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After total hip replacement, continued pharmacological prophylaxis following hospital discharge is controversial.The primary objective of our study was to determine the safety and efficacy of continued prophylaxis with nadroparin three weeks after hospital discharge. The secondary objective was to evaluate the association between a confirmed venous thromboembolism and risk factors for deep venous thrombosis.This study was an open-label, randomized, multicentre, prospective trial. Patients were evaluated for deep venous thrombosis with duplex ultrasonography at discharge and 3 weeks later. Walking ability (mobility score) was assessed at the same times. Patients without deep venous thrombosis at discharge were randomly assigned to continued nadroparin (n=155) versus no pharmacologic prophylaxis (n=141) for three weeks.The rate of deep venous thrombosis three weeks post discharge was significantly lower in the nadroparin group: two patients (1.3%) versus nine (6.4%) without prophylaxis (p = 0.021; relative risk reduction = 79%). No significant difference in terms of safety was observed between groups and no major bleeding occurred.Three weeks after discharge, patients who developed deep venous thrombosis were significantly less mobile (p = 0.018).In conclusion, after total hip replacement, continued prophylaxis with nadroparin for 3 weeks after hospital discharge is beneficial.

After recalling different indications of arthroscopy of the knee, the authors evaluate the use and the reliability of this technique in 109 consecutive examinations. Both clinical diagnosis and proposed surgical treatment are totally or partially modified in more than half of the cases out of 79 patients 16 arthrotomies are avoided. Overall reliability is only 85%, but attains 94% in the last 59 examinations. The value of arthroscopy and arthrography are compared (90% of reliability for arthroscopy, 15 mistakes out of 37 arthrographies). Arthroscopic control examinations may in some cases help to evaluate results of surgical treatment in chondromalacia patellae.

The authors present a prospective series of 32 fractures of the tibia, treated by Sarmiento's technique. Consolidation of the fracture has been obtained in 3 to 4 months. Five open tibia fractures healed in 4 months. Functional recovery is complete in 90% of the cases. Two failures needed late surgical treatment (one centro-medullary nailing and one plate-fixation). These fractures are studied in detail.