Autogenous bone marrow grafting for treatment of nonunited fractures

A prospective study on fifty eight patients with establish nonunion of different bone segments was carried out. Patients were treated by autogenous bone marrow aspiration and re injection at the site of nonunion. Eight of those patients were lost on follow-up. Some cases had other associated problems as infection, gaping, negligence, hyper mobile fracture, or systemic compromise. It was intended that non of the cases have an associated rigid immobilization. Few of them received minimal external or internal splinting, which,is not expected to disseminate union in normal circumstances. On final assessment 34 cases [68%] gained excellent or good results, with 16 [32%] having poor results. Factors affecting the final results were analyzed, and a conclusion was reached, to which cases would be expected to get maximal benefit of this technique

Simultaneous versus staged bilateral total knee arthroplasty

Eleven patients had bilateral simultaneous total knee arthroplasty [done under single anesthetic]. Operative, as well as one year follow up data were compared to those of similar number of patients, who had bilateral knee arthroplasty done on two stages, with an average of 6 months interval. Simultaneous bilateral arthroplasty consumed an average of 86 minutes more than each stage of the staged procedures. There was no significant difference between both procedures regarding the rate of peri-operative as well as the follow-up complications. Rehabilitation period was the same [average of 6 weeks] for both procedures. The mean hospital stay for both procedures was 18 days for the bilateral procedure compared to 33 days for the sum of the stages of the staged procedure. Accordingly, bilateral procedure is considered to be more economic. This is added to its advantage of rapid full functional recovery by avoiding time lage in staged arthroplasty. We think that it may be beneficial to offer both procedures to the patient for choice