Differences between sexes in the standard and advanced dimensioning of lateral meniscal allografts.

BACKGROUND: There are many different methods of meniscal allograft measurements, which depend on individual tissue bank procedures. Due to the lack of a standardised method of dimensioning, measurement results may vary between individual cases. Consequently, allograft may be mismatched to the patient's knee anatomy. The purpose of this study was to measure four meniscal dimensions - two standard and two specific - and then compare them between sexes. METHODS: Fourteen cadaveric lateral menisci (seven male and seven female) were scanned using a microtomography scanner. The obtained three-dimensional (3-D) models of each meniscus were analysed, taking into account four dimensions: circumference, width, central meniscal concavity, and total meniscal volume. The computer researcher was not informed of the original data of the meniscal samples until the calculations were completed. RESULTS: No statistical between-sex differences were found in the standard dimensions. The specific dimensions, in turn, presented statistically significant between-sex differences (P>0.05). The mean difference between male and female total volume of the meniscus was equal to 36.59%, and the mean difference between male and female central meniscal concavity surface was equal to 31.22%. CONCLUSION: This study found that sex should be taken into account as an important factor during a matching procedure performed by tissue bank staff.

Medical and Economic Advantages of Postoperative Blood Salvage in Total Knee Replacement.

BACKGROUND: Total knee replacement surgery causes large blood loss leading to worsening of the patient's physical capacity, difficulties in rehabilitation and necessity of transfusions. The re-infusion of drainage fluid has been described as an alternative way to improve hematological parameters. The aim of the study was to determine the effectiveness of re-transfusion with regard to the allogeneic transfusion rate, duration of treatment and costs. MATERIAL AND METHODS: We performed a prospective randomized study of 101 patients, divided into an RTF group for re-transfusion from the drain and a DRN group for standard drainage. We could not re-transfuse drainage blood in 6 cases. 38 patients (RTF2) received their blood back and the remaining 63 patients (DRN2) did not. Depending on blood loss, laboratory tests and general condition, decisions were made to proceed with allogeneic transfusions. RESULTS: In spite of the re-transfusion, 39.4% of the patients in RTF2 required an additional transfusion, compared to 53.9% of the patients in DRN2 (p=0.15). Mean deterioration in hematological parameters was 72.9% of baseline in RTF2 and 75.0% in DRN2 (p=0.45), mean treatment time was 10.3 days for RTF2 and 11.1 for DRN2 (p=0,24) and mean cost was PLN 5426.5 in RTF versus PLN 5587.21 in DRN (p=0.76). CONCLUSION: The effect of re-transfusion on reducing allogeneic blood usage is not significant, does not alter patients' general condition and lab test results and does not eliminate the need for transfusion or influence the duration of hospital stay and the costs.

Orthopaedic problems in patients affected by alkaptonuria. A case report.

Alkaptonuria is a rare congenital metabolic disorder. A defect of the enzyme homogentisic oxidase results in a block of the metabolic pathway of the amino acids phenylalanine and tyrosine. Deposits of homogentisic acid polymers in connective tissue cause various organ manifestations, including musculoskeletal symptomatology. A 66 year-old woman was twice admitted to our Department because of progressive knee and low back pain. Physical examination and accessory investigations confirmed that her various complaints were caused by underlying alkaptonuria. We use this case and a review of literature to discuss orthopaedic problems in patients with alkaptonuria and describe the cardinal signs and symptoms of this disease, its diagnosis and treatment.