Search

The functional outcomes of 143 total knee arthroplasties performed by 1 surgeon between 1988 and 1992 were reviewed. Ninety-three procedures were carried out with sacrifice of the posterior cruciate ligament (PCL); in 50, the PCL was preserved. All cases were performed using the Kinemax prosthesis (Howmedica, Rutherford, NJ). Demographically, there were no differences between the 2 patient groups. Patients were evaluated over a mean follow-up period of 3 years (range, 2-6 years) using the 100-point Hospital for Special Surgery knee scoring system. The data revealed no difference in clinical or early radiographic outcome between PCL-sacrificing and PCL-retaining arthroplasties and support the argument that PCL sacrifice should be considered in cases in which extensive releases and complex ligamentous balancing are required.

A retrospective study was undertaken to determine the intraoperative blood loss and the subsequent need for blood transfusion in primary total knee arthroplasty. Fifty-six patients were operated on with the use of an arterial tourniquet (group 1), and 50 patients, without the use of a tourniquet (group 2). The mean intraoperative blood loss was significantly different between the two groups (P = 0.001). The 1-hour postoperative hemoglobin decrease was also significantly different between the two groups (P = 0.006). Thirty-four patients (61%) in group 1, and 32 patients in group 2 (64%) required a blood transfusion prior to discharge from the hospital. This difference was not significantly different. Although intraoperative blood loss was increased in the group when no tourniquet was used, the overall incidence of transfusion was the same between the two groups. It may therefore be justified to question the routine use of a tourniquet during total knee arthroplasty.

Osteopetrosis is due to a defect in osteoclastic cell function and results in osteosclerosis and progressive obliteration of the marrow spaces. Early onset osteoarthritis is associated with osteopetrosis. The authors describe a case of early onset osteoarthritis associated with osteopetrosis treated by total knee arthroplasty. The marblelike quality of osteopetrotic bone makes surgical treatment of these patients technically challenging and requires modification of standard surgical technique.