Autotransfusion drains in total knee replacement. Are they alternatives to homologous transfusion?

We prospectively randomised 104 consecutive patients undergoing primary cemented total knee arthroplasty into two groups of 52 patients each, with one group to receive a standard suction drain (Redivac) and the other, an autologous transfusion drain (Bellovac). Randomisation was achieved using the software programme MINIM: , which was set to randomly allocate patients to either of the two groups based on their age, sex and body mass index (BMI). All procedures were performed under pneumatic tourniquet. Drains were released in the recovery room 20 min after surgery and removed 24 h following surgery. Blood collected in the standard suction drain (control group) was discarded, while blood collected in the autologous transfusion drains (study group) was transfused unwashed back to the patient within 6 h of collection. Thirteen patients (25%) in the study group had two or more units of homologous blood transfused in addition to the blood collected postoperatively and re-transfused (average: 438 ml). Twelve patients (23%) in the control group had two or more units of homologous blood transfused. No sepsis, transfusion reactions or coagulopathies were associated with the autologous blood transfused in the study group. The use of the autologous transfusion system (Bellovac) proved to be safe but failed to reduce the need for postoperative homologous blood transfusion following uncomplicated total knee arthroplasty.

Displaced supracondylar fractures of the humerus in children.

We performed an outcome study of completely displaced supracondylar fractures in children in order to assess the outcome of primary open reduction and internal fixation for these injuries. A total of 16 patients (mean age of 5.9 years) were included in the study. The mean follow-up was 2.6 years and patients were assessed after fracture healing using the criteria of Flynn et al. and Mark et al. Thirteen patients had an excellent result, two had good results with less than 10 degrees loss of carrying angle and one had a fair result based on degree of loss of elbow flexion. Open reduction and internal fixation of these fractures is an effective and safe method of primary treatment and is associated with good outcomes. We recommend a low threshold of proceeding to open treatment in these serious injuries.