Cementless Total Knee Arthroplasty and Effects of Disease Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis / 대한정형외과학회잡지

PURPOSE: We reviewed patients with rheumatoid arthritis to evaluate the results of cementless total knee replacement and the effects of Disease Modifying Anti-Rheumatoid Drugs. MATERIALS AND METHODS: The results of 59 cementless total knee arthroplasty in 35 patients were retrospectively analyzed. Cases were divided into two groups: one was treated with Disease Modifying Anti-Rheumatic Drugs and the other without them. Clinical and radiological outcomes were evaluated using the Knee Society clinical rating system and Knee Society roentgenographic evaluation and scoring system, respectively. RESULTS: At the most recent follow-up, femoral flexion angle, tibial angle and total valgus angle in anteroposterior view were 97.1, 89.1 and was 7.6. Femoral flexion angle and tibial angle in lateral view were 3.0 and 91.0. There were no statistical differences as compared with the postoperative values. There were also no statistical differences between the two groups. Knee score and function score of all cases were 85.5 and 67.6. Those of the group treated with Disease Modifying Anti-Rheumatic Drugs were 90.9 and 78.1. Those of the group without them were 74.0 and 45.5. CONCLUSIONS: Results of the cementless total knee arthroplasty in rheumatoid arthritis are very promising and Disease Modifying Anti-Rheumatic Drugs have an effect on the postoperative clinical results.

Effects of Fresh and Degenerated Autogenous Nerve Graft in Segmental Defect of Sciatic Nerve of Rabbit / 대한정형외과학회잡지

The potential for nerve regeneration and recovery of its function exists in the presence of a suitable pathway for regenerating axon and endoneurial tube can serve as nerve conduit for regenerating axon in fresh nerve graft. But value of degenerated nerve as donor nerve has not been established till now. This experiment assessed the chronologic influence of fresh and degenerated nerve graft on axonal growth for 10mm gap of sciatic nerve in rabbit and how long degenerated nerve was ahle to serve as a nerve conduit microscopically. Electromicroscopically, the regenerating axons which were ohserved in the degenerated nerve graft had more abundant unmyelinated fibers and revealed abundant collagen fibers in the endoneurium. And these regenerating axons became gradually surrounded with newly developed basal lamina and decreased the collagen fibers at l2 week of degenerated nerve graft. Histologically, myelinated axons which were observed in central area of the degenerated nerve graft at 8 week of degenerated nerve graft were relatively thinner, but a definite structural difference of regenerating axons was not found except reduction of number compared with those of tresh nerve graft. The numher of myelinated axons was 6,072+/-l42 in normal sciatic nerve, 4,479+/- 157 in fresh nerve graft group, and 2,968+/-168 in the degenerated nerve graft group. Difference of the number of myelinated axons between fresh and degenerated nerve graft group was significant stati stically(P<0.05). These results showed that the ability of a degenerated nerve graft as a passage for the regenerating axons and it can be employed as one of the favorable nerve conduits.

Fracture of Tibial Base Plate Following Total Knee Arthroplasty: Report of a Case / 대한정형외과학회잡지

Fracture of the metal base of tihial components of total knee arthroplasty has heen occasionally reportecl. The most common cause of the failure of the metal hase plate was known to be a fatigue fracture around the screw hole where the strength of the metal hase plate was the weakest. We experienced a case of the fracture of the metal hase plate secondary to the t'racture of the posteromedial corner of the metal tihial condyle which was weakened due to the shoil peg hole for the base plate of MG II implant. Since the proximal portion of the posterior tihial condyle was normally thin, cutting the hone for the base plate made it thinner and wcaker than normal. Therefore stress fracture of the bone occurred and the overlying metal plate was subsequently hroken. From this experience. we concluded that the posterior peg hole may cause unwanted failure of the posteromedial corner of the tibial base plate.