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: 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.

Introduction: The hypothesis of this work is to demonstrate that the Flexible Flat Foot (FFF) in children is not affected for any kind of treatment. The objective is: 1.-Rate the evolution of FFF during growing. 2.- Evaluate the accuracy of diagnosis criterion. 3.-Appoint the optimal age to diagnose and treat the FFF. 4.- Evaluate the different kinds of treatment.

Material and methods: 242 children of both sex, aged between 3 and 5 years old, diagnosed of flexible flat foot. We compare three groups of treatment during three years. One group were treated with orthopaedic shoes and internal wedges, other with inserts, and the third were a control group. We evaluated: Clinical findings: age, sex, flat foot family antecedents, weight, degree of flat foot, valgus of ankle, age of begin to walk, ligament hiperlaxity, vicious direction of leg axis and erosion of shoes. Radiological measurements: An astragalus-1°metatarsian, Moreau and Costa-Bartani, and astragalus-calcaneus divergence angles, valgus of ankle according Viladot system. We perform a walking test with an electronic baropodometer “PEL 38” with 20 children of every group.

Results: An 85 % child of our series has been normalized with growing. The overweight and ligament hiper-laxity are the most predisponent family antecedents. The Jack Test is not a prognostic factor of FFF. The vicious direction of leg is not related with the FFF. The valgus of ankle is physiologic. X-ray are not reliable to diagnose a FFF in children, while the walking test give us dates about the dynamic behaviour of FFF.

Conclusions

– The flexible flat foot in children is normally corrected with growing and is a normal step of foot evolution.