The aim of this study is to evaluate the mid-term results of the Genesis Total Knee Prosthesis, one of the first prostheses with asymmetric shape of the tibial component .The arthroplasty was performed on our patients with retention of the posterior cruciate ligament and, in most of the cases, without replacement of the patella. During the period 1992–1999, 90 patients (116 knees) were operated in our clinic: 81 of them were women and 9 were men with an average age of 68 (52–82) years. The primary indication for the operation was osteoarthritis. 84 patients (109 knees) were evaluated clinically and roentgenographically (Knee Society Knee Score) for a mean time of 98.1 (29.6 – 137.7) months after surgery. There were no infections. (Three) Four of the patients had to undergo a second operation . Two of them, eventually, had their patellae replaced (1,5 and 3 years postoperatively) due to persisting pain of the patellofemoral articulation and lateral patellar subluxation .The other two patients had to undergo revision arthroplasty due to wear of the polyethylene component, one at five years and the other at nine years . Moreover, wear of the polyethylene was also observed on another patient, radiographically, six years after the operation. However, the patient seemed to have no symptoms and was, therefore, unwilling to undergo a revision. The clinical results were satisfactory with a Knee Score of 97(74–100) and Function Score 80 (5–100) .The mean range of motion was 113°(85°–135°). There was no evidence of loosening or any radiolucent lines found radiographically .We consider the results of the Genesis Total Knee Arthroplasty satisfactory .The asymmetric shape of the tibial condyles ensures the fitting of the tibial component. With the exception of cases of severe patella damage, replacement of the patella is not required. The presence of any problems in the patellofemoral articulation is usually connected to the maltracking of the patella or to errors in the surgical technique.

Aims: Evaluation of the efficacy of autotransfusion in reducing the need for homologous blood transfusion in total knee arthroplasty. Methods: Prospective randomized study. Patients undergoing total knee arthroplasty were divided in: Group A (72 patients) receiving autotransfusion (Suretrans) and control group B (30 patients) with suction drainage only. Preoperative Hb and demographics of the two groups were comparable. The level of Hb was followed for the first 5 days postoperatively. The amount of homologous blood transfused was also recorded. Results: The average autotransfusion volume in group A was 405±191ml. On the day of the operation and the first postoperative day the Hb in group A was found statistically significantly higher (p< 0.05). On the second and third day the Hb in group B, achieved levels comparable to group A, because patients received homologous blood transfusion. The amount of homologous blood transfused to the patients was significantly higher in group B (average: group A 0.36 ± 0.74u, group B 1.2 ±1u, p< 0.001). Multiple regression analysis suggests that the only factor reducing the need for homologous blood transfusion is the use of the autotransfusion system. Conclusions: there is a statistically significant reduction in the need for blood transfusion by using an autotransfusion system reducing also the possible dangers and complications. Autotransfusion is a simple, safe and cost effective method.

The aim of this study is to evaluate the mid-term results of the Genesis I Total Knee prosthesis (asymmetric tibial component plateaus), retaining the posterior cruciate ligament and not resurfacing the patella in all patients.

Between 1992 and 1999, 90 patients (116 knees) were operated (81 women and 9 men) of an average age of 68 (52–82) years. The indication for the operation was osteoarthritis. 84 patients (109 knees) were evaluated clinically and roentgenographically (Knee Society Knee Score). The average follow-up time was 74.1 (29.6–113.7) months.

There were no cases of infections. Three of the patients required a second operation. Two of them had their patellae replaced (1,5 and 3 years postoperatively) due to persisting patellofemoral pain. In a third patient the knee was revised due to excessive wear of the polyethylene component five years postoperatively. Moreover, major polyethylene wear was also observed six years postopertively on another patient, asymptomatic and unwilling to undergo a revision. The clinical results were satisfactory with a mean Knee Score of 97 (74–100) and a Function Score of 80 (5–100). The mean range of motion was 113° (85°–135°). There was no evidence of loosening or any radiolucent line found radiographically.

We consider the results of the Genesis I Total Knee Arthroplasty satisfactory. The asymmetric shape of the tibial condyles ensures the fitting of the tibial component. Even in cases of severe patella damage, we believe that replacement of the patella is not required. Occurrence of patellofemoral problems can be usually attributed to mal-tracking of the patella or to component malposisioning.