Total Knee Arthroplasty Using Bone Graft in Neuropathic Knee: Preliminary Report

INTRODUCTION: Recently, total knee arthroplasty is being considered as an alternative to the arthrodesis for neuropathic knee. This study was performed to prove the results of the total knee arthroplasty using autograft or femoral head allograft. SUBJECTS AND METHOD: In 8 patients, total knee arthroplasty was performed from July 1992 to January 2002. PCL substituting type with extension rods, constrained condylar knee prostheses were used. In all cases, auto or allo-grafts were used. The follow-up period was an average 3 years and 6 months. HSS knee score and radiographic findings were analysed. RESULT: The preoperative HSS score was an average 42 points and follow up was a 89 points, which was more than good. The average range of motion was increased from 110 degrees to 122 degrees, femorotibial alignment was corrected to 6.1 degrees valgus. There was a no radiolucent line over 2mm and loosening of implant. But, one case had a partial absorption of medial tibial bone graft site, and complained the subluxation after 6 years and 5 months. So the meniscal bearing was exchanged from 12.5mm to 17.5mm. CONCLUSION: If the proper choice of prostheses and bone grafts are accompanied, the total knee arthroplasty can be used to treat the neuropathic joint concurrently with arthrodesis.

Effects of the Strengthening Exercise on Back Muscles after Lumbar Discectomy / 대한척추외과학회지

STUDY DESIGN: A retrospective study about lumbar strengthening exercise after lumbar discectomy. OBJECTIVES: To evaluate the effect of lumbar strengthening exercise on muscle power and pain, to analyze the problem of rehabilitation program after lumbar discectomy. SUMMARY OF LITERATURE REVIEW: The effectiveness of Lumbar strengthening exercise is still controversy and we can not found the similar article for this kind problem. MATERIALS AND METHODS: Three-hundred twenty eight patients of microscopic lumbar discectomy from 1998 to 1999, were divided into 2 groups; exercise group was 72 cases among 119 patients, and non-exercise group was 58 cases among 208 patients. degree of pain and functional activity were evaluated by visual analog scale and API test, respectively, at postoperative 3 months, 6 months, 1 year. the reason for not exercising was surveyed in non-exercise group. RESULTS: Exercise group 119 patients(36%). The most common cause of Non-Exercise was a deficiency of importance for lumbar strengthening exercise and exercise was done better in civil peoples than inrural peoples. There was a significant good result in exercise group by visual analog scale for pain at 3 months and 6 months postoperatively, but no difference between two groups after 1 year. exercise group had better results in flexion/extension test and fatigue endurance test. Lumbar strengthening exercise was a good method for relieving the pain in short term, but it was not effective in long term follow up. CONCLUSIONS: These results suggest that good results after lumbar discectomy in exercise group result from the secondary effects of increasing muscle power rather than relieving pain.