The Clinical and Radiological Availability of Percutaneous Balloon Kyphoplasty as a Treatment for Osteoporotic Burst Fractures

STUDY DESIGN: We retrospectively assessed the results of percutaneous balloon kyphoplasty (KP) by clinical and radiological methods. PURPOSE: To evaluate the outcome of KP as a treatment for osteoporotic burst fractures. OVERVIEW OF LITERATURE: Many surgeons are concerned about the possibility of neurological complications after percutaneous kyphoplasty for osteoporotic burst fractures, secondary to intra-canal cement leakage. METHODS: We performed KP as a treatment for osteoporotic burst fractures. We studied 12 patients/13 vertebrae. The two control groups consisted of patients who only underwent conservative treatment and those who underwent posterior instrumentation and fusion. We measured each preoperative/postoperative vertebral kyphotic deformity angle (KDA) using simple lateral spine images and checked for leakage of cement, as well. The preoperative/postoperative visual analog scale (VAS) scores for back pain, degree of daily activity, and postoperative complications were evaluated. RESULTS: The mean improvement in KDA after KP was 9.7+/-2.2degrees. The mean preoperative and postoperative VAS scores for back pain were 8.3+/-0.4 and 3.1+/-0.17, respectively. Regarding the control group, the mean postoperative VAS score for the conservative group and the posterior surgery group decreased by 4.5+/-0.17 and 3.2+/-0.19, respectively. There was no statistically significant difference between the KP and posterior surgery groups (p=0.125). However, there was a statistically significant difference between the KP and conservative treatment groups (p=0.012). CONCLUSIONS: KP is safe and useful for treating osteoporotic burst fractures.

Etiologic Transition of Septic Arthritis of the Knee

PURPOSE: The purpose of this study was to retrospectively analyze the etiologic transition of the predisposing factors and organisms for septic arthritis of the knee. MATERIALS AND METHODS: Between January 1995 and December 2006, 122 cases of septic arthritis of the knee were retrospectively evaluated for the etiologic transition and causative organism with using the patients' medical records. We researched the incidence and causative factor of septic arthritis of the knee, which was diagnosed via the patients' symptoms, physical examinations, hematologic exams, culture studies & cytology of the joint fluid. We assessed the correlation of disease with age, the year the disease happened, the causative factors and the incidence. RESULTS: Septic arthritis of the knee was increased after 40 years old, and it also increased after 1998. The most common predisposing factor was intra-articular injection of the knee joint. Even though there were no detected organisms in 79 cases (64.8%), the most common causative organism was S. aureus (20.5%). CONCLUSION: The most common etiologic factor of septic arthritis of the knee was an intra-articular injection. We should be prudent for using good aseptic technique and the correct procedure to reduce the secondary infection that's recently due to increased invasive treatment of the knee joint.

Surgical Reconstruction of Lateral Capsule-ligament Complex with Reinforcement by Periosteal Flap of Distal Fibula and Inferior Extensor Retinaculum for Chronic Lateral Ankle Instability / 대한족부족관절학회지

PURPOSE: To evaluate the results of surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum for chronic lateral ankle instability. MATERIALS AND METHODS: From April 2003 to August 2006, 62 patients with chronic lateral ankle instability were operated. There were 38 males and 24 females with a mean age of 39.6 years (range, 18~61 years). Mean follow-up period was 32 months (range, 10~48 months). All patients were checked with preoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device. The clinical results were graded according to the VAS and AOFAS scale. RESULTS: VAS score improved from preoperative 8.2 points to 3.1 points. There were 38 patients who were excellent (above 90 points), 18 who were good (between 76 and 90 points), 5 who were fair (between 60 and 75 points), and 1 who was poor (below 60 points) according to the AOFAS ankle and hindfoot scale. The excellent and good results amounted to 90.3%. CONCLUSION: Surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum is believed to be a effective method for chronic lateral ankle instability.