The Results of High Tibial Open Wedge Osteotomy with Arthroscopic Surgery for Varus Gonarthrosis / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical and radiographic outcomes of high tibial open wedge osteotomy combined with arthroscopic surgery in patients with medial unicompartmental osteoarthritis. MATERIALS AND METHODS: Between January 1999 and May 2002, 29 patients with 30 cases were treated with high tibial open wedge osteotomy combined with arthroscopic surgery for the treatment of osteoarthritis. The mean age of the study group was 44.7 years old (range, 20 to 56 years old). 4 cases with more than 1 cm openings were treated by autologous bone grafts, and another 26 cases were treated by Puddu plates alone after osteotomy. The clinical assessment was performed using the Hospital for Special Surgery (HSS) knee rating system. The radiologic analysis was performed by measurement of the femorotibial angle and posterior inclination of the tibial articular surface. RESULTS: The mean knee rating score by the HSS knee rating system improved from 64.7 points (range, 52.0 to 69.5 points) to 82.4 points (range, 78 to 90) at the last follow-up. Radiologic bone union was accomplished in all cases. Preoperative varus angles of 6.3 degrees (range, 3.5 to 8.0 degrees) and posterior inclinations of 6.6 degrees (range, 5.0 to 7.3 degrees) improved, on average, to postoperative valgus angles of 8.2 degrees (range, 5 to 10 degrees) and posterior inclinations of 7 degrees (range, 5.0 to 8.5 degrees). At the last follow-up valgus angles had improved, on average, to 7.3 degrees (range, 4.5 to 9.0 degrees). CONCLUSION: High tibial open wedge osteotomy combined with arthroscopic surgery significantly improved knee joint function.

Short-term Follow up after Meniscus Allograft Transplantation with Clinical Results and MRI Findings

PURPOSE: We investigated the clinical results and MRI findings follow up after meniscal transplantation using fresh frozen meniscal allograft. MATERIAL AND METHODS: From Dec. 1999 to Dec. 2001, we evaluated 17 patients (12 cases: male, 5 cases: female) after meniscal transplantation using fresh frozen meniscal allograft. The patients performed the lateral meniscal transplantation were 12cases, the medial were 5cases. The average age was 32 years old (ranging from 19 to 50 years old), and was follow up period 18 months (ranging from 12 to 26 months). Among them we studied MRI findings in 16 patients and the postop-period was 16.9 months (ranging from 5 to 26 months). We analyzed the clinical data by applying KASS(knee assessment scoring system) & Lysholm knee score, and rehabilitation ability using of Tegner activity scale. It investigated the retrogressive changes of joint effusion, misfortune degree of meniscal location, intensity, tear and degenerative change which was made from the MRI. RESULTS: The follow up mean KASS score and Lysholm score were 84.3 (ranging from 61 to 94), and 81.1 (ranging from 63 to 90). Among the 17 patients, 15 patients showed good results. But painful swellings were 2 cases and intermitent locking symtom was 1 case. The MRI findings were 14 cases increasing signal intensity, 2 cases peripheral displacement, 2 cases partial meniscal tear and some degree effusions of 13 cases. CONCLUSION: The meniscal transplantation using fresh frozen allogrft came to be thought with the surgical method which improved the function of knee joint after operating it brought a successful result from the MRI.

Spared Corticospinal Tract Projections Through Lateral Funiculi after Dorsal Section of the Rat Mid-thoracic Spinal Cord / 대한정형외과연구학회지

In the rat lumbar spinal cord, the pathways and distribution of corticospinal tract (CST) axons were investigated using retrograde transport of Fast Blue(FB) and Fluoro-Gold(FG). The purpose of this study was, therefore, to fond the extent of CST projections in the lateral funiculus in the rat. Total of twelve female rats were used in this study. The laminectomy was performed at the 78 cord level to expose the spinal cord. Using a radiofrequency lesioning device, the CST, including the dorsal columns, were lesioned bilaterally. Three to seven days after lesioning, two laminectomies were performed at C6-8 and L3-5 to expose the spinal cord for dye injections. Retrograde tracing of fast blue(FB) and fluoro-gold(FG) were used to quantitate the number of cerebral cortex neurons projecting to the lumbar cord through tracts other than the CST in the dorsal column. New findings of the this study are : (1) a small number of CST axons projected to lumbosacral spinal cord bilaterally in the dorsolateral funiculi. (2) some axons projecting to the lumbar cord through the dorsolateral funiculi are collateral of neuron that project to the cervical spinal cord. Our results suggest that there are a larger number of CSTs than previously thought projecting to the lumbar spinal cord through the lateral funiculi. These residual tracts may play a role in the functional recovery of the affected limbs.