{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:53:43Z","timestamp":1792587223909,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,10,11]],"date-time":"2020-10-11T00:00:00Z","timestamp":1602374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Bernese periacetabular osteotomy (PAO), an effective treatment for patients with developmental dysplasia of the hip (DDH), is characterized by wide exposure, cancellous bone surgery, and difficult techniques. In addition, the hip joint is deep and of rich muscles and neurovascular supply, which significantly increases bleeding. For patients who had combined proximal femoral osteotomy (PFO), the blood loss may be tremendous. The blood management for PAO is still challenging. We aimed to evaluate the effectiveness of multi\u2010modal blood management for PAO and PAO\u2009combined with\u2009PFO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>We retrospectively evaluated patients who had PAO with or without combined procedures from June 2010 to December 2018 in our department. The multi\u2010modal blood management protocol included three parts: (i) pre\u2010operation \u2013 autologous component blood donation and iron supplement\/erythropoietin; (ii) during operation \u2013 controlled hypotension anesthesia, intraoperative auto\u2010blood transfusion, tranexamic acid (20\u2009mg\/kg, IV \/ 0.5\u2009g local), and standardized surgical procedure to shorten surgical time; and (iii) post\u2010operation \u2013 no drainage used, selective allo\u2010blood transfusion, and ice packing technique. As the lacking of the above standard blood management protocol during PAO or PAO\u2009+\u2009PFO initially, we divided all the patients into three groups: Group A (PAO) \u2013 before protocol started, 74 hips; Group B (PAO) \u2013 after protocol finalized, 178 hips; Group C (PAO\u2009+\u2009PFO) \u2013 after protocol finalized, 55 hips. The intraoperative blood loss, surgical time, allo\u2010transfusion rate, pre\u2010 and postoperative hemoglobin were compared among groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both the general characteristics and preoperative hemoglobin were comparable among the three groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The intraoperative blood loss was 797.1\u2009\u00b1\u2009312.2, 381.7\u2009\u00b1\u2009144.0 and 544.1\u2009\u00b1\u2009249.1\u2009mL, respectively. The surgical time was 109.6\u2009\u00b1\u200918.5, 80.2\u2009\u00b1\u200920.0 and 154.3\u2009\u00b1\u200944.7 min, respectively. The allo\u2010transfusion rate was 86.5%, 0%, and 2%, respectively. The mean decreased value of hemoglobin on the first postoperative day of group B and group C was greater than that of group A, which was associated with the higher allo\u2010transfusion rate of group A. However, on the third postoperative day, the mean decreased value of hemoglobin of group B was less than that of group A and group C.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Perioperative multi\u2010modal blood management for PAO or PAO\u2009+\u2009PFO can significantly decrease intraoperative blood loss, reduce allo\u2010transfusion rate from over 80% to 0%, and ensure the rapid recovery of postoperative hemoglobin level.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12794","type":"journal-article","created":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T06:40:04Z","timestamp":1602484804000},"page":"1748-1752","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effectiveness of <scp>Multi\u2010Modal<\/scp> Blood Management in Bernese Periacetabular Osteotomy and Periacetabular Osteotomy with Proximal Femoral Osteotomy"],"prefix":"10.1111","volume":"12","author":[{"given":"Ji\u2010jun","family":"Shang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Orthopaedic Hospital of Xinmi City  Zhengzhou China"},{"name":"Department of Orthopaedics The Fourth Medical Center of Chinese People's Liberation Army General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen\u2010dong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Seventh Medical Center of Chinese People's Liberation Army General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dian\u2010zhong","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Fourth Medical Center of Chinese People's Liberation Army General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Fourth Medical Center of Chinese People's Liberation Army General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9201-6274","authenticated-orcid":false,"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Fourth Medical Center of Chinese People's Liberation Army General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.5312\/wjo.v7.i5.280","article-title":"Bernese periacetabular osteotomy for hip dysplasia: surgical technique and indications","volume":"7","author":"Kamath AF","year":"2016","journal-title":"World J Orthop"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198807000-00006"},{"key":"e_1_2_6_4_1","first-page":"239","article-title":"Periacetabular osteotomy: the Bernese experience","volume":"50","author":"Siebenrock KA","year":"2001","journal-title":"Instr Course Lect"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/112070000801800205"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-5119-2"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-17-00623"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.JOACP_35_18"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.86B4.14508"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016647977"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-10-167643"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.5301\/hipint.5000062"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12910"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-015-4334-6"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20151222-10"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000161825.90633.12"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453679608995620"},{"key":"e_1_2_6_18_1","doi-asserted-by":"crossref","first-page":"366","DOI":"10.4172\/2155-6148.1000366","article-title":"The impact of hypotensive epidural anesthesia on distal and proximal tissue perfusion in patients undergoing Total hip arthroplasty","volume":"4","author":"Danninger T","year":"2013","journal-title":"J Anesth Clin Res"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200103000-00003"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011967"},{"key":"e_1_2_6_21_1","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1302\/0301-620X.97B12.35797","article-title":"Tranexamic acid reduces the blood loss and blood transfusion requirements following peri\u2010acetabular osteotomy","volume":"97","author":"Wassilew GI","year":"2015","journal-title":"Bone Joint J"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12202"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2009.01223.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410180108040"},{"key":"e_1_2_6_25_1","doi-asserted-by":"crossref","first-page":"e1147","DOI":"10.3928\/01477447-20160819-08","article-title":"Factors that predict blood loss after Bernese Periacetabular osteotomy","volume":"39","author":"Novais EN","year":"2016","journal-title":"Orthopedics"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.12794","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.12794","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.12794","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T13:22:38Z","timestamp":1693747358000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.12794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,11]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/os.12794"],"URL":"https:\/\/doi.org\/10.1111\/os.12794","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,11]]},"assertion":[{"value":"2020-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}