[Perioperative blood management in primary total knee arthroplasty]. / Manejo perioperatorio de sangre en cirugía protésica primaria de rodilla.

Preoperative autologous blood collection and the reinfusion of postoperative blood salvaged from wound drainage can help to decrease the use of homologous blood transfusion in total knee arthroplasty. We have evaluated 100 primary total knee arthroplasties carried out at the García Orcoyen Hospital between 2001-2003. Eighty-eight point seven percent (88.7%) of available autotransfusion blood packs were employed and the average blood reinfusion from wound drainage was 374 ml. (range: 200-950 ml) when this method was possible. In 69% of cases homologous blood transfusion was not necessary. While other techniques are being developed, we think that autologous blood collection and blood reinfusion from wound drainage are effective in reducing the need for homologous blood transfusion; this is important because of the potential risk of reactions, disease transmission and limited blood bank resources.

[Acute local reaction to intra-articular infiltration with synvisc (Hylan GF20). About two cases]. / Reacción aguda local tras infiltración intraarticular con Synvisc (Hylan GF 20). A propósito de dos casos.

A second stage in the treatment of arthrosis following the non-steroid anti-inflammatories is formed by the so-called chondroprotectors and intraarticular viscosupplementation with hyaluronic acid, generally in the knee. Although infrequent, cases have been described of transitory inflammatory arthritis following intra-articulary administration. The main problem is differential diagnosis with a septic secondary arthritis and its consequences. This is a generally benign process with a still unknown transitory aetiology with different hypotheses, but which involves suspension of the treatment. We present two cases that resolved the sequels with different moments of appearance, the first in the three hours following infiltration, and the second four days later.