Introduction and purpose: Methods are needed to store blood for scheduled surgery with high transfusion requirements. We evaluated the transfusion requirements in patients undergoing surgery for total hip replacement (THR) and the results of the autotransfusion programme.

Materials and methods: We assessed 211 patients who underwent primary or secondary THR between November 1999 and November 2004 and were included in the blood-storing programme. The variables analysed were: sex, age, operation, start of weight bearing, hospital stay, units extracted and transfused, basal hemoglobin and follow-up and use of allogeneic blood.

Results: 177 patients entered the programme, 14 on EPO and 13 with no blood-storing procedure. The mean age was 61.8. The male/female ratio was 1.5, and 109 patients (52%) were transfused. We found differences (p< 0.01) between non-transfused and transfused patients in relation to their basal Hb (14.4 vs 13.7), start of weight bearing (4.6 vs 9.6 days) and hospital stay (9.1 vs 10.3 days). Of the patients in the autotransfusion programme, 58% (103) required transfusion and used 54% of the units extracted. Seven percent (13) required allogeneic blood. Of 138 patients with primary THR, 80 were transfused – 83% women and 36% men (p< 0.001). Of the 39 revision THRs, 23 patients were transfused with no differences between the sexes. Overall, 31 units of allogeneic red cell concentrate were used, 192 autologous. 87 patients required 2 units, 15 patients 1 unit and one patient 3 units.

Conclusions: The autotransfusion programme for THR patients is adequate for storing allogeneic blood. Nevertheless, it should be included in this protocol via an individualised interdisciplinary programme.

Introduction and Objectives: Among the pathological conditions associated with the subacromial space is rupture of the rotator cuff. Patients affected by this injury have a poorer response to medical or rehabilitative treatment than do patients with subacromial injuries without concurrent tearing of the rotator cuff. For this reason, surgical treatment is more often needed. Surgical treatment includes the excision of subacromial osteophytes and repair of the affected tendon. Even though acromioplasty can be performed arthroscopically, cuff repair generally requires small incisions due to the technical complexity of the procedure.

Materials and Methods: We have carried out a prospective study of 36 patients with torn rotator cuffs diagnosed by MRI who underwent acromioplasty performed with an incision of approximately 4cm when necessary and cuff repair either by direct suturing or reinforcement with rotator cuff plasty performed by the same surgeon. The rehabilitation protocol included early mobilisation at 24–48 hours, passive assisted mobilisation until the 4th week, and active mobilization after the 5th week. Follow-up time was a minimum of one year with pre- and postoperative Constant scale evaluations. We compared various results including previous duration of symptoms, the severity of cuff tearing, and the surgical technique that was used.

Results: Favorable results were achieved in terms of pain relief and restoration of mobility compared to the preoperative period, even though strength was not equal to that of the contralateral shoulder.

Discussion and Conclusions: Open surgery for rotator cuff tear repair continues to be the best surgical option if a small incision is made, good technique used, and early rehabilitation is performed.

A case of duplication of the patella in the coronal plane is reported. Previously reported cases of double patella have shown sagittal or vertical duplication, and some have been associated with multiple epiphyseal dysplasia. In our case, excision of one patella and realignment of the extensor mechanism relieved symptoms of giving-way.

The effects of gamma irradiation on the growth plate have been studied in nineteen rabbits with a 1,000 rads/skin dose. The rabbits were killed after one to ninety days. The growth plates were studied by microscopic examination, thymidine-H3 autoradiography, and fluorescence with radiographic measurement. Changes were already detected after twenty-four hours at the cell mitosis level, which showed the sensitiveness of the chondrocyte itself. The lesions were clearly seen with the optical microscope after seven days, and they were most advanced between the fourteenth and twenty-first day after irradiation. Regeneration of the cartilage began in the fourth week and the histological appearance became normal after seventy days. Fluorescence with tetracycline showed a temporary retardation of growth, with consequent shortening of the affected limb.