No abstract

The comparison of bilateral dynamic X-rays in passive anterior and posterior drawer with a load of 9 kg, and the arthrometer KT 1000 measurements obtained from 100 patients before anterior cruciate ligament reconstruction, confirms the good diagnostic efficiency of the following methods: (1) radiological measurement of the anterior translation of the medial compartment, as an absolute value and especially as a differential value in relation to the opposite, uninjured knee, the normal value limits being respectively 5 and 2 mm; and (2) arthrometric measurement of the maximal manual translation, also as absolute and differential values, the normal value limits being 10 and 2 mm respectively. These two measurements have a predictive value of 90%. No numerical equivalency exists between the radiological and arthrometric values, but their variations in relation to each other are statistically correlated. The arthrometer, simple to use and totally innocuous, is an excellent test device for consultation, while dynamic X-rays allow separate studies of each compartment to look for lesions of the posteromedial or posterolateral corners.

Sixty patients were operated on for primary gonarthrosis by means of a cemented, posterior cruciate preserving total knee and were randomly allocated to postoperative drainage or nondrainage. The primary criterion was duration of hospital stay. Secondary criteria included serial evaluation of knee pain, knee flexion, knee circumference, calculated blood loss after 7 days, complications, reoperations, and the need for blood transfusions. There was no difference between the two groups in any of the criteria during the entire follow-up. There was a nonsignificant trend to a decreased calculated blood loss in the nondrained group and significantly less transfused blood units in the nondrained group. Lack of drainage does not increase complication risk after total knee prosthesis implantation. We therefore recommend using no routine drainage after this procedure.

Level IV. Prospective study.

III.