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Background: There are risks related to blood incompatibility and blood-borne diseases when using allogeneic blood transfusion. Several alternatives exist today, one of which, used for autologous blood salvage perioperatively, is the Sangvia Blood Management System. This study was designed to investigate the efficacy of the system and to add data to previously reported safety results. Methodology/Principal Findings: Two hundred sixteen patients undergoing primary or revision total hip arthroplasty (THA) were enrolled in this randomized, controlled, assessor-blinded multicenter study. Randomization was either autologous blood transfusion (Sangvia group) or no use of autologous blood (Control group), both in combination with a transfusion protocol for allogeneic transfusion. Patients were followed during hospital stay and at two months after discharge. The primary outcome was allogeneic blood transfusion frequency. Data on blood loss, postoperative hemoglobin/hematocrit, safety and quality of life were also collected. The effectiveness analysis including all patients showed an allogeneic blood transfusion rate of 14% in both groups. The efficacy analysis included 197 patients and showed a transfusion rate of 9% in the Sangvia group as compared to 13% in the Control group (95%CI 20.05-0.12, p = 0.5016). A mean of 522 mL autologous blood was returned in the Sangvia group and lower calculated blood loss was seen. 1095 mL vs 1285 mL in the Control group (95%CI 31-346, p = 0.0175). No differences in postoperative hemoglobin was detected but a lower hematocrit reduction after surgery was seen among patients receiving autologous blood. No relevant differences were found for safety parameters or quality of life. Conclusions/Significance: General low use of allogeneic blood in THA is seen in the current study of the Sangvia system used together with a transfusion protocol. The trial setting is underpowered due to premature termination and therefore not able to verify efficacy for the system itself but contributes with descriptive data on safety. [ABSTRACT FROM AUTHOR]

The benign fibrous histiocytoma is a rare tumor with only a few descriptions. In order to better define the optimal therapeutic procedure and the necessity of surgery we retrospectively analyzed the patients of the orthopedic department. Benign fibrous histiocytoma occurred in the femur (n = 3), pelvis (n = 2), humerus, tibia, fibula, rib and spine. Pain as the cardinal symptom and a median age of 28 years are factors that differentiate benign fibrous histiocytoma from other metaphyseal fibrous lesions such as the nonossifying fibroma. Radiographic investigation of this entity showed osteolytic lesions with eccentric thinning of the cortex and small fissures. To a variable extent, sclerosis was found in the margin of the lesions. Computer tomography revealed dense soft tissue in the lesions, but one lesion was filled with fluid. The tumor was restricted to bone, with no periosteal or soft tissue reaction. Magnetic resonance imaging showed enhancement of the tumor after administration of contrast medium. All lesions had uniform histological findings. Although no pathologic fracture occurred in any case, local expansion of the tumor was indicated by cortical thinning, small fissures and pain. This implied that the patients needed prophylactic curettage and bone grafting. Surgery restricted to the osteolytic area was sufficient to prevent recurrence.