Serial Magnetic Resonance Imaging Evaluation of Bioabsorbable Interference Screws in Anterior Cruciate Ligament Reconstruction / 대한정형외과학회잡지

PURPOSE: To evaluate the changes at the postoperative site of anterior cruciate ligament (ACL) reconstruction, in which bioabsorbable screws were used for fixation, by magnetic resonance imaging (MRI) and to evaluate the efficacy and safety of Bioscrews(R) (Linvatec, Largo, FL). MATERIALS AND METHODS: This prospective study was initiated in May 1997 upon 38 patients receiving Bioscrews(R). All patients with arthroscopically assisted primary reconstruction of ACL involving fixation with Bioscrews were examined 3, 6, 12 and 24 months after operation by Lysholm score, KT-2000 arthrometer and MRI. MR Images were interpreted by musculoskeletal radiologists. RESULTS: There were no complications related to loss of fixation. The Lysholm scores and the KT- 2000 arthrometer measurement at final follow-up were 95.6 and 1.8 mm respectively. Even after two years there was evidence of screw material in all cases. MRIs taken at 3 months showed fluid collections inside the tibial tunnel (n=3) and the anterior aspect of the tibial tunnel (n=1), Though these fluid collections disappeared gradually. Varying amounts of edma were observed around the tunnels. We divided the bone edema into the ring (n=5) and diffuse types (n=16), which disappeared gradually. CONCLUSION: The Bioscrews(R) was found to be a safe and effective alternative for fixation in ACL reconstruction, but requires the long term follow-up to confirm its safety.

Factors Affecting the Results of Proximal Tibia Opening Wedge Osteotomy / 대한정형외과학회잡지

PURPOSE: This study sought to perform proximal tibia opening wedge osteotomy on osteoarthritis patients, assess the treatment and identify factors affecting clinical results. MATERIALS AND METHODS: Nineteen patients (19 cases) who had opening wedge osteotomy at our hospital from November 1987 to 1998, and were followed up on for at least 2 years were enrolled in the study. The follow-up period ranged from 2 years to 10 years 4 months averaging 5.3 years. We analyzed those factors that affected the results of operation, such as age, weight, joint space nar-rowing and corrective angle. RESULTS: Preoperative mean varus angle was 6.8 degrees and postoperative mean valgus angle 6.8 degrees. Mean valgus angle was degrees at the final follow-up. Clinical assessment of the patients following the final follow-up showed: excellent in 8 cases, good cases, and fair in 2 cases. In addition, the remaining one case, assessed as poor, received total knee arthroplasty. The postoperative score was 86.3 +/-10.6 in the lower age group, and 82.4 +/-8.8 in the higher age group (p>0.05). The postoperative knee score was 89.2 5.2 in the non-obesity group, and 78.0 +/-11.0 in the obesity group (p<0.1). In relation to Ahlback classification, the postoperative score was 88.3 +/-5.0 in the stage I group and 70.0 +/-9.9 in stage II group (p<0.05). The postoperative knee scores were 77.3 +/-10.8, +/-8.0 and 91.0 +/-5.3, for those with postoperative valgus angles of below 5 degrees, 6 to 7 degrees, and over 8 degrees, respectively (p<0.05). CONCLUSION: We conclude that opening wedge osteotomy with overcorrection of the postoperative valgus angle may be an effective method in osteoarthritic patients with a mild loss of joint space.