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Background and Aim: The current COVID-19 pandemic scenario has driven surgical departments to a transformation. The worldwide spread of the disease has led to a public health quarantine where health care professionals are at high risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. This study aims to demonstrate that a combined framework based on telematics and in-person clinical encounter not only ensures medical care but the safety of healthcare professionals and patients., Material and Method: Descriptive observational study on the follow-up of patients during the COVID19 Pandemic, combining telephone and traditional., Results: A total of 5031 telephone calls were made, differentiating between medical referrals, specialized primary care visits, and outpatient consultation. They were classified as successful, required an in-person visit, or no successful telephone contact. Furthermore, we divided them into 2 groups: resolved and unresolved. 53% of all telematic visits were successful., Conclusions: Telematic medical systems are a feasible option in a orthopedics department and an interesting resource to preserve once the pandemic is resolved. Future lines of research should be opened to improve system success, analyze its cost-effectiveness ratio, and correct any legal conflicts that may exist., (Publicado por Elsevier España, S.L.U.)

Objective: To evaluate the influence of tourniquet pressure (TP) on the postoperative pain of patients undergoing total knee arthroplasty (TKA)., Material and Methods: This prospective double-blind study enrolled 86 patients scheduled for TKA. The patients were randomized to groups to receive either a high TP (400 mgHg) or a low TP (100 mgHg above systolic pressure). A spinal block was performed in each patient. Intravenous morphine and metamizol were infused through a patient-controlled analgesia device. Postoperative pain was estimated on a visual analog scale (VAS). We also recorded the amount of morphine infused, functional recovery of the limb and the presence of complications., Results: Surgical field conditions were considered good in all but two low PT cases. Postoperative pain was less intense in the low TP group at 6, 12, 24 and 36 hours, and that group required less morphine (11.38 +/- 4.9 mg vs. 15.13 +/- 4.9 mg, p < 0.05). More patients achieved 90 degrees flexion four days after surgery in the low TP group (65%) than in the high TP group (41%) (p < 0.05)., Conclusions: Applying a lower-than-usual TP in orthopedic surgery could be sufficient for reducing postoperative pain while still providing a bloodless surgical field.