Intra-articular administration of morphine or bupivacaine is not indicated after elective knee-arthroscopy in patients with minor pre-operative pain and a small surgical trauma.

Summary: The role of polymorphonuclear leukocytes (PMNLs) in postischemic delayed hypoperfusion in the rat brain was investigated. Cerebral ischemia was accom plished by reversible bilateral occlusion of the common carotid arteries for 15 min combined with bleeding to an MABP of 50 mm Hg. The animals of one group were depleted of their circulating PMNLs by intraperitoneal injections of an antineutrophil serum (ANS) prior to the experiment. All animals included in this group had fewer than 0.2 x 109 circulating PMNLs/L at the start of the experiments. In another group ANS was injected intra venously for 5 min starting 2 min after the ischemic insult. After 4 min of recirculation, the number of circulating PMNLs in this group was below 10% of the normal. Con trol animals were injected with the same amount of nor mal sheep serum or were not treated at all. Sixty minutes Under experimental conditions, reversible in complete cerebral ischemia is followed first by a brief period of hyperperfusion and subsequently by a substantial decrease in CBF. This progressive generalized decline in CBF in the postischemic pe riod has been observed in several studies (Hoss mann et aI., 1973; Snyder et aI., 1975; Ginsberg et aI., 1978) and has been termed postischemic de layed hypoperfusion (DHP). It has been claimed that restriction of this perfusional derangement would improve the final neurological outcome, and it is thus believed to represent a late threat to the survival of neurons after cerebral ischemia that

Background and purposeDebridement and retention of the prosthesis is often attempted to treat early prosthetic joint infection (PJI). However, previous studies have found inconsistent results, with success rates ranging from 21% to 100%, and little has been written in the literature about hip function. We have therefore analyzed the clinical and functional outcome of early PJIs treated with this procedure.Patients and methods38 patients with early PJI after primary hip arthroplasty who were treated with debridement and retention of the implant between 1998 and 2005 were studied prospectively, with a median follow-up time of 4 (0.8–10) years. Early infection was defined as that which occurred within 4 weeks of index arthroplasty. The primary outcome measure was infection control. Functional outcome was assessed with the Harris hip score.Results27 of 38 patients were successfully treated, with no signs of infection or continued antibiotic treatment at the latest follow-up. Median Harris hip score was 86 (47–100) points. In 9 of the 11 patients for whom treatment failed, infection was successfully treated with 1-stage or 2-stage reimplantation or resection. Intraoperative cultures were positive in 36 hips, and the most frequently isolated organisms were Staphylococcus aureus and coagulase-negative staphylococci (CoNS). 15 infections were polymicrobial, and only 8 of them were successfully treated with debridement and retention of the implant.InterpretationOur data suggest that debridement and retention of the prosthesis is a reasonable treatment option in early PJI after primary hip arthroplasty, with satisfactory functional results.

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