ABSTRACT
To determine the need of prophylactic antibiotics in knee arthroscopic procedures. Three thousand patients, who presented to our sport medicine clinic in The Royal Rehabilitation Center at King Hussein Medical Center between January 2002 and February 2004, were assessed. Patients who refused to be enrolled in the study, those who would need complex procedures as anterior cruciate ligament reconstruction or accompanied arthrotomy and those with predisposing factors to infection as diabetes mellitus, immune deficiency disorders and steroid therapy were excluded from the study. Patients were divided into two groups; patients in group A were given one gram 1[st] generation cephalosporins at the induction of anesthesia and patients in group B were kept without antibiotic prophylaxis. All surgeries were conducted under general anesthesia with tourniquet. The patients were followed at 1, 3, 7 days and 3, 6 months for signs of infection. Statistical analysis was performed using the student t- test. One hundred eighty patients were included in the study and divided into two groups with equal numbers. There were no significant differences between the two groups in terms of age, pathology detected in knees, surgical procedures performed and operative time. No infection was detected in both groups during follow up. No complications of antibiotic use were encountered. Our results are preliminary to an ongoing study but we can conclude that using antibiotic prophylaxis, as a routine, in operative knee arthroscopy is not mandatory. Antibiotic usage may increase cost and may lead to antibiotic complications. Antibiotic prophylaxis may have a role in complex knee arthroscopic procedures as anterior cruciate ligament reconstruction
ABSTRACT
The objective of this study was to evaluate the efficacy of unfractionated heparin, warfarin and low molecular weight heparins [LMWH] used for the prevention of venous thromboembolism in arthroplastic surgery of the knee joint. In this prospective study from August 2002 to November 2004, 60 patients were included and divided into three groups with equal numbers, with each group receiving different treatment protocol. Postoperatively, the occurrence of symptomatic deep vein thrombosis [DVT] or pulmonary embolism [PE] was recorded during the first 30 days after surgery and at a routine follow-up visit. A significantly lower prevalence of DVT and PE was found in patients using warfarin and LMWH as prophylaxis in comparison with patients using unfractionated heparin. Warfarin and low molecular weight heparins are more beneficial and effective than unfractionated heparin for DVT and PE prophylaxis in arthroplastic knee surgeries