The aim of this study is to evaluate the mid-term results of the Genesis Total Knee Prosthesis, one of the first prostheses with asymmetric shape of the tibial component .The arthroplasty was performed on our patients with retention of the posterior cruciate ligament and, in most of the cases, without replacement of the patella. During the period 1992–1999, 90 patients (116 knees) were operated in our clinic: 81 of them were women and 9 were men with an average age of 68 (52–82) years. The primary indication for the operation was osteoarthritis. 84 patients (109 knees) were evaluated clinically and roentgenographically (Knee Society Knee Score) for a mean time of 98.1 (29.6 – 137.7) months after surgery. There were no infections. (Three) Four of the patients had to undergo a second operation . Two of them, eventually, had their patellae replaced (1,5 and 3 years postoperatively) due to persisting pain of the patellofemoral articulation and lateral patellar subluxation .The other two patients had to undergo revision arthroplasty due to wear of the polyethylene component, one at five years and the other at nine years . Moreover, wear of the polyethylene was also observed on another patient, radiographically, six years after the operation. However, the patient seemed to have no symptoms and was, therefore, unwilling to undergo a revision. The clinical results were satisfactory with a Knee Score of 97(74–100) and Function Score 80 (5–100) .The mean range of motion was 113°(85°–135°). There was no evidence of loosening or any radiolucent lines found radiographically .We consider the results of the Genesis Total Knee Arthroplasty satisfactory .The asymmetric shape of the tibial condyles ensures the fitting of the tibial component. With the exception of cases of severe patella damage, replacement of the patella is not required. The presence of any problems in the patellofemoral articulation is usually connected to the maltracking of the patella or to errors in the surgical technique.

Introduction: Loss of the cervical lordosis is a common finding on the emergency department in patients who have been involved in a car accident as well as in those who have suffered head and neck injury. The difficult circumstances, under which the plain films are usually taken, make the use of CT indispensable. Our study presents the CT findings from the cervical spine in patients with loss of the cervical lordosis.

Method-Patients We studied 120 patients from February 2003 to January 2004. Their mean age was 37 years old. Our protocol included the lateral-AP view, while in the absence of findings, except loss of cervical lordosis, from the plain films, the patients underwent spiral CT within 24 h.

Results: Fractures of the cervical spine were found in 7 patients (5,8%). In 5 of them these involved the A1–A2 level. In two patients fractures of the occipital condyles were found. One A7 fracture coexisted with an A2 fracture. No patient had neurological symptoms.

Conclusions: The complete investigation of the cervical spine at the emergency department is often quite difficult. The possible underlying injuries can be potentially life threatening. The percentage of positive findings in our study is quite high to justify the routine use of spiral CT for the detailed investigation of such patients.

Aims: Evaluation of the efficacy of autotransfusion in reducing the need for homologous blood transfusion in total knee arthroplasty. Methods: Prospective randomized study. Patients undergoing total knee arthroplasty were divided in: Group A (72 patients) receiving autotransfusion (Suretrans) and control group B (30 patients) with suction drainage only. Preoperative Hb and demographics of the two groups were comparable. The level of Hb was followed for the first 5 days postoperatively. The amount of homologous blood transfused was also recorded. Results: The average autotransfusion volume in group A was 405±191ml. On the day of the operation and the first postoperative day the Hb in group A was found statistically significantly higher (p< 0.05). On the second and third day the Hb in group B, achieved levels comparable to group A, because patients received homologous blood transfusion. The amount of homologous blood transfused to the patients was significantly higher in group B (average: group A 0.36 ± 0.74u, group B 1.2 ±1u, p< 0.001). Multiple regression analysis suggests that the only factor reducing the need for homologous blood transfusion is the use of the autotransfusion system. Conclusions: there is a statistically significant reduction in the need for blood transfusion by using an autotransfusion system reducing also the possible dangers and complications. Autotransfusion is a simple, safe and cost effective method.