Introduction: Nowadays, the use of antibiotic-impregnated cement in revision total knee arthroplasty procedures is widespread, and a substantial body of evidence demonstrates its efficacy in deep infection prevention

Nevertheless, it is not clear that it is necessary or desirable as a routine means in primary total knee arthroplasty.

Some European studies demonstrate that the use of antibiotic-impregnated cement, shows to be effective in the prevention of early to intermediate deep infection following primary total knee artrhoplasty

Material and Methods: A retrospective review of 642 primary total knee arthroplasties (Legacy-Zimmer) was made between 2003–2006

Two groups were established:

A group of 296 patients with a primary total knee arthroplasty cemented without impregnated antibiotic.

The mean follow up was 12 months.

We analyze the differences in the infection rate between the two groups, within the first year of follow-up

Results: No significant differences were found between groups in terms of demographic variables, surgical procedure duration, tourniquet time, postoperative blood transfusion index or medical complications.

10 postoperative deep infections were found in the antibiotic non-impregnated cement group (3.3% of infection)

A comparative analysis was performed which showed to be statistically significant.

Conclusions: Gentamycin-impregnated cement shows statistically significant effectiveness in the prevention of early to intermediate deep infection following primary total knee artrhoplasty

Introduction: Scaphoid fractures are the most common carpal fractures, mainly affects young man.

The fixation of the displaced fractures is well accepted, but more controversy is seen with the fixation of nondisplaced fractures.

Surgery offers less cast time, and faster return to daily and sports activities.

MATERIAL AND Methods: We present 20 patiens (17 man- 3 woman), mean age 31 years old, that sustained a nondisplaced scaphoid fracture.

Surgical treatment was performed with a volar percutaneous fixation with a Herbert canulated screw. Patients were casted for 1–2 weeks and then rehabilitation was started.

Results: 60% of the fractures were produced after low energy trauma.

Functional evaluation 2 months postoperative were flexion 60°, extension 55°, radial deviation 21, ulnar deviation 18°.

Patients returned to sports activities at 11 weeks and at 13 weeks to their previous work.

Time to bone union was 9 weeks

In 5 cases pain in the place of the surgical scar were present, we had one case of sensitive branch lesion.

Conclusions: The percutaneous fixation of the nondisplaced scaphoid fractures with a Herbert screw allowed a fast functional recovery, good union rate and few complications.

Introduction: Knee replacement surgery is associated with minimal intraoperative blood loss, but marked postoperativelloss.

Allogenic blood transfusions are associated with known risks.

The need to establish programmes of blood conservation in knee replacement surgery becomes evident.

We present a retrospective comparative study of 3 blood salvage methods used in TKR: autologous blood donation, cell saver and tranexamico acid.

The purpose of this study is to asses the results of tranexamic acid compared with other used methods.

Material and methods: We reviewed 90 TKR operated during 2002–2003 with the same technique and by the same surgical team.

3 patients cohorts have been done based on the blood saving method used,

Patients and surgical variables were recorded, to confirm the homogeneity of the groups.

Haemoglobin and hematocrit levels in preoperative, early postoperative and late postoperative were collected, as well as blood loss and the number of blood units transfused.

Results: The statistic analysis of the 3 groups didn’t show any differences between them, assuring the homogeneity.

ANOVA statistical analysis was done, showing significative differences in the early postoperative Hb and HTC, 9.4 g/dL −28.1% in autologous group, 9.6g/dL−28.5% in cell saver group and 10.8g/dl−31.4% in the tranexamic acid group.

Total blood loss was 1088.5 mL in the autologous group, 1080mL in the cell saver group and 690.3 mL in the tranexamic acid group, showing significant differences (p.< 0.001).

The autologous group received 1.4 units of blood per patient, compared with 0.6 in the cell saver group and 0.2 in the tranexamic acid group (p< 0.05).

Conclusions: We conclude that the use of tranexamic acid in total knee replacement reduces postoperative blood loss, keeps Hb and HTC during the postoperative and significatively reduces the need of blood transfusion compared with other systems.