The Diagnostic Availability of Multidetector-Row Computed Tomography(MDCT) in Deep Vein Thrombosis Developed after Joint Arthroplasty / 대한정형외과학회잡지

PURPOSE: To evaluate the accuracy and availability of Multidetector-Row Computed Tomography (MDCT) and Color Doppler Sonography as a method for making an early diagnosis of DVT after joint arthroplasty. MATERIALS AND METHODS: A total of 71 cases (63 patients) were selected. 32 cases (32 patients) underwent a THRA and 39 cases (31 patients) underwent a TKRA between April 2004 to August 2004. All cases underwent both Color Doppler Sonography and MDCT, before and after surgery. No prophylactic medications for DVT were given. Patients who previously had DVT or pulmonary embolism or a medication history of anticoagulation therapy were excluded. RESULTS: DVT was found by MDCT in 33 cases (46.5%) and by Color Doppler Sonography in 15 cases (21.1%). In the 33 cases of DVT diagnosed by MDCT, 24 cases developed in the calf vein, among them, only 4 cases were positive and remaining 20 were negative in Color Doppler Sonography. In the 15 cases of DVT diagnosed by Color Doppler Sonography, 13 cases were positive and only 2 cases were negative in MDCT. CONCLUSION: MDCT is effective in diagnosing DVT after joint arthroplasty in terms of the objectivity, efficacy and accuracy.

Total Knee Arthroplasty with NexGen(R) System: Minimum Two Years Follow up Results / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical and radiological results of patients that underwent total knee replacement arthroplasty (TKRA) using a NexGen(R). implant, and who were followed up for at least 2 years. MATERIALS AND METHODS: Between July 1996 and June 2002, 100 knees in 67 patients, and followed up for at least 2 years following TKRA using a NexGen(R). implant were retrospectively assessed for clinical and radiological results using the assessment standards of the Knee and Functional Score of the American Knee Society. RESULTS: The average preoperative range of motion in patients with osteoarthritis and rheumatoid arthritis were 107.4degrees (50-140degrees) and 105.8degrees (70-120degrees), respectively, which had improved to 127.2degrees (85-140degrees) and 125.6degrees (90-140degrees), respectively, at the final follow up. In addition, the preoperative flexion contracture improved from 11.3degrees (0-30degrees) and 10.6degrees (0-30degrees) to 1.3degrees (0-15degrees) and 3degrees (0-15degrees) postoperatively. The results using the assessment standards of the Knee and Functional Score of the American Knee Society were improved from 62 (35-82) and 40 (0-70) to 95.8 (87-100) and 97 (70-100) in patients with osteoarthritis, whereas the patients with rheumatoid arthritis were improved from 53.8 (32-73) and 36 (0-50) to 95.1 (89-98) and 79 (55-95). As a complication, infection occurred in 2 cases; they were given a reimplantation. CONCLUSION: TKRA using a NexGen(R). implant showed satisfactory improvement in pain relief and function, such as range of motion, as well as a lower occurrence rate of complications.