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Objectives: We present the medium-term results of 453 primary, posterior cruciate retaining total knee replacements.
Methods: We used the Genesis I prosthesis to 453 knee-joints between 1993–2001. The patients included were 386 (67 bilateral) with age between 58–87 years (aver. 68,5 yrs). The diagnosis was osteoarthritis in 418 cases, rheumatoid arthritis in 21 cases, post-traumatic arthritis in 9 cases and osteoarhritis combined with rheumatoid disease in 5 cases. The knees flexion was ranged from 60° to 120° and the extension from 0° to 20°. In 423 cases a 5°–30° varus knee and in 31 cases a 5°–20° valgus knee was documented. The Genesis I knee prosthesis was used with cement, without patellar component implantation. The postoperative protocol included early weight bearing and follow up on the 3rd, 6th,12th month and every year.
Results: The follow up period was ranged from 2 to 10 years (aver. 5,2 yrs). Superficial infection was noted in 5 patients with a satisfactory outcome, pneumonic embolism in 3 (1 death) and deep venous thrombosis in 7 patients. The clinical and radiological assessment followed the Knee Society standards. Postoperatively the flexion was ranged from 80° to 130° with full extension of the knees. The preoperative varus &
valgus deformity was totally corrected. No signs of mechanical loosening were documented. No revision surgery was needed. All the patients are happy with a good level of every day activity.
Conclusions: Our results eight years postoperatively are quite satisfactory (98%). All the prosthesis exhibit good behaviour and we believe that this type of prosthesis is a positive solution for the arthritis of the knee which needs surgical assessment.
Aim: The scope of this study is to estimate the blood loss in major orthopaedics operations in the 24 and 48 hours, in order to evaluate the need of drainage for more than 24 hours.
Material-Methods: 100 consecutive in-patients included in this study and we formed 4 groups. Group A: THR (cemented-cementless), group B: TKR, group C: hemiarthroplasty, group D: DHS due to intertrochanteric fracture. We applied a drainage in all the patients for 48 hours and we measured the blood loss in 24 and 48 hours, the Hb for the next three days and the transfusion units.
Results: In group A the mean blood loss is 513, 75 ml in 24 hours and 147,08 ml in 48 hours. In group B the mean blood loss is 559, 62 ml in 24 hours and 91,31 ml in 48 hours. In group C the mean blood loss is 190 ml and 35, 6 ml in 48 hours. In group D the mean blood loss is 140, 48 ml and 16, 4 ml in 48 hours.
Conclusions: There is no need to keep the drainage more than 24 hours in the groups of hemiarthroplasty and DHS since the blood loss after 24 hours is minimum. We suggest to keep the drainage more than 24 hours in the groups of THR and TKR since there is significant blood loss after 24 hours.