Traditional use of tourniquets and reinfusion drains in total knee replacement (TKR) has recently been challenged. Many studies have challenged the benefits of their use. Our aim was to compare the outcomes of three different blood management techniques in primary TKR. We conducted a prospective randomised study of 87 patients with a mean age of 71 years. All patients were randomised into three groups: Group A (29 patients without tourniquet and drain), Group B (27 patients without tourniquet or drain but cell salvage system) and Group C (31 patients with the use of tourniquet and drain). The results showed no difference between the postoperative haemoglobin drop and blood transfusion rate between the groups. At day two, range of knee movements (Group A: 80.2 degree; Group B: 79.6 degree; Group C: 77.9 degree) showed no significant difference. Two Group C patients (6.4%) had postoperative thromboembolic events (one DVT, one TIA). Knee stiffness leading to readmission (Group A: 6.8%; Group B: 7.4%; Group C: 3.2%) and superficial wound problems did not reveal any significant difference. The average operative time and hospital stay were the same in all groups and there was no wound haematoma or deep infection in any groups. There was no statistical difference between the groups for any outcome measure assessed thus the use of tourniquets and drains in total knee arthroplasty are controversial and questionable. We can conclude that all techniques are safe and it is the surgeon's choice as to which they apply routinely in their clinical practice.
Osteoarthritis of basal joint of the thumb represents one of the commonest degenerative diseases of the hand and wrist region. Depending on the severity of clinical symptoms surgical treatment is often recommended. Resection arthroplasty of the CMC joint with tendon interposition can be regarded as the gold standard. The aim of our study is to compare the Burton Pellegrini technique with a new modified technique of resection arthroplasty with interposition of local capsule tissue. We retrospectively evaluated 2 groups of patients. Two Consultant Surgeons took part in the study, one for each group, with each consultant performing trapeziectomies using only one of the techiniques for all his patients. The first group underwent trapeziectomy and local capsule interposition. It consists of 26 patients with a female/male ratio of 20/6, an average age of 64 years (range 53–88), an average follow up of 3.15 years (range 9–1) and a left/right ratio of 16/10. The second group underwent a standard Burton Pellegrini including flexor tendon interposition. It consists of 13 patients with a female/male ratio of 5/8, an average age of 68 years (range 58–85), an average follow up of 4.46 years (range 9–1) and a left/right ratio of 5/8. The outcomes were compared using the Michigan Hand Outcomes Questionnaire. A 2-tailed independent samples t-test was used for the statistical analysis of our data.Background
Materials and Methods
The traditional use of pneumatic tourniquets and reinfusion drains in total knee replacement (TKR) has recently been challenged and the aim of our study was to compare the outcomes of three different blood management techniques in primary TKR. We prospectively conducted a study of 87 patients with mean age of 71 (44-91) years old. They were randomised into three groups: Group A: 29 patients without the use of tourniquet and reinfusion drain, Group B: 27 patients without the use of tourniquet and reinfusion drain but application of intraoperative cell salvage system and Group C: 31 patients with the use of tourniquet and reinfusion drain. All groups were well matched and all patients were reassessed at the 2nd postoperative day.Purpose
Methods
