Postoperative Safety of Sequential Bilateral Total Knee Arthroplasty in Low Risk Patients / 대한정형외과학회잡지

PURPOSE: To study the safety of sequential bilateral total knee arthroplasty in low risk patients. MATERIALS AND METHODS: Those who had received the surgery all at once were grouped as the first group, those who had received the surgery over two weeks interval were the second group and the last group, third group were those who had received the first surgery on only one knee and they were gotten re-hospitalized for the second surgery on the rest of the knee. These groups were compared on the aspects of complication, postoperative bleeding amount, average transfusion amount, operation time and admission period. RESULTS: There were no major complications found in all groups and the minor complication rate of occurrence was 3%, 4%, 6% in each, which did not constitute a significance difference. Each of the total blood loss was 1442.9 mL, 1567.4 mL, 1616.6 mL and which did not constitute a significance difference, either. Each of the average volume of blood transfused was 1220.3 mL, 680.1 mL, 692.2 mL, and the first group had the largest volume transfused (p<0.05). The operation time was 186, 196, 211 minutes in each and the first group had the shortest duration (p<0.05). The average admission periods were 16.8, 28.6, 29.8 days and the first group had the shortest period (p<0.05). CONCLUSION: We suggest that when there are no medical diseases contracted on patients, the sequential bilateral total knee arthroplasty can be performed safely without definite increase in perioperative complications.

Prevention of New Vertebral Fractures after Treatment with Risedronate, Alendronate or Calcium Carbonate in Patients with Osteoporotic Compression Fracture Treated with Cement Augmentation / 대한정형외과학회잡지

PURPOSE: To evaluate the rate of new fractures of the spine after risedronate, alendronate or calcium carbonate in patients who had vertebroplasty or kyphoplasty due to compression fracture. MATERIALS AND METHODS: We studied 292 patients with osteoporotic compression fractures who had received vertebroplasty or kyophoplasty between June 2003 and October 2007. Of these, 199 were evaluated for new fractures of the spine after treatment with risedronate, alendronate or calcium carbonate. Patients (n=199) were assigned to 1 of 4 groups: No treatment (n=71), risendronate (n=64), alendronate (n=42) or calcium carbonate group (n=22). RESULTS: New fractures of the spine were morphogenically found in 19 patients (26.8%) in the no treatment group, in 11 (17.2%) in the risendronate group, in 8 (19.1%) in the alendronate group, in 5 (22.8%) in the calcium carbonate group. Symptomatically, they were found in 6 patients (8.5%) in the no treatment group, in 4 (6.3%) in the risendronate group, in 3 patients (7.1%) in the alendronate group, and in 2 patients (9.1%) in the calcium carbonate group. CONCLUSION: At one year follow up none of the differences between groups in new fracture rates of the spine were statistically significant.

Displacement of Polished Femoral Stem during Reduction of a Dislocated Cemented Total Hip Arthroplasty: A Case Report

Displacement of a polished femoral stem from its cement mantle occurred during an attempted reduction of a dislocated total hip arthroplasty. This might be related to the geometry and surface finish of the stem, as well as the wedge-shaped and highly polished design. The stem became displaced when the femoral head impinged the acetabular margin during the reduction of the dislocated prosthesis. Surgeons need to be aware of this complication associated with using a polished femoral stem. This can be avoided by cementing over the shoulder of the stem as well as careful reduction under fluoroscopic control.