Correlation of Notch Configuration between Subjects with and Subjects without Anterior Cruciate Ligament Injury / 대한정형외과학회잡지

PURPOSE: The aim of this study was to evaluate the correlation between the 3-dimensional (D) notch volume and the 2D notch width and notch shape as measured on magnetic resonance imaging (MRI), between subjects with anterior cruciate ligament (ACL) injury and those without ACL injury. MATERIALS AND METHODS: Knee MRI images were taken from 72 subjects with ACL injury and 80 subjects without ACL injury (January 2007 to January 2012; Gyeongsang National University Hospital, Jinju, Korea). We measured 3D notch volume and 2D notch width and notch shape. The measured values from MRI figures between ACL-injured subjects and non-ACL-injured subjects were compared and analyzed. These measurements (notch width, notch ratio) were correlated to notch volume. Both intra-observer reliability and inter-observer reliability were calculated. RESULTS: Notch width differed significantly between ACL injured subjects and non-injured subjects (p<0.001), while no significant differences in notch volume and notch shape were observed between the groups (male: p=0.43, female: p=0.22). CONCLUSION: The results of this study might suggest that certain 2D measurements (notch width) of the notch could be better than notch volume for prediction of ACL rupture risk.

Traumatic Lumbosacral Spinal Subdural Hematoma Mimicking Subdural Lipoma: Value of Computed Tomography / 대한정형외과학회잡지

Traumatic lumbosacral spinal subdural hematoma due to anatomical and pathological causes is rare, compared to epidural hematoma. If the time of trauma cannot be determined, intracranial and intraspinal signal intensity according to lapse of time are not coincident, resulting in confusion in terms of differentiation. Fat suppression magnetic resonance image (MRI) and computed tomography (CT) are utilized for differentiation. The intention of this study is to report on a case where spinal subdural hematoma of unknown time of occurrence is differentiated from subdural lipoma by taking advantage of fat suppression MRI and CT in order to perform an early surgical decompression with auxiliary review of literature demonstrating good prognosis of the procedure.

Comparison of Closing-Wedge and Opening-Wedge High Tibial Osteotomies / 대한정형외과학회잡지

PURPOSE: The aim of this study is to compare the clinical results and radiologic changes of closing-wedge high tibial osteotomy (CW HTO) and opening-wedge high tibial osteotomy (OW HTO). MATERIALS AND METHODS: Seventy five knees were treated with a CW HTO and 41 with an OW HTO. For each patient the hip-knee-ankle (H-K-A) axis was evaluated and the degree of the medial compartmental arthrosis was measured by Ahlback-type radiological classification. The function of the knee was evaluated by the Tegner activity score, the Lysholm knee scoring scale and the Western Ontario and McMaster University index. Lateral radiographs were taken to assess the patellar height and the posterior tibial inclination. RESULTS: In both groups significant improvement of the visual analogue scale and range of motion was achieved. The frontal plane H-K-A axis was corrected significantly from varus to the range of physiological valgus and the arthrosis of the medial compartment of the knee progressed gradually. The body mass index was significantly influential to the progression of arthrosis. The functions of the knee were improved significantly in all cases. In the closing-wedge group, the patella height was increased at the postoperative period, while it was decreased in the opening-wedge group. There was a tendency of a decrease of the tibial inclination in the CW HTO group and a statistically significant increase of the tibial inclination in the OW HTO group. Recurrence of varus occurred in sixteen cases. CONCLUSION: In both groups, improvement of the function of the knee was achieved, but there was no statistical difference. However, the opposite result was found in the patella height and the tibial inclination.

Measurement of Knee Morphometrics Using MRI: A Comparative Study between ACL-Injured and Non-Injured Knees

PURPOSE: The purpose of this study is to find out the differences of distal femur morphology between the anterior cruciate ligament (ACL)-injured and the non-ACL injured on an magnetic resonance imaging (MRI), and the difference of bone structure by gender. MATERIALS AND METHODS: MRI Measurements of notch width (NW), bicondylar width (BCW), medial condyle width (MCW), lateral condyle width (LCW), medial-to-lateral condyle ratio (M:L ratio), and notch entrance width (NE) were taken from 120 subjects with ACL injury and the other 106 subjects without ACL injury, by three independent observers, at two different times. The measured values from MRI figures between the ACL-injured and the non-ACL-injured were compared and analyzed, with consideration of the differences by gender. Both intra and inter-observer reliability were calculated. RESULTS: There were significant differences of NW, BCW, MCW, LCW and NE by gender (p<0.001). While NW and MCW in male group were different (p<0.001), NW, MCW, M:L ratio and NW index (NWI) in female group were significantly different (p<0.001) in the bone morphology between the ACL-injured and non-ACL-injured. The intra- and inter-observer reliability was satisfying. CONCLUSIONS: If necessary to take an MRI, female patients with small NWI and NW injury should be carefully treated because of possibility of ACL injuries.