The Short-term Follow-up Results of Open Wedge High Tibial Osteotomy with Using an Aescula Open Wedge Plate and an Allogenic Bone Graft: The Minimum 1-Year Follow-up Results

BACKGROUND: This study examined the results of open wedge high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft as a surgical technique for the patients who suffer from osteoarthritis of the knee with a genu varum deformity. METHODS: From March 2007 to August 2007, 33 patients (37 cases) with osteoarthritis of the knee and a genu varum deformity underwent a high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft. The patients were followed up for more than 1 year. Before and after surgery, the correction angle of the genu varum was measured by the lower extremity scannogram and the posterior tibial slope, the joint space distance and the time to bone union were evaluated. The functional factors were evaluated using the Knee Society Score. RESULTS: The average knee score and function score improved from 52.19 +/- 11.82 to 92.49 +/- 5.10 and 52.84 +/- 6.23 to 89.05 +/- 5.53, respectively (p < 0.001). According to the lower extremity scannogram, the mean preoperative varus angle was -1.86 +/- 2.76degrees, and the average correction angle at the last follow-up was 10.93 +/- 2.50degrees (p < 0.001). The tibial posterior slope before surgery and at the last follow-up were 8.20 +/- 1.80degrees and 8.04 +/- 1.30degrees, respectively (p = 0.437). The joint space distance increased from 4.05 +/- 1.30 mm to 4.83 +/- 1.33 mm (p < 0.001). The average time to complete bone union was 12.69 +/- 1.5 weeks. CONCLUSIONS: An open wedge high tibial osteotomy using an Aescula open wedge plate and an allogeneic bone graft to treat osteoarthritis of the knee with a genu varum deformity showed good results for the precision of the correction angle, the time to bone union and the functional improvement.

Perioperative Changes in C-Reactive Protein Levels after Unilateral and Simultaneous Bilateral Total Knee Replacement / 대한정형외과학회잡지

PURPOSE: The objective of this study was to determine the patterns of C-reactive protein (CRP) changes during the postoperative period after total knee replacement (TKR), and to determine the CRP changes associated with infection after TKR. MATERIALS AND METHODS: A retrospective analysis of the pattern of CRP changes during the first 6 postoperative months was conducted on 2,315 patients who underwent unilateral or simultaneous bilateral TKR. This data was also compared with the pattern of CRP changes which occurred in 19 patients with a deep prosthesis infection who were not enrolled in the main study. RESULTS: The CRP levels peaked 3 days postoperatively, and then decreased to baseline levels at 15-28 days postoperatively. Within 14 days postoperatively, the CRP levels were significantly higher in the simultaneous bilateral TKA group than in the unilateral group (p<0.01). Thereafter, no significant difference in CRP levels existed between two groups. After the 8th postoperative day, a significant difference in CRP level existed between patients with and without deep prosthesis infections. CONCLUSION: CRP changes post-TKR provide an effective means of monitoring of infections. In cases of non-inflammatory arthritis in which the CRP levels are significantly difference after the 8th postoperative day or are elevated after the 4th postoperative week, an infection should be suspected.

Long Term Results After Resection of the Discoid Meniscus in Children / 대한정형외과학회잡지

PURPOSE: We retrospectively reviewed the long term results of arthroscopic resection of the discoid meniscus in children and evaluated postoperative clinical symptoms and radiological changes. MATERIALS AND METHOD: The results of arthroscopic surgery in 27 symptomatic discoid menisci of 22 patients who were under 15 years old at the time of operation (average; 11 year 9 month old) were evaluated. Average follow-up period was 9 years 4 months (5 years-18 years 1 months). Clinical results were analyzed according to Ikeuchi's clinical grading system and radiological degenerative changes were classified according to Fairbank at the last follow-up. RESULTS: According to Ikeuchi's grading system, excellent results were obtained in 10 cases (37.0%), good in 12 cases (44.4%), fair in 5 cases (18.5%). No radiological change was observed in 1 case (3.7%), 1 radiological sign in 5 cases (18.5%), 2 radiological signs in 13 cases (48.1%) and more than 3 radiological signs in 8 cases (29.6%) in the last follow-up radiograph. No correlation between clinical results and radiological changes. CONCLUSION: Arthroscopic resection of discoid meniscus in children was effective at relieving symptoms over a follow up of more than 5 years, though radiological degenerative changes occurred. We recommend that follow up is resuired to determine whether the clinical results of knees in middle or older age groups will worsen.