUSION: To our knowledge, this is the largest reported sample of Jehovah's Witness patients undergoing total joint arthroplasty. Postoperative hemoglobin values did not prompt additional intervention in the overwhelming majority of patients, and complication rates were acceptable. Our data suggest that primary arthroplasty is safe in the Jehovah's Witness population. Additionally, we show preliminary evidence that revision arthroplasty is safe in Jehovah's Witness patients; METHODS: We retrospectively reviewed 184 total joint arthroplasties in Jehovah's Witnesses between 2011 and 2019. Each patient was enrolled in the institutions' Bloodless Medicine program. Hemoglobin levels were recorded through standard laboratory testing while in the hospital. Primary outcomes were changes in preoperative and postoperative hemoglobin measures, short-term outcomes measures, and complications; RESULTS: A total of 103 total knee arthroplasties (8 revisions) and 81 total hip arthroplasties (5 revisions) were performed. Hemoglobin drift was 2.5 +/- 1.0 for primary TKA and 2.6 +/- 1.3 for primary THA (p = 0.570). Hemoglobin drift was 1.9 +/- 0.9 for revision TKA and 1.9 +/- 0.2 for revision THA (p = 0.990). Only 2.7% of patients met the transfusion requirement of 7 g/dL. The major complication rate for the cohort was 1.6% systemic and 4.9% local, respectively, with no mortalities. The overall readmission rate was 2.7%
UR  - https://dx.doi.org/10.1007/s00590-020-02852-7
ER  -