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Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 326 - 326
1 May 2006
Silvestre A Argüelles F Arana E García-Gomez J
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Introduction and purpose: We present a new decision-making method to assist orthopaedists and radiologists in diagnosing soft-tissue tumours. It can distinguish between benign and malignant characteristics in these lesions and classify them histologically with satisfactory efficiency. The pre-surgical diagnosis of the nature of the tumour and whether it is benign or malignant is crucial to planning surgical procedures.

Materials and methods: We reviewed our cases of soft-tissue tumours (47) studied by MRI over the past year and a half. They are part of a multicentre study involving several European hospitals (430 patients).

We analysed the clinical and MRI data: age, clinical presentation, size, shape, location, edges, image signal, calcification, intratumour fat, dependency, fibrosis, relation to fascias, bone and vessel disorders.

Results: With this method we detected 62% benign tumours and 38% malignant. The system sensitivity and specificity are 86% and 95%, respectively.

Conclusions: It is easy to distinguish between vascular, nerve and cystic lesions. The diagnosis of fibrous, synovial and fatty lesions is complex in all cases.

The method can help orthopaedists make a diagnosis before surgery, which will facilitate planning of surgical procedures.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 325 - 325
1 May 2006
Lòpez R Goterris R Pascual A Silvestre A Teruel A Arbona C Gomar F
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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.