We studied the influence of different femoral alignment systems on blood loss and the need for blood transfusion after total knee arthroplasty. We retrospectively recorded the blood loss in two groups of consecutive patients. The first group consisted of 46 patients in whom the total knee arthroplasty was performed using an intramedullary femoral alignment system and the second group consisted of 45 patients in whom the procedure was performed with the extramedullary system.

In the first group, the mean volume of drained blood was 758 milliliters, while in the second group it was 613 milliliters (p< 0.05). More patients in the first group required blood transfusions, but there was no significant difference in the number of blood units transfused per patient.

In conclusion, extramedullary femoral alignment instrumentation reduces the blood loss after the cementless total knee arthroplasty.

Aim: To evaluate the clinical and radiological results of hydroxyapatite stem in primary total hip replacement.

Method: A prospective review was performed on 22 osteoporotic patients (Singh index 1–3) with hydroxyapatite-coated total hip replacements. These results were compared with a control group (Singh index 4–6) of 45 patients (48 hips) with respect to clinical and radiographic data. Surgery was performed over a six year period (1991–1996) and the time to follow-up evaluation averaged 5 years (range 2–7 years). Clinical evaluation was based on the Harris Hip score and radiographic evaluations using Engh’s criteria.

Results: There was no significant difference between the final average Harris hip score in the osteoporotic bone group which was 87 points and that for the control group which was 91 points (p> 0.05). Radiographic evaluation demonstrated confirmed bone ingrowths in all patients except for one patient in each group, each with suspected bone ingrowth. There were no stems revised for aseptic loosening and no endosteal lysis was found. Progressive bone formation was seen around the femoral stem proximally. The acetabular components demonstrated no sign of mechanical loosening or osteolysis. Bone formation was found in most patients in zone I, and less in zone III.

Conclusion: The basis of the results of this study, it is believed that osteoporotic bone as a factor by itself should not compromise the early results of hydroxyapatite total hip arthroplasty and hopefully give as good results n the long term.