ANZ Journal of SurgeryVolume 88, Issue 1-2 p. E97-E98 IMAGES FOR SURGEONS Intrapelvic dislocation of trial femoral prosthesis in hip arthroplasty Brahman Shankar Sivakumar MBBS, BSci (Med), MS, Brahman Shankar Sivakumar MBBS, BSci (Med), MS Department of Orthopaedic Surgery, Liverpool Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorArnold Suzuki MBBS, FRACS (Ortho), Arnold Suzuki MBBS, FRACS (Ortho) Department of Orthopaedic Surgery, Fairfield Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorPeter Lorentzos MBBS, Peter Lorentzos MBBS Department of Orthopaedic Surgery, Westmead Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorMayuran Suthersan MBBS, BSci (Med), MS, Mayuran Suthersan MBBS, BSci (Med), MS Department of Orthopaedic Surgery, Fairfield Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorJaykar Dave MBBS, FRACS (Ortho), Jaykar Dave MBBS, FRACS (Ortho) Department of Orthopaedic Surgery, Fairfield Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this author Brahman Shankar Sivakumar MBBS, BSci (Med), MS, Brahman Shankar Sivakumar MBBS, BSci (Med), MS Department of Orthopaedic Surgery, Liverpool Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorArnold Suzuki MBBS, FRACS (Ortho), Arnold Suzuki MBBS, FRACS (Ortho) Department of Orthopaedic Surgery, Fairfield Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorPeter Lorentzos MBBS, Peter Lorentzos MBBS Department of Orthopaedic Surgery, Westmead Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorMayuran Suthersan MBBS, BSci (Med), MS, Mayuran Suthersan MBBS, BSci (Med), MS Department of Orthopaedic Surgery, Fairfield Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this authorJaykar Dave MBBS, FRACS (Ortho), Jaykar Dave MBBS, FRACS (Ortho) Department of Orthopaedic Surgery, Fairfield Hospital, Sydney, New South Wales, AustraliaSearch for more papers by this author First published: 01 September 2015 https://doi.org/10.1111/ans.13281Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1Ozkan K, Ugutmen E, Altintas F, Eren A, Mahirogullari M. Intraoperative dislocation of the prosthetic femoral head into the pelvis during total hip arthroplasty. Acta Orthop. Belg. 2008; 74: 553–555. Google Scholar 2Alfonso D, Idjadi J, Lamont JG. Retrieval of a trial femoral head that displaces into the periacetabular soft tissue during mini incision total hip arthroplasty: a case report. J. Bone Joint Surg. Am. 2006; 88: 866–868. Google Scholar 3Batouk O, Gilbart M, Jain R. Intraoperative dislocation of the trial femoral head into the pelvis during total hip arthroplasty: a case report. J. Bone Joint Surg. Am. 2001; 83-A: 1549–1551. Google Scholar 4Bicanic G, Crnogaca K, Simunovic M, Delimar D. Dislocated trial femoral head during total hip arthroplasty: review of the literature and the new algorithm for treatment. BMJ Case Rep. 2015. doi: 10.1136/bcr-2014-208693. 10.1136/bcr‐2014‐208693 Google Scholar 5Callaghan JJ, McAndrew C, Boese CK, Forest E. Intrapelvic migration of the trial femoral head during total hip arthroplasty: is retrieval necessary? A report of four cases. Iowa Orthop. J. 2006; 26: 60–62. PubMedGoogle Scholar 6Vertelis A, Vertelis L, Tarasevicius S. Trial femoral head loss in to the soft tissues of pelvis during primary total hip replacement: a case report. Cases J. 2008; 1: 151. 10.1186/1757-1626-1-151 PubMedGoogle Scholar 7Citak M, Klatte TO, Zahar A et al. Intrapelvic dislocation of a femoral trial head during primary total hip arthroplasty requiring laparotomy for retrieval. Open Orthop. J. 2013; 7: 169–171. Google Scholar 8Madsen WY, Mitchell BS, Kates SL. Successful intraoperative retrieval of dislocated femoral trial head during total hip arthroplasty. J. Arthroplasty 2012; 25: 820, e9–11. Google Scholar 9Ziv YB, Backstein D, Safir O, Kosashvili Y. Intraoperative dislocation of a trial femoral head into the pelvis during total hip arthroplasty. Can. J. Surg. 2008; 51: E73–74. Google Scholar 10Ikeuchi K, Hasegawa Y, Warashina H, Seki T. Intraoperative migration of the trial femoral head into the pelvis during total hip arthroplasty. Nagoya J. Med. Sci. 2014; 76: 203–210. Web of Science®Google Scholar Citing Literature Volume88, Issue1-2January/February 2018Pages E97-E98 ReferencesRelatedInformation

Background: The functional benefits of tourniquet application for short periods compared with standard duration applications during total knee arthroplasty surgery have not been well explored. We aimed to compare functional outcomes between tourniquet application of short duration (during cement fixation only) and tourniquet application of longer duration (from skin incision to just after cement fixation). Methods: We planned to randomize 230 patients to short and long duration groups. The primary outcome was Oxford Knee Score at 10 weeks post-surgery. In-hospital blood transfusion rate was also a primary safety measure. Serial measures of knee function were taken together with knee range, quadriceps lag and timed stair tests. Results: The trial was discontinued after randomization of 65 patients. Interim analysis indicated a higher risk of transfusion (odds ratio 7.38, P= 0.015) in the short duration group. No significant difference was observed in Oxford Knee Score at 10 weeks. There were no between-group differences in rate of recovery up to 52 weeks for any outcome. Conclusions: Restricting tourniquet application to the period of cementing is associated with a significantly higher risk of transfusion. This approach is impractical if it is not offset by gains in functional recovery.