Introduction and Objectives: There is more experience with the use of cemented models of knee prosthesis. However, non-cemented models are proving to have equivalent survival. Our aim was to analyze our experience of long term survival of non-cemented total knee replacement prosthesis.

Materials and Methods: We included the patients operated in our unit between 1989 and 1996. In all cases the same implant was used (LCS Total Knee Replacement, Depuy, Warsaw, IN). We included a total of 129 knees (117 patients). The variables we studied were: Age, sex, follow-up time, KSS score, implant survival and reasons for revision.

Results: Follow-up was 14.5 years and mean age was 78.7 years. A total of 60 knees did not complete the study correctly. For the 69 knees that remained in the study, the results were: 11 TKR (16%) were reoperated: 2 due to dissociation-dislocation of the patellar component, 3 due to wear or rupture of the tibial polyethylene, 6 were revised due to aseptic loosening. There were no cases of infection. The mean KSS score was 90.29.

Discussion and Conclusions: In our experience, the use of non-cemented TKR prosthesis:

Provides an excellent clinical and functional result, assessed by KSS.

If we include all reoperations, survival free of reintervention was 84%.

Introduction and Objectives: Indications for surgery in the treatment of lumbar disc herniation are still the subject of some controversy, in spite of previous systematic studies demonstrating its effectiveness. Many believe that this treatment should be avoided in working patients, in whom results of vertebral surgery tend to be poorer. Health-related quality of life indicators permit the objective measurement of the degree to which the health of the patient is improved by a particular type of procedure. They also permit a comparision of health improvement for patients with various types of treatment interventions. The goal of this study is to evaluate the impact of lumbar microdiscectomy on health-related quality of life in working patients.

Materials and Methods: A total of 105 patients of working age who underwent surgery at the Vertebral Surgery Unit of an On-the-Job Accident Cooperative were evaluated prospectively. Of these patients, 89 (84.8%) were male, and 51% were working in jobs that involved heavy lifting; 68.6% had high-school or less education or no education. Patients were evaluated before and 3 months after surgical intervention using a validated Spanish version of a questionnaire on the following clinical dimensions: Health-Related Quality of Life (SF-36), Lumbar Spine Function (Oswestry’s questionnaire), Lumbar and Radicular Pain (Visual Analogue Scale). Unvalidated versions of Work Situation and Satisfaction with results (GEER scales) were used.

Results: Statistically significant and clinically relevant improvement was observed in the following parameters: Intensity of lumbar pain (preoperative: 61.7; postoperative: 33.5; p< 0.001) and radicular pain (preoperative: 76.1; postoperative: 28.4; p< 0.001), specific lumbar spine function (preoperative: 44.3; postoperative, 18.3; p< 0.001), patient satisfaction and the SF 36 Physical Function items (preoperative: 38.1373; postoperative, 71.152; p< 0.001), physical role (preoperative,6.2092;postoperative,24.8366; p< 0.001), bodily pain (preoperative, 24.5196; postoperative, 51.0882; p< 0.001), general health (preoperative, 59.2607; postoperative, 62,901; p< 0.044), vitality (preoperative, 45.8333; postoperative, 58.2843; p< 0.001), social function (preoperative: 55.6373; postoperative: 73.8971; p< 0.001), and mental health (preoperative: 61.9706; postoperative, 70.9706; p< 0.001). A statistically significant improvement was not found in emotional role (preoperative: 65.6766; postoperative, 72.9373; p=0.182).

Discussion and Conclusions: Apart from the impact on their work situation, working patients who underwent microdiscetomy for lumbar disc herniation enjoyed significant short-term clinical improvement in multiple areas of their health.