The efficacy and safety of postoperative autologous transfusion of filtered shed blood and anticoagulant prophylaxis in total knee arthroplasty patients.

PURPOSE: To assess the efficacy and safety of autologous transfusion of filtered shed blood in total knee arthroplasty (TKA). MATERIALS AND METHODS: A total of 42 patients with TKA (group A; without autologous transfusion in 15 patients, group B; with autologous transfusion in 27 patients) were evaluated retrospectively. The influence of autologous reinfusion of filtered blood, bleeding tendency, amount of blood drainage, rate of allogenic transfusion, and the postoperative changes of hemoglobin were analyzed. RESULTS: Allogenic transfusion was needed in 26.7% (4/15) of group A and none of group B till postoperative 48 hours. Till postoperative 14 days, 46.7% (7/15) of group A needed allogenic transfusion while 7.4% (2/27) in group B. The average drained blood volume was 1,197±400 mL in group A and 975±422 mL in group B. The average decrease of hemoglobin at postoperative 1, 7, and 14 days was 2.9±1.5, 2.9±1.6, and 2.3±1.5 g/dL respectively in group A and 2.7±0.8, 4.0±1.0, and 2.9±1.3 g/dL respectively in group B. CONCLUSIONS: An autotransfusion system lowered the allogenic transfusion rate, while anticoagulants did not increase the amount of drained blood. An autotransfusion system with anticoagulants was effective and safe to save the shed blood in TKA.

Lateral closing wedge osteotomy with or without medialisation of the distal fragment for cubitus varus.

PURPOSE: To compare treatment outcomes after closing wedge osteotomy and plate fixation for cubitus varus deformity undertaken with or without medialisation of the distal fragment. METHODS: Records of 21 men and 16 women aged 20 to 34 years who underwent closing wedge osteotomy and plate fixation for cubitus varus deformity with (n=21) or without (n=16) medialisation of the distal fragment were reviewed. A daily alternate flexion-extension splinting was applied for one week for early restoration of full range of motion. The carrying angle and range of motion of the elbow were measured. RESULTS: All patients regained the normal carrying angle and range of motion; none had loss of fixation or limitation in range of motion exceeding 10 degrees. Outcomes were excellent in 23 patients and good in 9. A small bony prominence over the lateral condylar region ('lazy S' deformity) was noted in group-1 but not group-2 patients. CONCLUSION: Closing wedge supracondylar osteotomy with medialisation of the distal fragment was an effective treatment for cubitus varus deformity and minimised the risk of 'lazy S' deformity.

Palmar scaphoid dislocation associated with dorsal perilunate dislocation: case report.

Most dislocations of the carpal bones present as a lunate or perilunate dislocation. We report a case of a palmar scaphoid dislocation combined with a dorsal perilunate dislocation.

Low grade fibromyxoid sarcoma in thigh.

A low grade fibromyxoid sarcoma is a rare soft tissue tumor that has a tendency to develop in the deep soft tissue of young adults and the potential for local recurrence or distant metastasis. There have been several case reports and sporadic reports in the literature. However, only 1 case has been reported in Korea but without a follow-up result. We describe a 54-year-old female patient with a low-grade fibromyxoid sarcoma of the thigh that had been growing slowly for 34 years. A marginal resection of this tumor was performed. Currently, the patient is doing well without evidence of local recurrence or distant metastasis at 5 years after surgery.

Multiple pyogenic spondylodiscitis with bilateral psoas abscesses accompanying osteomyelitis of lateral malleolus - a case report -.

A psoas abscess is a potentially life-threatening infection. Multiple pyogenic spondylodiscitis with bilateral psoas abscesses accompanying an osteomyelitis of the lateral malleolus is an extremely rare event. We present our experience with needle aspiration for the treatment of osteomyelitis of the lateral malleolus and CT-guided percutaneous catheter drainage for a psoas abscess in an elderly patient. Both infections were completely resolved without recurrence. A psoas abscess should be included in the differential diagnosis of a patient with low back pain during musculoskeletal infection. Percutaneous needle aspiration or CT-guided percutaneous catheter drainage is an effective method for treating certain musculoskeletal infections.