Diagnosis and Arthroscopic Treatment of Symptomatic Medial Patellar Plica Syndrome of the Knee / 대한정형외과학회잡지

PURPOSE: To evaluate the efficacy of physical examination and dynamic arthroscopy in the diagnosis and treatment of medial patellar plica syndrome which is likely to be overlooked. SUBJECTS AND METHODS: 23 cases diagnosed as medial patellar plica syndrome from August 1998 through December 1999 were evaluated. Diagnosis was made by a symptom of a pain and a click sound during knee flexion, a physical examination of mass palpation and dynamic arthroscopy. RESULT: A dynamic rotation test was an useful physical examination having 96% rate of sensitivity. The results of excellent and good cases were in 19 cases (83%) and there was no worsened case symptomatically after arthroscopic resection. Postoperative complications were 3 cases including incomplete excision (1 case), postoperative hemarthrosis (1 case) and medial meniscus instability due to incorrect arthroscopic technique (1 case). In patients younger than 30 year old, the result of arthroscopic excision was better than that in older ones. CONCLUSION: Careful physical examination with dynamic arthroscopy is a useful method to diagnose the medial patellar plica syndrome which is likely to be overlooked, and arthroscopic complete excision result in excellent results which is of benefit to fast rehabilitation.

Dislocation After Total Hip Arthroplasty / 대한정형외과학회잡지

PURPOSE: Despite many recent advances in total hip arthroplasty, dislocation remains a common postoperative complication. This study was undertaken to evaluate the incidence and causes of dislocation. MATERIALS AND METHODS: We experienced 16 hip dislocations in 217 cases of total hip arthroplasty performed between June 1990 and March 1999. We analyzed the incidence and causes of dislocation retrospectively. We classified the factors of dislocation as component malposition, Soft tissue imbalance and patient factor. Radiographic measurements were performed to evaluate component malposition and soft tissue imbalance. To evaluate patient factor, we analyzed the patient's past history and posture when the dislocation occurred. RESULTS: The leading causes of hip joint dislocation after total hip arthroplasty are acetabular component malposition (9 cases), followed by patient factor (5 cases) and soft tissue imbalance (3 cases). It took an average of 40.5 days following surgery for hip joint dislocation to occur with 13 out of 16 cases (90.2%) developing hip dislocation within 2 months. CONCLUSION: In order to prevent acetabular component malposition, careful insertion of acetabular component is required. Preventive measure and care should be taken during the early postoperative period. Those presenting with improper anteversion, accurate analysis of the extent of acetabular and femoral component anteversion based on CT scanning is helpful.