Background: Measurement of quality of life (QOL) and functional status provides important additional information for priority setting in health policy formulation and resource allocation. Our aim was to define the differences in the health-related quality of life between hip artroplasties with cementation and without cementation. The last objective was to reunite evidences on the advantages and disadvantages of both systems of hip arthroplasty fixation. Methods: We analyzed a random sample of patients in surgical waiting list of total hip arthroplasty, between 65 and 75 years, divided in two groups of 40 patients who received a cemented or uncemented THA, respectively. We compared the pre-operative characteristics and at a year after operation changes in the Nottingham Health Profile (NHP) and SF-12 self-administered questionnaires. We also performed the specific Harris hip score. To make the different scoring systems comparable, all scores were transformed to a 0-to 100-point scale, with 100 points indicating best health. Differences among these groups were compared using the Mann-Whitney U test. Results: All patients increased their QOL scores. Both groups had similar QOL scores before surgery. At 1 year, patients with the uncemented prosthesis had slightly higher scores for energy, pain, and emotional reaction. Changes in QOL scores were, however, very similar. Conclusions: The use of an uncemented prosthesis does not impair early outcome.

Background: Total knee replacement (TKR) failure is usually due to alignment, stability or fixation defects. Objective: To quantify the loads distribution using an absorptiometric method with two different tibial stems.

Methods: We analyzed 20 patients with cemented TKR, in two groups: one of them cylindrical and the other with cruciform stem. We studied the periprosthetic bony density evolution in three areas: under the stem, internal and external baseplate. We performed dual-energy x-ray absorptiometric (DEXA) measurements at 2, 3 and 7 years of follow-up.

Results: The evolution of the bony density under the internal baseplate to 2 and 3 years decreased from 0.920.20 to 0.900.19 g/cm2; under the external baseplate changed from 0.970.36 to 0.970.38 and under the stem raised from 1.050.25 to 1.080.26 in the cylindrical group. In the cruciform group, under the internal baseplate decreased from 0.750.08 to 0.710.05, under the external one decreased from 0.890.01 to 0.850.07 and under the stem changed from 1.060.06 to 1.040.29.

Comparing only the cylindrical subgroup (three missing patients), the DEXA measurements at 2, 3 and 7 years of follow-up were: 0.88, 0.84 and 0.80 g/cm2 under the internal baseplate; 0.79, 0.78 and 0.77 under the external one, and 0.99, 0.96 and 0.99 under the stem.

Conclusions: Loss of bony density is observed progressively after TKR. Comparativily, the diminution is greater for the cruciform stem. The internal compartment is more affected.

Aims: To study the utility of a computer assisted orthopaedic surgery (CAOS) wireless system (navigator) in Total Knee Arthroplasty (TKA). Methods: Randomised prospective study. A sample of 40 TKA patients was randomised in two groups: CAOS was used in 20 of them. In the other group standard technique with manual alignment was performed. Femoral angle (formed between the femoral mechanical axis and the femoral component), tibial angle (formed between the tibial mechanical axis and the tibial platform) and femorotibial angle (formed between femoral and tibial mechanical axes) were measured from Computed Tomography Surviews taken in the immediate postoperative period. Results: In the standard group (without navigator) the femoral angle mean was 91.7° (ranged 90 to 94°). Tibial angle mean was 90.2° (87°–95°) and femorotibial angle mean was 175.9° (172°–180°) showing a slight prevalence of varus deviation of the extremity mechanical axis. In the group with navigator the femoral angle mean was 90.2∞ (87–93°), tibial angle mean 89.6°(85°–93°) and femorotibial angle mean 179.2° (177°–182°). There were statistically significant differences between groups for the femoral angle (p=0.001), and the femorotibial angle (p < 0.001). An ideal femorotibial angle (180±3°) was achieved for all the patients of the CAOS group but only 9 patients of the standard technique group reached this objective (p< 0.001). Conclusions: The use of CAOS for TKA favors the implant placement in a position nearer to the ideal mechanical axis.