Is Intraoperative Use of QuikClot Combat Gauze Effective for Hemostasis after Total Knee Arthroplasty?

BACKGROUND: To assess the hemostatic effect of QuikClot Combat Gauze (QCG) compared to that of standard gauze during cruciate-retaining total knee arthroplasty (TKA). METHODS: Sixty knees underwent TKA using a pneumatic tourniquet in this prospective randomized study. After implantation of the femoral and tibial components and hardening of the bone cement, the tourniquet was deflated and QCG (group 1) or standard gauze (group 2) was packed into the joint cavity for 5 minutes for hemostasis. Perioperative bleeding volume and blood transfusion volume were compared between two groups. RESULTS: The mean intraoperative bleeding volume was 64.7 ± 12.7 mL in group 1 and 63.9 ± 9.2 mL in group 2 (p = 0.808). The mean postoperative blood drainage was 349.0 ± 170.6 mL in group 1 and 270.1 ± 136.3 mL in group 2 (p = 0.057). The average postoperative blood transfusion volume was 323.7 ± 325.9 mL in group 1 and 403.6 ± 274.8 mL in group 2 (p = 0.314). CONCLUSIONS: QCG was not significantly effective for reducing perioperative bleeding volume or the blood transfusion rate compared with standard gauze during TKA.

Calcaneo-stop Procedure for Management of Pediatric Symptomatic Flexible Flatfoot / 대한족부족관절학회지

PURPOSE: The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot. MATERIALS AND METHODS: Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed. RESULTS: Clinically, AOFAS ankle-hindfoot scale improved from 70.3+/-5.6 to 97.3+/-2.5 and VAS improved from 6.4+/-1.6 to 0.2+/-0.4. Radiographically, talonavicular coverage angle improved from 28.3degrees+/-12.3degrees to 10.9degrees+/-8.1degrees, lateral talo-first metatarsal angle improved from -19.3degrees+/-9.0degrees to -2.4degrees+/-8.1degrees, and hindfoot alignment angle improved from valgus 11.9degrees+/-10.0degrees to 3.5degrees+/-4.3degrees at minimum 2-year follow-up. No complications occurred postoperatively. CONCLUSION: Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.