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BACKGROUND:Usual y, amount of bleeding during replacement and drainage amount after replacement were recorded to evaluate the amount of bleeding in patients with arthroplasty. These are dominant blood loss. Studies demonstrated that recessive blood loss exceeded 50%of total amount. OBJECTIVE:To compare the blood loss during total knee arthroplasty under high negative pressure drainage and common negative pressure drainage and to assess the effect of high negative pressure drainage on hidden blood loss in total knee arthroplasty. METHODS:A total of 60 patients undergoing lateral total knee arthroplasty were equal y divided into high negative pressure drainage group and conventional drainage group (control group). We calculated the total blood loss (dominant blood loss and hidden blood loss) and blood transfusion amount with the Gross equation. The recovery after surgery and complications were compared. RESULTS AND CONCLUSION:In high negative pressure drainage group, the total blood loss was (646±184) mL and the hidden blood loss was (215±128) mL. In the control group, the total blood loss was (867±296) mL and the hidden blood loss was (457±268) mL. The total blood loss and hidden blood loss in the high negative pressure drainage group were significantly less than those in the control group (P<0.05). The average blood transfusion amount was 224 mL in the high negative pressure drainage group and 467 mL in the control group. Fol owing unilateral total knee arthroplasty, total blood loss, hidden blood loss and blood transfusion amount after arthroplasty were less in the high negative pressure drainage group than those in the control group. In particular, the decrease in hidden blood loss was helpful to observe and treat the pathogenetic condition and to avoid potential risk, and benefits the recovery of knee joint function after surgery.
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BACKGROUND: Suture silk or steel ring, Kirschner wire tension wire, modified AO band and screw are always used to treat patellar fractures. These methods cause large wound, slow fracture healing and limited joint function. OBJECTIVE: To analyze the therapeutic effect of Ti-Ni shape memory alloy clamp on patellar fractures. DESIGN, TIME AND SETTING: Retrospective analysis was performed at the Luoyang Hospital of Orthopedics and Traumatics from June 2001 to June 2006. PARTICIPANTS: 121 patients of patellar fractures (123 knees), 78 males (80 knees) and 43 females (43 knees), aged 38.3 years (range 21–67 years). There were 47 cases with left patellar fracture, 72 cases with right and 2 with bilateral; 53 knees were transverse,36 knees were comminuted, 32 avulsion, and 2 vertical fracture; 23 cases were injured by direct violence, and 98 by indirect violence. METHODS: Vertical incisions were made to expose fractures. The deep layer of the tendinous membrane was remained. The fracture was repositioned and the lacerated retinaculum and tendinous membrane were sutured. After the vertical diameter of the patella was measured, suitable clamp was selected and placed. After well repositioned, heat saline gauze was used to make the clamp reposition and fix the fractures. The incision was finally closed. MAIN OUTCOME MEASURES: Material and host responses; functional assessment of the patella fractures using Bostman. RESULTS: 121 cases were followed-up for 8 months8. All fractures were healed. No infection occurred. A little displacement of fractures occurred in 4 cases, early traumatic arthritis in 1 case, and slippage of the clamps in 2 cases. According to the functional assessment of the patella fractures of Bostman, the excellent results were 107 knees, and good were 16 knees. CONCLUSION: Ti-Ni shape memory alloy clamps exhibit reliable fixation, with soft tissue remaining, which is important to retain the blood supply of the patella. Moreover, it accelerates the healing of fractures.
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[Objective]To find out the reason of patellar clunk syndrome after total knee replacement and define its countermeasure.[Method]From January 2001 to December 2004,total knee replacements were performed on 57 cases(82 knees).Patellar clunk syndromes were found in 14 knees.The reason was analyzed.[Result]The reason of patellar clunk syndrome was abnormality of patellofemoral tracking,including type intercondylar notch and type trochlear groove.[Conclusion]The problem of patellofemoral joint is very important in total knee replacement.With adopting accurate technique of cutting and component implantation,perfecting the design of prostheses,patellar clunk syndrome could be avoided completely.