Orthopedic surgery is one of the most blood-consuming surgeries. Currently there has been a radical change in transfusion policies, developing a series of therapeutic measures essentially created to minimize the use of allogeneic blood.

On the one hand, the safety of our patients must be even more our main objective. On the other hand, our economic resources are more restricted and therefore we must evaluate our surgical techniques and proceedings in order to be safer and more cost-effective.

The aim of this study is to report our results of the blood lost, the percentage of blood loss, the necessity of transfussions and how many blood pakages are needed.

From a sample of 2400 total knee arthroplasties proceedings, we analyze some surgical proceedings such as lligament balance, patelar traking, artrotomy, ischemia, femoro-tibial axis and type of arthroplasty.

We also examine the total blood lost and the percentage of total blood loss after 4 hours, after 24hours and after 48 hour of the total knee arthoplasty surgery.

We made a statistical analysis with t-test or anova test when it was necesassary.

The outcome of our investigation show that the blood loss when the ischemia is less than 50 minutes is 1470 cc and 1603 cc when is more than 50 minuntes (p<0.05). If we use the medial arthrotomy, the total bleeding is 1563cc, but with subvastus arthrotomy is 1294cc (p<0.05). If we use a primary rotational total knee arthroplasty the bleeding is 953cc, but if we use a PS or PCR the bleeding is 874cc (p<0.05).

As a conclusion we should know that our patients have more blood loss when the ischemia is more than fifty minutes, the bleeding is higher when we make a medial arthrotomy and when we use a rotational knee primary arthroplasty.

Objective: Exogenous hyaluronic acid (HA) acts as a lubricant and shock absorber, and is considered to have many other beneficial effects in the joint. Several studies have shown that HA is able to provide pain relief and promote the synthesis of endogenous HA and protect the cartilage and synovia by covering joint surfaces. The objective of this study is to investigate wheter an isotonic solution of hyaluronan reduces post-arthroscopic symptoms in the knee such as joint pain, swelling and impairment of function when injected into the joint following arthroscopic surgery.

Material and Methods: A total of 93 patients (66 men, 27 women) were assessed in a multicentre, controlled study conducted by several investigators from different orthopedic surgery departments in Spain. All investigators were highly skilled in arthroscopy. Patients were allocated into two groups, control group (45 patients) or treatment group (48 patients). The treatment group received an injection of 10ml of isotonyc solution of hyaluronan (ISH) 0.5% with a physiological pH value at the end of the knee arthroscopy after final lavage with normal irrigating solution. Untreated patients underwent standard arthroscopic surgery (meniscectomy or articular lavage) and did not receive any further treatment on completion of the procedure. Pain in patientes were assessed using a 100mm visual analog scale (VAS). Between-group comparative analyses were performed before surgery and 1 and 4 weeks after surgery using a Mann-Whitney U-test.

Results: One week after surgery, a significant reduction in pain (up to 17%) was observed for patientes treated versus control patients (p< 0.01). This improvement was maintained until week 4, although the difference between control group and treated group decreased over time. The area under the curve of VAS was 39% lower for treated patients versus untreated patients. On comparing both groups, there was a significant 8% difference in the reduction of other functional symptoms at 1 week after surgery but no difference at 4 weeks after surgery. No adverse events were reported.

Conclusions: The results show that there were was a significant decrease in pain in the first week after surgery, accompanied by a significant reduction in sum of symptom scores. These results suggest that ISH accelerates post-arthroscopy recovery during this important period by reducing pain and discomfort, and increasing the mobility of the affected knee.