Background Postoperative suction drains are used after total knee arthroplasty to avoid intra-articular hematoma formation although they can increase blood loss due to a negative suction effect. The use of tranexamic acid to reduce blood loss may nullify this. The aim of this study was to compare outcomes in patients undergoing total knee arthroplasty with or without drains and to analyze whether the drain's diameter also has an impact. Methods This is a prospective randomized study of patients undergoing unilateral total knee arthroplasty performed by a single surgeon. The study population was divided into three groups (A, 10G drain; B, 12G drain; and C, no drain). Pain, blood loss, swelling, wound-related complications, functional outcomes and questionnaire-based outcomes were assessed postoperatively. Results Each group had 35 patients comparable in most demographic and pre- and intraoperative characteristics. During the first 6 hours postoperatively, opioid consumption was significantly higher when the drain was not used ( p = 0.036). At 3 months postoperatively, new Knee Society Score (NKSS) was highest with the use of 12G drain ( p = 0.018). However, NKSS at 1 year was comparable across the three groups. With the use of tranexamic acid, blood loss and incidence of soakage of dressing were unaffected by the presence or absence of a drain. The calf girth, suprapatellar girth, soakage of dressing and range of motion were comparable in all three groups. There was no incidence of surgical site infection or deep vein thrombosis. Conclusions Presence of a suction drain significantly reduces opioid consumption during the first 6 hours after total knee arthroplasty. Use of a drain made no difference to the functional outcome at 1 year postoperatively. With the use of tranexamic acid in total knee arthroplasty, the total blood loss and the requirement of blood transfusion were unaffected by the presence or absence of closed suction drainage or by the bore of the drain used. The clinical parameters such as swelling, range of motion, infection and deep vein thrombosis also remained the same.

Solitary plasmacytoma (SP) of bone is rare presentation and only few cases are reported in scientific literature. We report a case of solitary plasmacytoma of bone treated at our tertiary care hospital in Mumbai.

Ulnar nerve compression at guyon's canal is rare and very few cases have been reported in literature. It can be missed due to its rarity. Symptoms vary from pain and paresthesia to wasting and significant loss of muscle strength, with significant deformities of the hand. The diagnosis is made by detailed history and examination, electromyography, nerve conduction velocity test, ultrasound and magnetic resonance imaging. Early decompression of nerve is treatment of choice. Here we are presenting a case of compression of ulnar nerve in guyon's canal due to ganglionic cyst.

Biodegradable implants degrade in a biologic environment. The use of bioabsorbable implants in spine surgery is expanding at a rapid pace. Their future as a carrier of biological agents, such as bone morphogenetic proteins and bone graft exten ders, their radiolucency, and their eventual resorption make them an ideal implant for use in spinal degenerative disease. For spine fixation, ideally these implants should have mechanical characteristics equal to those of standard metal implants and would degrade with the healing process, so that fixation is not lost before adequate healing and load is gradually transferred to the healing tissue. Several new experimental bioabsorbable devices are in the process of consideration as spinal implants. These include a myriad of posterior lumbar interbody fusion devices, anterior spinal plates, and a variety of screw and mesh designs.