Retraction: Stress Fracture of the Tibial Plateau After Navigation Assisted Unicondylar Knee Arthroplasty: A Report of 2 Cases / 대한정형외과학회잡지

This article has been retracted.

Prognostic Value of Modified Lateral Pillar Classification in Legg-Calve-Perthes Disease

BACKGROUND: To evaluate the usefulness of the modified lateral pillar classification as a prognostic factor in Legg-Calve-Perthes disease (LCPD). METHODS: Thirty nine patients diagnosed with lateral pillar C in LCPD from May, 1977, to October, 2001 were reviewed, and their skeletal maturity was followed. The mean follow up duration was 12 years and 7 months (4 years, 6 months to 24 years, 9 months). Lateral pillar C classification was divided into C1 (50-75% collapse of the lateral pillar) and C2 (> 75%). All radiological and clinical prognostic factors were evaluated. The final results were evaluated according to the Stulberg classification. RESULTS: Twenty one and 18 of the affected hips were in groups C1 and C2, respectively. According to the Stulberg classification, the final results of group C1 were better than those of C2 (p = 0.002). Patients with more head-at-risk signs had significantly poorer outcomes. CONCLUSIONS: The modified lateral pillar classification has significant value for predicting the prognosis of LCPD.

Computer Assisted Knee Surgery Using Navigation System

Navigation systems are currently being widely used in orthopedic surgery, and especially for total knee arthroplasty (TKA) or UKA. The mechanical axis alignment and component insertion can be judged accurately via a navigation system and this also helps in ligament balancing. A navigation system can also be used in ACL reconstruction and High Tibial Osteotomy (HTO). In open-wedge HTO, accurate multiplane measurements of the lower limb alignment can be made intraoperatively in real time, and alignment adjustments can be made as the surgeon desires. Navigation more accurately improves the postoperative lower limb alignment than the conventional cable-method, and it significantly reduces the radiation exposure time. Navigation for ACL reconstruction allows exact placement of the tibial and femoral tunnels and it prevents impingement, and it also significantly improves the results of isometricity of the femoral tunnel and the stability of the reconstructed ACL ligament. Using a navigation system in knee surgery provided useful intraoperative information about the anatomical placement that's done intraoperatively in real time. It helps perform accurate surgery, it improves the radiologically assessed implantation and it allows precise correction of a mechanical axis, and so we can expect improved clinical results.

Short Term Analgesic Effects of Intraoperative Periarticular Injection in Total Knee Arthroplasty / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the clinical results of intraoperative periarticular injection for osteoarthritic patients who are treated with total knee arthroplasty (TKA). MATERIALS AND METHODS: Forty patients (2 males and 38 females) who underwent TKA under general anesthesia from January 2007 to May 2007 were enrolled in this study. We classified 20 cases to the injection group and 20 cases to the control group. For the injection group, we injected ropivacaine 40 mg, ketolocac tromethamine 2 mg, epinephrine 0.5 cc and morphine 0.8 cc to the periarticular soft tissue before inserting the prosthesis, and the same amount of saline was injected in the control group. We assessed the clinical results according to preoperative and postoperative range of motion (ROM), the visual analogue scale (VAS), and the dosage of the patient controlled anesthesia (PCA) in both groups. RESULTS: There was no significant difference in preoperative ROM and VAS between the groups (p>0.05). However, significant differences between the groups were reported for the postoperative ROM at 6 and 12 hour. In terms of the VAS, it showed significant differences between the groups at 6 and 12 hours and at the first and second days after operation. The dosage of PCA was significantly lower at postoperative 6 and 12 hours. CONCLUSION: For the patients treated with TKA, periarticular injection to the operation site is supposed to be an effective method at the early stage for recovery of the ROM, the postoperative pain control and to decrease of the PCA dosage.

Stress Fracture of the Tibial Plateau After Navigation Assisted Unicondylar Knee Arthroplasty: A Report of 2 Cases / 대한정형외과학회잡지

Satisfactory results of unicondylar knee arthroplasty (UKA) have been reported since minimally invasive UKA had been introduced. However, several stress fractures of the tibial plateau, related to instrumentation design, have been reported. We report two cases of periprosthetic stress fractures of the tibial plateau after navigation-assisted unicondylar knee arthroplasties.