Study Design: A prospective observational study including 43 patients who underwent surgery for degenerative lumbar disease.

Objective: The purpose of this study was to know wich were the expectancies about improvement of patients who underwent a degenerative lumbar disease surgery.

Materials and Methods: Patients with a surgical indication for a degenerative lumbar disease, and followed by spine surgery unit of our insitution, were included. During the day before surgery, Health related quality of life mesures were administrated including SF-36, Oswestry Disability Index (ODI) and a questionnaire adapted to know which ones were our patients preoperative expectancies and the grade of unsatisfaction in case they didn’t accomplish those expectancies after surgery.

Results: 43 patients (22 male, 21 female) were included. Age average was 54 years (rang 22–83), average preoperative ODI value was 48,14 (SD 22’4) and average expected value was 13,14 (SD12,1), with an average of improvement of 72’8% (SD 24’8). Diagnose of estenosis with neurological simptoms was the only parameter associated to improvement in front of isolated low back pain (66,0 SD 29’3; 79’6 SD 17’6 p=0’26%). Previous state, gender, age, SF-36 scores were’nt globaly related to expectancies.

‘Pain’ and ‘to seat’ expectancies were worse in females (r= 0’40 p= 0’023). Age was associated to ‘to lift weight’(r=0’337 p= 0’041), ‘to travel’ (r=0’513 p=0’001) and borderline for ‘sexual activity’ (r=0’315 p= 0’061).

Mental SF-36 score was inversely associated to ‘pain intensity’ (r=−0’449 p= 0’013) and ‘sexual activity’ (r=−0’362 p=0’05). Patients included in our study didn’t expect any improvement for subjects as ‘Personal care’, ‘to sleep’ and ‘to lift weight’ (p=0’9 p=0’2 y p=0’7).

In the group fo workers (16 individuals, 47% of sample), the grade of unsatisfaccion in case of not to be able to return to their occupation, was low. This result was independant to age, gender and diagnose.

Conclusions: Preoperative expectancies of patients before underwent the same surgery are differents. To know about it using a Health related quality of life mesure wich gives the same especific weight to all activities of daily life without knowing which ones are more importants for our patients (according to age, gender, diagnose, social estatus..) could be a bias to evaluate results and the grade of satisfaction of them. More studies are necessary to know if the accomplishment of those expectancies affects the final result of surgery.

Introduction: Correct alignment of prosthetic components is considered one of the most important factors for TKR (total knee replacement) survival. It is our aim, in this study, to determine the degree of correlation between measurements made by 2 observers and the assistant navigator during prosthetic knee surgery.

Materials and methods: In a total of 55 non-selected patients, operated with navigator assistance, two resident physicians in our Department, using a computer system measured, during the preoperative period, the ipsilateral and contralateral femorotibial axis, the femoral and tibial axis, and the inclination of the tibial plateau. They also measured, during the postoperative period, the tibiofemoral axis by means of digitalized X-rays. These measurements were compared with those made by the navigator.

Results: The degree of correlation between measurements was variable. The greatest degree of correlation between values was that of the preoperative tibiofemoral axis, with an r of: 0.83 (0.68–0.91 CI 95%) and the lowest degree of correlation was that of the measurements of the posterior tibial inclination.

Conclusions: A large number of axes and useful measurements have been described for the planning of reconstructive knee surgery, but since the introduction of new technologies applicable in this field, it is necessary to determine the degree of reliability and reproducibility of these so they can be correctly used by the orthopedic surgeon in their everyday clinical practice.

Introduction: Prostheses radiolucent lines are currently used to evaluate the components fixation. The objective of this study is to determine concordance and reproducibility of humeral stem radiolucent lines evaluation.

Material and method: Five observers evaluated 64 x-ray belonging to 32 pairs (1 antero-posterior view and 1 outlet view) obtained from 16 shoulder prostheses. 16 x-ray pairs were obtained immediately after surgery and 16 one year after surgery. Evaluation in four degrees of radiolucent width for each of the 7 zones that the humeral component was divided for. Evaluation of the component-cement interface and the cement-bone interface. Each observer made two evaluations of the 64 x-ray separated in 6 weeks. Statistics : index kappa with quadratic weighting.

Results: Intra-observer results: mean kappa index for component-cement interface: 0,3274. mean kappa index for cement-bone interface: 0,5269. Inter-observer results: mean kappa index for component-cement interface: 0,1242. mean kappa index for cement-bone interface: 0,2478. Evaluation of 2 pairs of x-ray of the each prostheses taken in a period of 1 year: component-cement interface: mean of 91,67% of plausible results, cement-bone interface: mean of 80,2% of plausible Results:

Conclusions:

- low kappa index of reproducibility (0,3274–0,5269) of humeral component radiolucent lines evaluation for component-cement interface as well as for cement-bone interface.

Background and goal of study: Although a great percentage of the total postoperative bleeding corresponds to a hidden blood loss in the tissues and joint, visible blood from the drainage is considered the gold standard for monitoring blood loss after a knee arthroplasty. Only one study was not able to find a consistent relationship between the total blood loss and postoperative drained blood. The aim of our study was to assess the usefulness of a postoperative drainage as a monitor of bleeding following a knee arthroplasty.

Material and methods: Fifty patients undergoing unilateral arthroplasty from March to November 2004, were prospectively followed until the fourth postoperative day. Drained red blood cells(RBC) loss was assessed by multiplying the drained blood volume by an haematocrit (Hct) of 30% from a pilot study. Total RBC loss and hidden RBC loss from each patient were calculated. Regression analysis was performed to assess the relationship between the total RBC loss and drained RBC loss.

Results and discussions: The average age of the fifty ASA 2 patients was 72 +− 7 years. Nearly all the procedures were performed under intradural anaesthesia. Cemented technique and tourniquet were used in all cases. The mean total RBC loss was 615 +−197ml. The mean drained RBC loss was 206+− 113ml, and mean hidden RBC loss was 414 +−194ml. Thus the hidden loss was 67% of the total blood loss. Regression analysis shown a poor correlation coefficient between the total RBC loss and drained RBC loss (r= 0.31, p< 0.03).