What is already known on this topic: Local infiltration analgesia in combination with a multimodal pain approach helps for adequate postoperative pain control. Blood saving alternatives should be implemented in the process of primary total hip and knee arthroplasties. The endpoint in patient blood management studies is usually Transfusion. What this thesis adds: Local infiltration as defined in this study can be used safely in combination with an autologous blood transfusion drainage system. Key clinical components of a randomised trial are frequently inadequately taken into account when performing a systematic review. The endpoint transfusion in patient blood management studies needs additional information to make it a strong endpoint What is necessary in the future: More evidence based practice, use the correct available evidence in the light of your own hospital figures, in patient blood management. More adequate reporting of and explanations for the transfusion decisions made in patient blood management trials.UBL - phd migration 201
