The aim of this study is the presentation of the midterm results of the radial head replacement with pyrocarbon head prosthesis (MoPyc).

Thirty two patients (20 males and 12 females) with a mean age of 54 y.o. (32–68 y.o.) were subjected to replacement of the radial head with a pyrocarbon head prosthesis. Twenty of them had a comminuted radial head fracture(15 Mason IV type and 5 Mason III), two had a malunion and ten had a complex elbow injury (ligamentous rupture and comminuted radial head fracture with/without coronoid process fracture). In 22 patients the fracture was on the dominant side. The mean follow up time was 27 months (21 – 46 months).

The post-operative results were:

The mean range of motion in flexion-extension was 130° (105° to 150°), while in pronation and supination was 74° (60°–80°).

Pain was evaluated with a visual analogue scale. Finally there was also a radiographic evaluation of the patients (that yielded six cases of loosening or osteolysis without any clinical manifestation)

Replacement of the radial head with the specific prosthesis leads to very satisfactory results when performed under specific indications.

Background. The postoperative salvage and re-infusion of autologous blood, has become a very attractive alternative to allogenic transfusion, especially in patients that undergo primary Total Knee Arthroplasty (TKA). The increased demand for blood that is required during this operation, the fear of transfusion-related diseases and the continuingly increasing pressure that is forced on hospitals’ blood depots has rendered this procedure quite popular. In order to assess the efficacy of autologous blood drainage and re-transfusion as far as the amount of salvaged blood, the need for allogenic transfusion and the effect of this procedure on the postoperative haemoglobin value are concerned, we conducted a prospective study.

Methods. One hundred and fifty five patients suffering from primary osteoarthritis of the knee that were treated with TKA in 2002 were included in this study. A tourniquet was used in all cases. In Group A» (n=77) it was released prior to the wound closure in order to achieve haemostasis and 2 standard suction drains were then placed. In Group B» (n=78) it remained until the completion of the operation, an auto-transfusion system was placed and the salvaged blood was re-transfused within 6 hours postoperatively. Group’s «B» patients were further divided into 2 subgroups according to the administration or not of methylprednisolone before the auto-transfusion. The patients’ haemoglobin and platelets were measured before, at 8 and 24 hours after surgery. The days of postoperative fever were also noted.

Results. Over 170 units of blood were salvaged and re-transfused. No Group B» patient received allogenic blood preoperatively. Group’s B» patients received only 42 while Group’s A» 124 units of allogenic blood. Patients who received autologous blood had higher levels of haemoglobin at 8 (p< 0.05) and at 24 hours postoperatively (p< 0.01) and needed less allogenic blood (p< 0.01). The administration of methylprednisolone ameliorated the postoperative febrile movement (p=0.01).

Conclusions. Postoperative blood salvage and re-tperfusion in patients undergoing TKA, was found to be an efficient, safe and patient-beneficial method.