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
Two groups were established:
A group of 296 patients with a primary total knee arthroplasty cemented without impregnated antibiotic. In the second group of 346 patients a primary total knee arthroplasty was performed with the use of gentamycin-impregnated antibiotic in all cases. 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
10 postoperative deep infections were found in the antibiotic non-impregnated cement group (3.3% of infection) 3 postoperative deep infections were found in the antibiotic-impregnated cement group (0.09% of infection) A comparative analysis was performed which showed to be statistically significant.
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.
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.
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.
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.
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.
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).