Woo Shin Cho

The Effect of Norepinephrine Irrigation in Primary Total Knee Replacement Arthroplasty

Purpose: We studied the effect of norepinephrine irrigation during total knee replacement arthroplasty (TKRA) on blood loss reduction. Materials and Methods: A prospective study of 30 patients who received TKRA from the same surgeon between March 2003 and November 2003, was done. Patients were alternately allocated into two groups. The study group included 15 cases in which 1:200,000 diluted norepinephrine was used for irrigation intra-operatively, whereas the control group included 15 cases received normal saline irrigation. Postoperative drain and transfusion amounts were compared between the two groups using the independent t-test. Results: Early bleeding amounts for 6 hours after surgery were a significant difference between the two groups (study group 410.3 cc, control group 517.3 cc, p-value=0.03). However, delayed bleeding amounts during postoperative 6-48 hours (study group 163.8 cc, control group 244.7 cc, p-value=0.05) and transfusion amounts (study group 0.80 unit, control group 1.47 unit, p-value=0.07) were smaller in the study group, but showed no significant differences. Conclusion: Using norepinephrine diluted in normal saline as an irrigation solution during TKRA can be considered for reducing early post operative bleeding.

Mobile bearing joint in Total Knee Arthroplasty

Purpose : To assess the clinical and radiological results of mobile bearing total knee arthroplasty using the LCS system and to analyse complications arising. Materials and Methods : From Oct. 1992 to Dec. 1998, 135 cases of total knee arthroplasty was performed using the LCS mobile bearing system. Among those are evaluated 108 cases which were followed up for a mean of 4.8 years (3-9.2 years). Retrospective analysis was done by the clinical and radiological evaluations usinga ROM, tibio-femoral alignment, HSS score and radiological loosening. Results : The preoperative mean HSS score (58.6) was improved to 89.5 at final follow up. Tibio-femoral angle changed from a varus of to a valgus of . Arc of motion was reduced from to in osteoarthritis and increased from to in rheumatoid arthritis. There were 16 cases of osteolysis, but no case provoked clinical problems or more than 4 points in the radiolucent score. Complications were one polyethylene dislocation and one intraoperative tibia plateau fracture. Conclusion : Mobile bearing knee system showed excellent and predictable clinical and radiological results at a mean 4.8 years follow-up.