Data from 565 knee arthroscopies performed by two experienced knee surgeons between 2002 and 2005 for degenerative joint disorders, ligament injuries, loose body removals, lateral release of the patellar retinaculum, plica division, and adhesiolysis was prospectively collected. A subset of 109 patients from the above group who sequentially had clinical examination, MRI and arthroscopy for suspected meniscal and ligament injuries were considered for the present study and the data was reviewed. Patients with previous menisectomies, knee ligament repairs or reconstructions and knee arthroscopies were excluded from the study. Patients were categorised into three groups on objective clinical assessment: Those who were positive for either meniscal or cruciate ligament injury [group 1]; both meniscal and cruciate ligament injury [group 2] and those with highly suggestive symptoms and with negative clinical signs [group 3]. MRI was requested for confirmation of diagnosis and for additional information in all these patients. Two experienced radiologists reported MRI films. Clinical and MRI findings were compared with Arthroscopy as the gold standard. A thorough clinical examination performed by a skilled examiner more accurately correlated at Arthroscopy. MRI added no information in group 1 patients, valuable information in group 2 and was equivocal in group 3 patients. A negative MRI did not prevent an arthroscopy. In this study, specificity, positive and negative predictive values were more favourable for clinical examination though MRI was more sensitive for meniscal injuries. The use of MRI as a supplemental tool in the management of meniscal and ligament injuries should be highly individualised by an experienced surgeon.

In patients undergoing total knee replacement we carried out a longitudinal cohort study to determine the efficacy and safety of a postoperative autologous blood reinfusion system, as an alternative to homologous, banked blood transfusions. Fifty patients received reinfusion of unwashed, filtered, shed blood, supplemented with banked blood transfusions as required. A control group of 50 patients in whom standard suction drains were used received homologous blood transfusions as required. In the study group, the homologous blood requirement was reduced by 80%. There was no significant difference in the postoperative haemoglobin values between the two groups. None of the patients developed any adverse reactions after reinfusion.Résumé Chez des patients opérés par arthroplastie totale du genou nous avons fait une étude par cohorte longitudinale pour déterminer l'efficacité et la sécurité d'un système de réinfusion du sang de drainage postopératoire, comme une alternative aux transfusions de sang homologue. Cinquante patients ont eu une reinfusion du sang autologue filtré, complété par des transfusions de sang homologue selon les besoins. Un groupe témoin de 50 patients avec drainage standard a reçu des transfusions de sang homologue comme nécessaire. Dans le groupe de l'étude, la nécessité de sang homologue a été réduite de 80%. Il n'y avait aucune différence notable des taux postopératoires d'hémoglobine entre les deux groupes. Aucun des malades n'a présenté d'effet secondaire après reinfusion.

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Background: Skateboarding has been a popular sport among teenagers even with its attendant associated risks. The literature is packed with articles regarding the perils of skateboards. Is the skateboard as dangerous as has been portrayed?

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