Arthroscopic Evaluation of Allogenic Meniscal Transplantation / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate arthroscopically the morphological changes of the transplanted human allogenic meniscus including MRI changes at follow up. MATERIALS AND METHODS: From Feb. 1996 to Dec. 1997, among seventeen patients that received allogenic meniscal transplantation, fourteen patients underwent arthroscopic evaluation (7 medial and 7 lateral) at follow-up (from 26 to 48 months post transplantation, average 34 months). To fix the transplanted meniscus, we used a bone-plug method in ten, it key-hole method in three, and the bone-bridge method in one patient. MRI of the five volunteer knees were taken 6 months and 1 year after the operation. In three patients, biopsy samples were taken from the peripheral and central portion of the grafted meniscus. RESULTS: The second-look arthroscopy after allogenic meniscal transplantation revealed that grafts were viable and well incorporated with surrounding capsular tissue. In all cases, the substance of the meniscus was probed and seemed normal. There was no evidence of shrinkage except in one case. CONCLUSION: Second-look arthroscopy revealed excellent incorporation of the allograft with firm attachment throughout. Although early clinical results seem to be promising, further studies are necessary to properly assess whether meniscal transplants will prevent degenerative changes, and enhance knee joint stability.

The results of the Posterior Lumbar Interboby Fusion using Titanium mesh cage for Spondylolisthesis / 대한척추외과학회지

STUDY DESIGN: This is a retrospective study analysing and comparing what between posterior lumbar interbody fusion plus posterior lateral fusion(PLIF+PLF) and PLF alone for Spondylolisthesis(Degenerative type+Isthmic type). Thirty patients were treated by posterior lumbar interbody fusion(PLIF) using Harms' cage and posterolateral fusion(PLF) with transpedicular screw fixation. Forty-nine patients were treated by posterolateral fusion with transpedicular screw fixation. OBJECTIVES: This is to verify the advantages of adding posterior lumbar interbody fusion using Harms' cage to the usual posterolateral fusion with transpedicular screw fixation SUMMARY OF BACKGROUND DATA: Interbody fusions have certain distinct mechanical advantages over posterolateral ones. Autologous cancellous bone is the preferred graft material, but might be soft to maintain the disc space during fusion. METHODS: Union rate, slip reduction, sagittal angle correction, disc height restoration, and clinical results by Lin's criteria were analysed. RESULTS: Nonunion was observed in 5 PLF cases(10%) and one PLIF case(3%). Loss of slip reduction was 0.7% in PLIF and 2.59% in PLF(P<0.05). Loss of sagittal angle correction was 1.27degreein PLIF and 3.65degreein PLF(P<0.05). Loss of disc height restoration was 2.6% in PLIF and 7.6% in PLF(P<0.05). Clinical evaluation in PLIF+PLF was excellent in 67%, good in 30%, and fair in 3%. Clinical evaluation in PLF was excellent in 59%, good in 33%, and fair in 8%. More excellent results were noted in PLIF+PLFcases. CONCLUSIONS: Adding posterior lumbar interbody fusion using Harms' cage showed better radiological results and more excellent clinical results compared to posterolateral fusion with transpedicular screw fixation.