Minimum Five Year Follow-Up Study of Porous-Coated Versus Hydroxyapatite Porous-Coated Cementless Total Hip Replacement / 대한정형외과학회잡지

PURPOSE: To compare the results of hydroxyapatite (HA) -coated with porous coated prosthesis for a minimum of five years. MATERIALS AND METHODS: We reviewed radiographs of 43 patients in HA group (48 cases) and 44 patient in porous group (48 cases) that followed for a minimum of five years after primary cementless total hip arthroplasty. Average follow up period was 6.2 years in HA group and 6.8 years in porous group. RESULTS: Harris hip score was improved to 78.1 point in porous group, 90.9 point in HA group at 6 months after surgery, but at last follwo up, 94 point in HA group, 96 point in porous group, there was no significancy. Thigh pain was noted 22.9% in porous group and 6.3% in HA group at 6 months after surgery (P=0.047) . At last follow up, thigh pain was noted 6.3% and 2.1% respectively. The mean wear of polyethylene liner was 1.36 mm in porous group and 1.72 mm in HA group (P=0.067) . Endosteal bone formation of femoral stem was noted 56.3% of porous group and 91.7% of HA group at one year after surgery, but there was 97% of endosteal bone formation was noted in both group at last follow up. Osteolysis around acetabular cup was noted 8.3% in porous group and 10.4% in HA group, and osteolysis around femoral stem was noted in 20.8%, 37.5% respectively. CONCLUSION: The results of HA coated implant was better than that of porous group at initial, but there was no significant differency at last follow up. The difference in rate of osteolysis and polyethylene wear between both groups were not significant at the last follow up. Final acceptance must await follow-up at least of 10 to 15 years in comparison with current hip prostheses.

The Effectiveness of Transpedicular Bone Graft in Burst Fracture / 대한척추외과학회지

PURPOSE: To assess the effectiveness of transpedicular bone graft after short segmental fixation in the treatment of thora-columbar burst fracture. MATERIALS AND METHODS: Patients who were admitted to our hospital from January 1994 to December 1998 for thoracolumbar burst fracture and treated with open reduction and internal fixation were reviewed. Seventy-five cases who were followed up for more than 1 year were selected. Among of these, 45 cases were treated with internal fixation and posterior fusion only, and in 30 cases transpedicular bone graft was done additionally. Denis classification was used and preop., postop., final follow up wedge angle, Cobb's angle, the height of disc space, and anterior body height were compared and analized respectively. RESULTS: The preop, postop and final follow-up of wedge angle, cobb's angle, disc height and anterior body height were mea-sured. The preop, postop. and final follow up wedge angle of patients who underwent transpedicular bone graft and patients who were treated with posterior fusion only were 20.4 +/-8.4 degrees, 9.8+/-4.6 degrees, 11.5+/-5.3 degrees and 21.4+/-5.9 degrees, 6.7+/-3.1 degrees , 6.8+/-3.1 degrees respec-tively. The Cobb's angle were 19.2+/-7.3 degrees, 8.9 +/-4.4 degrees, 9.2+/-4.6 degrees and 20.2+/-9.9 degrees, 11+/-5.9 degrees, 15+/-6.9 degrees respectively. Anterior body height were 51+/-15.3%, 93 +/-8.8%, 91+/-8.9% and 53+/-11.3%, 88+/-12.8% and 84+/-15.3%. These values were statistically signifi-cant(p<0.05). CONCLUSION: Transpedicular bone graft reduced the loss of the Cobb's angle, wedge angle and anterior body height at postop. and last follow-up. The transpedicular bone graft was a valuable method to prevent reduction loss in the treatment of thoracolumbar burst fracture