This study examined the difference in the reduction of the amount of required allogenic transfusion after bilateral total knee arthroplasty when an autotransfusion device was used. Materials and Methods: The subjects were ninety five patients who underwent sequential bilateral total knee arthroplasty from January 2006 to May 2010 by one surgeon. The first group was 50 patients who did not have an autotransfusion device used and second group of 45 patients were those who had an autotransfusion device used during the postoperative period. Group 1 received allogenic blood transfusion with a standard level of postoperative hemoglobin. The group 2 patients were reinfused with as much blood as was collected by an autotransfusion suction bag and then they received allogenic blood transfusion with a standard level of postoperative hemoglobin. Results: The total blood loss and amount of blood transfusion were almost the same in the two groups. The mean amount of allotransfusion was 1,270.0 mL in group 1 and 564.4 mL in group 2 and the reduced amount of allotransfusion in group 2 was statistically significant (p＜0.05). Conclusion: Using an autotransfusion device is a good method to reduce the mean amount of allotransfusion after bilateral sequential total knee arthroplasty.

Purpose:We believe that cemented femoral stems will relieve the stiffness of ceramic-based bearings, resulting in reduced complication of ceramic-on-ceramic bearing total hip arthroplasty (THA). The purpose of this study was to evaluate the midterm effect of ceramic-on-ceramic bearing THA using cemented femoral stems. Materials and Methods:We studied 32cases (30 patients) of THA using ceramic-on-ceramic bearing cemented femoral stems and 33 cases (31 patients) of THA using ceramic-on-ceramic bearing cementless femoral stems. All total hip arthroplasties were performed between January 2004 and December 2005 and were followed up for more than 5 years. The clinical results and radiographic results were evaluated. Results:The mean HHS improved from points pre-operatively to points at the last follow-up in both the cemented and cementless stem groups (P<0.05). The mean WOMAC score also improved from points pre-operatively to points at the last follow-up in both the cemented and cementless stem groups (P<0.05). But no statistically significant difference was noted between the cemented and cementless stem groups in HHS and WOMAC scores (P=0.304, P=0.769). There were 3 patients with a sense of discomfort on ambulation and 5 patients with thigh pain in the cementless stem group and no cases in the cemented stem group. There was no instance of acetabular loosening in either group. Subsidenc of the cemented femoral stem was less than 1mm in 30 cases and less than 2 mm in 2 cases.All cementless femoral stems acquired firm bony union. Conclusion:Midterm results showed no statistical links between ceramicon-ceramic-bearing THA using cemented femoral stems or cementless femoral stems.

Patellar clunk syndrome after total knee arthroplasty is a complication that causes pain and poping or catching of patella. We experienced a case after mobile bearing total knee arthroplasty that medial synovial tissue was impinged between patella and femoral component and intra-articular fibrotic nodule of superior pole of patella was observed. Also, wear of Polyethylene were observed at anterio side. We resolved the patient symptom after excision of fibrotic nodule, synovectomy of medial synovial hypertrophy, and change of polyethylene. We report this case with literature review.