Arthroscopic Evaluation of Allogenic Meniscal Transplantation / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate arthroscopically the morphological changes of the transplanted human allogenic meniscus including MRI changes at follow up. MATERIALS AND METHODS: From Feb. 1996 to Dec. 1997, among seventeen patients that received allogenic meniscal transplantation, fourteen patients underwent arthroscopic evaluation (7 medial and 7 lateral) at follow-up (from 26 to 48 months post transplantation, average 34 months). To fix the transplanted meniscus, we used a bone-plug method in ten, it key-hole method in three, and the bone-bridge method in one patient. MRI of the five volunteer knees were taken 6 months and 1 year after the operation. In three patients, biopsy samples were taken from the peripheral and central portion of the grafted meniscus. RESULTS: The second-look arthroscopy after allogenic meniscal transplantation revealed that grafts were viable and well incorporated with surrounding capsular tissue. In all cases, the substance of the meniscus was probed and seemed normal. There was no evidence of shrinkage except in one case. CONCLUSION: Second-look arthroscopy revealed excellent incorporation of the allograft with firm attachment throughout. Although early clinical results seem to be promising, further studies are necessary to properly assess whether meniscal transplants will prevent degenerative changes, and enhance knee joint stability.

The Relationship between Sagittal Spinal Alignment and Surgical Results in Degenerative Lumbar Scoliosis with Spinal Stenosis / 대한척추외과학회지

STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze the correlation between clinical results and sagittal vertical axis, clinical results and total lumbar lordosis in degenerative lumbar scoliosis with spinal stenosis. SUMMARY OF LITERATURE REVIEW: There has been no report about the relation between sagittal spinal alignment and surgical outcome of degenerative lumbar scoliosis. MATERIALS AND METHODS: We reviewed 38 surgical cases of degenerative lumbar scoliosis from February 1997 to February 2001 with an average follow-up of 35 months. In whole spine standing AP and lateral radiographs, scoliotic angle(Cobb method), total lumbar lordosis(L1-S1) and the sagittal vertical axis(C7 plumb line) were measured. In lumbar flexion-extension and standing side bending views, the lateral translation was measured and instability was determined. Clinical results were evaluated based on the Kirkaldy-Willis criteria. RESULTS: The scoliotic angles at preoperative, postoperative and follow-up were 15.0+/-4.9, 5.3+/-3.1 and 7.1+/-3.7 degrees retro-spectively. Total lumbar lordosis were 28.7+/-6.1, 40.6+/-7.3 and 35.1+/-10.2 degrees retrospectively. Sagittal vertical axis at preoperative and the last follow-up were 3.3+/-3.2 and 0.1 +/-3.3 cm retrospectively. According to Kirkaldy-Willis criteria, 6 cases were excellent, 24 cases good, 7 cases fair and 1 case poor. There was no statistical correlation between total lumbar lordosis and the clinical results (r=-0.061, p=0.717). Sagittal vertical axis was significantly correlated with the clinical results (r=0.519, p=0.001). CONCLUSIONS: For improvement of surgical outcome of degenerative lumbar scoliosis, the sagittal vertical axis should be used as a parameter of sagittal alignment rather than the total lumbar lordosis.