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Xiangji Dang Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, P.R. China
Department of Pharmaceutical, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China

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Mei Liu The First Clinical Medical School, Gansu University of Chinese Medicine, Gansu, P.R. China

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Qiang Yang Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China

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Jin Jiang Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China

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Yan Liu Gansu High Throughput Screening and Creation Center for Health Products, School of Pharmacy, Lanzhou University, Lanzhou, P.R. China

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Hui Sun Cuiying Biomedical Research Center, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China

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Jinhui Tian Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, P.R. China

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– significant perioperative blood loss, estimated to range from 1450 mL to 1790 mL without specific interventions ( 3 ). Understanding the determinants of preexisting thromboembolic risk is pivotal for individuals undergoing TJA. Patients with a history of

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Stavros Tsotsolis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece
Trauma and Orthopaedics Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

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Eustathios Kenanidis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece

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Vasileios F Pegios Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece

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Michael Potoupnis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece

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Eleftherios Tsiridis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece

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year of publication restrictions were applied. The primary outcomes were the rate of postoperative complications in patients undergoing TJA with thyroid dysfunction. These were divided into four categories: implant-related, blood loss, infection, and

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Dieter Wirtz Department of Orthopaedic Surgery and Traumatology, University Hospital of Bonn, Germany

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Hendrik Kohlhof Department of Orthopaedic Surgery and Traumatology, University Hospital of Bonn, Germany

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pre-operative anaemia and peri-operative blood loss. In addition, post-operative anaemia was found to be quite common amongst those patients (51.0% and 87.1%, respectively). 6 – 7 Various studies have shown that peri-operative anaemia was

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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

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, the high risk of infection (7% on average) is a concern ( Fig. 8 ). 27 – 30 Reported results of primary TKR in haemophilia are satisfactory. 27 – 31 It is paramount today to use a multimodal blood-loss prevention approach (MBLPA) including

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Enrique Gómez-Barrena Department of Orthopaedic Surgery and Traumatology, Hospital La Paz-IdiPaz, Universidad Autónoma de Madrid, Madrid, Spain

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Christian Ehrnthaller Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Germany

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with RIA harvesting (up to 44%) ( 60 ) has been substantially decreased (down to 14%) ( 61 ) in other reports. The risk of cortical perforation and the frequently reported relevant intraoperative blood loss are complications that should be anticipated

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Jasmine N. Levesque Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada

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Ajay Shah Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada

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Seper Ekhtiari Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

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James R. Yan Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

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Patrick Thornley Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

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Dale S. Williams Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada

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expected low quality of evidence overall, a meta-analysis was not planned. A qualitative assessment of peri-operative outcomes (estimated blood loss (EBL), operative time, and fluoroscopy use) was performed using high-quality (i.e. Level I and Level II

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Philip F. Dobson Trauma and Orthopaedic Surgery, Royal Victoria Infirmary, Newcastle, UK

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Michael R. Reed Trauma and Orthopaedic Surgery, Royal Victoria Infirmary, Newcastle, UK

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are not warmed prior to transfer to the operating theatre. 19 Other benefits of avoiding hypothermia aside from reduced infection rates 11 include reduced hospital stay, 9 reduced blood loss, 20 and reduced mortality. 21

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SaTia T. Sinclair Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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Ahmed K. Emara Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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Melissa N. Orr Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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Kara M. McConaghy Case Western Reserve University School of Medicine, Cleveland, Ohio, United States

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Alison K. Klika Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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Nicolas S. Piuzzi Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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diseases Coagulopathy Obesity Weight loss Fluid/electrolyte disorders Blood loss anaemia Deficiency anaemia Alcohol abuse Drug abuse Psychoses Depression ACS NSQIP Surgical Risk Calculator Age group Sex Functional status Emergency case ASA

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Dimitrios A. Flevas First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

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Panayiotis D. Megaloikonomos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

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Leonidas Dimopoulos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

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Evanthia Mitsiokapa First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

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Panayiotis Koulouvaris First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

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Andreas F. Mavrogenis First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

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risk of cardiovascular events associated with stopping clopidogrel. The authors suggest that care should be taken intra-operatively to minimize blood loss due to the increased potential for bleeding. 100 Conclusions Patients undergoing major

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