Behcet's Arthritis / 대한정형외과학회잡지

PURPOSE: The clinical manifestations of Behcet's arthritis are similar to those of rheumatoid arthritis, and they need to be differentiated. The objective of this study was to evaluate the past history, diagnosis, treatments and clinical findings of Behcet's arthritis. MATERIALS AND METHODS: Among 1,602 cases with Behcet's disease, 87 cases with Behcet's arthritis were enrolled in this study between January 1990 and December 2000. A thorough review of each case was done by examining the patients' medical charts and personal interview. The clinical manifestation, the existence of morning stiffness and laboratory studies including ESR, CRP, AS, and RF were investigated. The Shimizu classification was used as diagnostic criteria. RESULTS: There was no preponderance of gender and the most prevalent age group was in their 3rd and 4th decades. The most common involved site was the knee joint (60 of 87 cases), and multiple site involvement was common (56.0%). Clinically, symptoms such as pain, tenderness and joint swelling were common. According to the Shimizu classification, the incomplete type was the most common (67.8%). The symptoms improved after conservative treatment, but 12 cases (21.0%) recurred within one year. Arthroscopic synovectomy was performed in 2 cases, but these cases showed no improvement. CONCLUSION: Behcet's arthritis should be differentiated from rheumatoid arthritis, and conservative treatment showed good clinical results.

Radiological Evaluation of Quadriceps-Sparing Minimally Invasive Total Knee Arthroplasty / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the radiological results of quadriceps-sparing total knee arthroplasty. MATERIALS AND METHODS: 50 consecutive total knee arthroplasties with a quadriceps-sparing surgical technique and 50 consecutive total knee arthroplasties with conventional surgical techniques were performed. The same surgeon performed all the operations with the same type of prosthesis (Nexgen LPS-flex Total Knee System). We compared the differences between these groups in terms of preoperative and postoperative femorotibial angles, tibial component alignment angles, tibial component inclinations, and ratios of size of the tibia component to tibial cutting size. RESULTS: There were no differences in preoperative femorotibal angles, tibial component alignment angles, tibial component inclinations, ratios of sizes of tibia tray to tibial cutting size, and blood loss between the two groups (p>0.05). The average ranges of motion and HSS scores at 8 weeks postoperatively in the quadriceps-sparing total knee arthroplasty group were greater than those in the conventional surgical technique (p<0.05). The mean postoperative femorotibial angle in the quadriceps-sparing total knee arthroplasty group was a valgus of 6.9+/-1.3 degrees compared with a valgus of 7.7+/-1.4 degrees in the standard arthroplasty group (p<0.05). CONCLUSION: A quadriceps-sparing total knee arthroplasty offers predictable results in terms of radiological comparison with the conventional arthroplasty technique. But this technique has the tendency of producing a decreased valgus angle at the distal femur.

Intramedullary and Extramedullary Combined Alignment System for Tibial Component Placement in Total Knee Arthroplasty

PURPOSE: The purpose of this study is to assess the usefulness of combined intramedullary and extramedullay tibial resection guide system. MATERIALS AND METHODS: 277 consecutive total knee arthroplasties were performed using three different alignment systems.: extramedullary system(group 1 ; 89 cases) , intramedullary system(group 2;134 cases), combined system(group 3;54 cases). We compared the differences of these groups in terms of preoperative femorotibial angle, postoperative femorotibial angle and postoperative tibial component alignment angle, respectively. RESULTS: Preoperatively, the three groups were similar in diagnosis, patient age, and preoperative femorotibial angle(p>0.05). Postoperative tibial component alignment angle and femorotibial angle were similar in each group(p>0.05). The optimal tibial component alignment angle was defined within 2 degree of the 90 degree and it was achieved in 51.7% in group 1, 47.8% in group 2 and 59.3% in group 3(p>0.05). The the optimal femorotibial angle was defined by the range from valgus 5 degrees+/-2 and it was achieved in 54.5% in Group 1, 54.5% in Group 2 and 55.6% in Group 3(p>0.05). CONCLUSION: This study demonstrated that the accuracy of the extramedullary system, intramedullary system, and combination system for tibial resection were similar. So the combination system can be one of the acceptable method for cutting the proximal tibia, because it utilizes the strength of the extramedullary system as well as the intramedullary system.