Adventitial Cyst of the Radial Artery in the Wrist: A Case Report

Simple ganglions are most common benign tumor of the hand and wrist. However, cystic adventitial disease is an uncommon vascular anomaly first described in 1947 in the external iliac artery. It usually involves the popliteal artery, although other arteries and veins may also be involved. Radial artery adventitial cysts are found directly within the adventitia, whereas the more common wrist ganglions may extrinsically compress or adhere to the artery walls. The diagnosis is rarely made before surgery because of their similar appearance and location. The authors report a rare case of a 46-year old woman with mucoid adventitial cyst of the radial artery in the wrist.

Risk Factors for Osteonecrosis of the Femoral Head in Patients with Heamatologic diseases

PURPOSE: We aimed to clarify the risk factors associated with the development of ONFH by comparing patients with hematologic diseases and osteonecrosis of the femur head (ONFH) to those patients without ONFH and who have hematologic diseases MATERIALS AND METHODS: The study population was limited to the patients admitted to our Hematology-Oncology department from 1 January 1994 to 31 May 2007. The patients were divided into 2 groups (those with ONFH, 54 patients and those without ONFH, 54 patients) and the risk factors for ONFH were evaluated by a comparative analysis. We analyzed the effect of a history of bone marrow transplantation (BMT), graft-versus-host disease (GVHD), total body radiation (TBI) and the amount of steroid used as the risk factors for ONFH. RESULTS: On the multiple logistic regression analysis, a total steroid use of >g/BMI was statistically identified as a significant risk factor for ONFH. The history of BMT and TBI were not statistically correlated with the development of ONFH. Among the patients with BMT, allogenic BMT and a history of GVHD were not statistically correlated with the development of ONFH on the multiple logistic regression analysis. CONCLUSION: Patients with hematologic diseases and who have used steroid >1.5g/BMI should carefully observed because they are more likely to develop ONFH.

Short Term Results of Cementation of a Polyethylene Liner into a Well-Fixed Metal Shell

PURPOSE: To evaluate the radiological and clinical results of cementation of a polyethylene liner into a well-fixed metal shell in revision total hip arthroplasty. MATERIALS AND METHODS: From November 2001 to April 2006, 11 cases (10 patients) were included in this study. There were 5 males (6 cases) and 5 females with a mean age of 54.3 years. The mean follow-up period was 35.2 months. The acetabular shells were stable and their position was acceptable in all cases. Pre-existing screws were removed and screw holes were filled with allogenic bone. The inner surface of the metal shells and convex backside of the liners were roughened with a burr. The clinical results were evaluated using the Harris hip score (HHS) and the radiological results with evidence of a positional change in the acetabular cup and liner, and the progression of osteolysis around the cup. RESULTS: The mean HHS was 69.5 points preoperatively and 89.2 at the last follow up. There was no change in the cup and liner position or progression of the osteolytic lesion around the femoral or acetabular components. CONCLUSION: Cementation of a polyethylene liner into a well-fixed metal shell showed satisfactory results in revisional total hip arthroplasty with a short term follow-up period.

Lateral Retinacular Release in Total Knee Arthroplasty; Patella Resurfacing versus Retaining

PURPOSE: To investigate the rate of lateral retinacular release and the contributing factors between the patellar resur- faced total knee arthroplasty(TKA) and patellar retained TKA. MATERIAL AND METHODS: From Jan. 2003 to Jan. 2006, 179 cases(90 patella retained, PR; 89 patellar resurfaced, PS) were enrolled in this study. To investigate the contributing factors on the lateral retinacular release along the patellar replacement, the preoperative and postoperative radiographic evaluation was done. Patellar height, congruence angle and medial displacement was measured with the Merchant view. Anterior-posterior knee distance was measured at a lateral film. The statistical significance between two groups was analyzed using the student's t-test. RESULTS: Lateral retinacular release was done in 59 of 179 cases. Thirty-six cases of PR group and 23 cases of PS group were undertaken. The rate of lateral retinacular release was higher in PR group(p<0.05). The difference between preoperative and postoperative patellar height at a Merchant was 2.5, 0.5mm reduction in PS and PR group respectively. PS group showed more medial displacement(mean 2.5mm) than PR group(mean 1.2mm)(p<0.05). CONCLUSION: In PR group, higher rate of a lateral retinacular release was shown than PS group. Less reduction of patellar height and less medial displacement of patella might be related with the high rate of a lateral retinacular release in PR group.