Evaluation of Muscle Strength Using Isokinetic Testing and Functional Result after Total Knee Arthroplasty / 대한정형외과학회잡지

PURPOSE: Objective measurements of knee of flexor and extensor strength using isokinetic equipment and function after total knee arthroplasty (TKA) were evaluated until postoperative 12 months. MATERIALS AND METHODS: The control group constituted of 15 persons who were of same age and weight without knee problems. Most of the patients (70%) were operated on both knees simultaneously. The patient group consisted of constituted with 20 patients (34 cases). Isokinetic testing (Cybex) of knee flexor and extensor strength of knee and functional evaluation by HSS score was performed preoperatively and at 3, 6, 12 months postoperatively. RESULTS: The peak torque of the knee extensor and flexor muscle in the patient group was decreased by 17-41% compared to the control group. Especially, the peak torque of extensor was more decreased than flexor muscles. At postoperative 12 months, the peak-torque values of hamstring and quadriceps were able to attain the same strength levels of the preoperative knee. According to the grade of the Hospital for Special Surgery knee rating scales by Insall, 28 cases (82 %) in the patient group could obtain good result at postoperative one year. CONCLUSIONS: Exercises to increase the strength of extensor should be emphasized in the rehabilitation programs after TKA

Patient Outcomes after Open Release of the Carpal Ligament on the Carpal Tunnel Syndrome / 대한정형외과학회잡지

We present at least a one-year follow up of the 19 patients(twenty-two hands) of a open release of carpal ligament and external neurolysis in surgery for carpal tunnel syndrome. The transverse carpal ligament is exposed through a three centimeter paJmar incision in line with the axis of the third finger, started at the mid-point of the distal wrist crease and then straightly advanced. We analysed clinical manifestations and the following results were obtained; The average follow-up period was 27 months (12 - 120months). 1. According to the patients satisfaction of results(Cseuz criteria), the large majority of patients(91%) obtained good results. In 9% of the case (two hands) symptoms were siightly improved followed the operation but pain, numbness and paresthesia remained troublesome. 2. The mean grip and pinch strength of the fifteen hands were 23.4kg and 5.97kg respectively. 3. Thirteen(87%) of the fifteen hands that had thenar atrophy regained normal muscle bulk. 4. Six(50%) of the twelve hands that had denervation findings such as fibrillation or sharp wave were disappeared. 5. Twenty(91%) of the twenty-two hands that had increased values for two-point discrimination had normal values at follow-up.

Decompressive Effect of Indirect Decompression in Thoracolumbar Burst Fracture / 대한정형외과학회잡지

This study was performed to establish a radiological indication and contraindication of indirect decompression in the thoracolumbar burst fracture as well as to clarify an acceptable degree of the canal constriction to enhance neurologic recovery and to prevent the spinal stenosis. The canal diameter ratio (CDR) of the constricted level was determined using pre-and post-operative CAT images of 31 thoracolumbar burst fractures, decompressed indirectly. The acceptable CDR was decided by the lower limit of the 95% confidence interval of the post-operative CDR in cases without neurologic deficit associated with the canal constriction. A radiological indication and contraindication of indirect decompression was establish based on the calculation of the discriminant equation and linear regression equation respectively. The results were as followings. 1. The acceptable CDR was 46% at the cauda equina level and 37% at the conus medullaris level. 2. According to the result of calculation of the regression equation, the radiological contraindication of indirect decompression was the pre-operative CDR of 13% or less at the cauda equina level and 27% or less at the conus medullaris level. In conclusion, the radiological indication of indirect decompression was the pre-operative CDR of 34% at the cauda eqbina level and 42% at the conus medullaris.