Relationship between the Synovialization and the Clinical Results after Anterior Cruciate Ligament Reconstruction Using Tibialis Tendon Allograft / 대한스포츠의학회지

The purpose of this study was to evaluate the relationship between the second-look arthroscopic findings of synovialization and the clinical results after the arthroscopic anterior cruciate ligament (ACL) reconstruction with the fresh-frozen tibialis tendon allograft. Fifty-seven patients could be examined with the second-look arthroscopy after the ACL reconstruction with tibialis tendon allograft. The average duration from reconstruction to second-look arthroscopy was 18.4 months (range, 4-48 months). The patients were classified, according to the extent of synovialization, into 3 groups; 37 cases (64.9%) in group A (good), 15 cases (26.3%) in group B (partial), and 5 cases (8.8%) in group C (poor). The clinical results were compared in each group. The 2000 International Knee Documentation Committee (IKDC) subjective knee score was 80 or more in 31 cases (83.8%) in group A, 9 (60%) in group B, and 1 (20%) in group C respectively. All thirty seven cases (100%) in group A had negative or 1+firm end-point Lachman test and negative pivot shift test, however, only 2 cases (40%) in group C. KT-1000 arthrometer measurement was less than 5 mm in 37 (100%) in group A, 14 (93.3%) in group B, and 2 (40%) in group C. According to the 2000 IKDC knee examination form, 37 (100%) in group A, 14 (93.3%) in group B, and 2 (40%) in group C respectively were normal or nearly normal. The synovialization of the graft had positive correlation with the clinical results after the ACL reconstruction with fresh-frozen allograft.

Can We Use the Posterior Condylar Off set as a Predictive Factor for Overhang of the Implant in Total Knee Arthroplasty?

PURPOSE: We tried to demonstrate whether the posterior condylar offset (PCO, the distance from the femoral diaphysis posterior cortex to the posterior condylar margin) and ratio (PCOR, dividing PCO by the maximum antero-posterior diameter of the distal femur) could be used as predictive factors for overhang of the implants or using gender implants in total knee arthroplasty (TKA). MATERIALS AND METHODS: One hundred and one women who underwent TKA using NexGen(R) (LPS) implants, were analyzed prospectively. After distal femoral resection, the mediolateral (ML) width was measured at four points (anterior, distal anterior, distal posterior and posterior) and compared with the ML width of the implant. The aspect ratio (AR, ML/AP ratio) and anterior/distal posterior ML width (Ant/DP) were calculated. Preoperative radiographic PCO and PCOR were measured. Differences of PCO, PCOR, AR and Ant/DP according to the size were analyzed and correlations between PCO, PCOR and AR were also analyzed. The patients were classified into two groups according to the presence of overhang, and differences of each parameter were compared between the two groups. RESULTS: The size of the implant was positively correlated PCO, not significantly correlated with PCOR, and negatively correlated with AR and Ant/DP. PCO and PCOR and AR showed no correlation with each other. PCO and PCOR were not significantly different between the two groups. However, AR and Ant/DP were statistically low in the group with overhang. CONCLUSIONS: Preoperative radiographic PCO or PCOR could not be used as a predictive factor for overhang of the implants or using gender implants in TKA.

Idiopathic Scoliosis in the Eleven Years Old: Prevalence Study / 대한정형외과학회잡지

PURPOSE: To evaluate the epidemiological findings of idiopathic scoliosis in eleven years olds. MATERIALS AND METHODS: A total of 18,521 adolescents who were eleven years old were screened for scoliosis. There were 10,204 boys and 8,317 girls. The adolescents who had an abnormal moire topography were assessed subsequently using standardized clinical and radiological examinations. The scoliotic curve was defined as a curve of 10 or more. RESULTS: The prevalence of scoliosis was 0.31 per cent (57 of 18,521 adolescents), and most of the curves (42; prevalence, 0.23 per cent) were small (10 to 19 degrees). The ratio of boys to girls was 1:4.7 overall. Thoracolumbar curves were the most common type of curve identified, followed by thoracic and lumbar curves. CONCLUSION: The prevalence of idiopathic scoliosis in eleven year olds was 0.31 per cent. The size and pattern of idiopathic scoliosis were similar with those in the adolescents twelve years and older reported in the literature.

Histological Assessment of Degeneration of Anterior Cruciate Ligament in Arthritic Knee / 대한정형외과학회잡지

PURPOSE: To assess the histological findings of anterior cruciate ligament (ACL) degeneration in an arthritic knee and its correlation with the gross appearance of the ACL, the patient's age and the functional status of the knee. MATERIALS AND METHODS: Histological evaluations of the ACL were carried out on 80 patients who had total knee arthroplasty. Five types of ACL degeneration were noted; 1) mucoid degeneration, 2) liquefaction, 3) hyaline degeneration, 4) calcification, and 5) fissuring. A scoring system for the level of ACL degeneration was made. Each type of degeneration was scored and the degree of ACL degeneration was graded by summing each score. The correlation between ACL degeneration and patient's age, gross appearance, and functional evaluation of knee by Knee Society Score (KSS) was analyzed. The gross appearance of the ACL was classified as normal, abnormal (thinned or hypertrophied), and tear. RESULTS: The scores for the histological degeneration of the ACL ranged from 2 to 10, and there was no correlation between the patient's age and the scores (p>0.05). The gross appearance of the ACL was "nor-mal" in 19 cases, "abnormal" in 57, and "tear" in 4 with an average score of histological degeneration in 3.47 (2-6), 5.95 (3-10), and 9.0 (8-10) respectively. The score for the histological degeneration of the ACL was correlated with the gross appearance of the ACL and a functional evaluation by the KSS (p<0.05). CONCLUSION: The degree of ACL degeneration was not closely related to the patient's age but there was some relationship with the gross degenerative changes in the ACL and the functional loss of the knee.