{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:17:52Z","timestamp":1787019472146,"version":"build-2736575974"},"reference-count":36,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2009,12,1]],"date-time":"2009-12-01T00:00:00Z","timestamp":1259625600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose.<\/jats:title>\n                    <jats:p>To compare outcomes of 2 types of perioperative optimisation for patients with sickle cell anaemia (SCA) undergoing various orthopaedic surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>12 female and 11 male patients aged 13 to 40 (mean, 18) years with SCA underwent 31 separate orthopaedic procedures for osteonecrosis of the femoral head. They were referred to a haematologist for 2 types of perioperative optimisation, based on the choice of the attending paediatrician. In the aggressive management group, patients received packed red blood cells preoperatively to increase the haemoglobin level to 9 to 11 g\/dl and to lower the haemoglobin S level to &lt;30%. Fresh frozen plasma was given when their Factor VII level was &lt;30%. In the conservative management group, patients received packed red blood cells preoperatively to increase the haemoglobin level to a minimum of 10 g\/dl. Fresh frozen plasma or packed red blood cells were given intra-operatively only when excessive bleeding occurred. The length of hospital stay, the number of perioperative complications, the number of transfusions, and episodes of alloimmunisation and\/or vaso-occlusive crises in the two groups were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>No patient in the aggressive management group received supplemental oxygen or had an estimated intra-operative blood loss of &gt;400 ml. Three patients in the conservative management group received multiple intra- and post-operative transfusions and supplemental oxygen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>Both aggressive and conservative protocols may be safely used in SCA patients. The more aggressive protocol resulted in lower rates for postoperative complications, transfusions, and resorting to supplemental oxygen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/230949900901700321","type":"journal-article","created":{"date-parts":[[2016,10,4]],"date-time":"2016-10-04T17:14:58Z","timestamp":1475601298000},"page":"346-350","source":"Crossref","is-referenced-by-count":14,"title":["Perioperative Management for Orthopaedic Patients with Sickle Cell Anaemia"],"prefix":"10.1177","volume":"17","author":[{"given":"German A","family":"Marulanda","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Sport Medicine, University of South Florida, Tampa, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina P","family":"Minniti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hematology-Oncology, Center for Cancer and Blood Disorders, Children's National Medical 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