Biomechanical and Histological Effects of Different Regimens of Immobilzation after Operative Treatment in a Ruptured Rabbit Achilles Tendon / 대한정형외과학회잡지

PURPOSE: To evaluate the effects of the different regimens of immobilization after surgery in a rabbit model. MATERIALS AND METHODS: The study was performed on the right Achilles tendon of 30 rabbits. Modified Kessler method was used to suture the transected tendon. Rabbits were divided into three groups, Group I (n=10) underwent long leg cast with equinus position for 6 weeks, Group II (n=10) underwent weekly cast correction to full dorsiflexion from 1 week after surgery, and Group III (n=10) underwent daily correction of equinous position with external fixator from 1 week after surgery. The contralateral Achilles tendon served as an unoperated control. And three groups were compared at 6 weeks after surgery. RESULTS: The maximal load at rupture (N) was 55.50, 97.46, 140.27, 180.98 for group I, II, III and control respectively. The strain was 0.44, 0.49, 0.74, 0.67. The stiffness (N/mm) was 9.63, 17.87, 19.01, 23.33. The absorbed energy to rupture (J) was 12.23, 23.98, 51.20, 60.78. Values among groups were significantly different considering the maximal load, strain, stiffness, and absorbed energy to rupture (p<0.05). Histological finding was revealed more mature restoration and more parallel arrangement of fiber bundles in the group II, and especially group III. Achilles tendon rupture, Maximal load, Strain, Stiffness, Tensile loading. CONCLUSION: Tensile loading of the healing tendon by postoperative continuous correction leads to changes in more similar to the normal Achilles tendon, biomechanically and historically.

Various Pathologic Lesions Associated with Anterior Shoulder Instability: Experience over 10-Years of Arthroscopic Treatment / 대한정형외과학회잡지

PURPOSE: We report upon the frequency and results of treatment for various pathologic lesions such as ALPSA lesions, capsular laxity, mid-capsular tear and HAGHL lesions in cases of anterior shoulder instability. MATERIALS AND METHODS: Two hundred and four consecutive patients with anterior shoulder instability underwent arthroscopic repair and the outcomes were evaluated according to various lesions and treatment modalities in a retrospective study afte a minimum of one year elapsed after surgery. RESULT: All 24 cases of ALPSA lesions were treated using the arthroscopic transglenoid suture technique. Clinical results were excellent in 18 cases. Of 67 cases of capsular laxity, type IV Bankart lesion was combined in 42. 47 cases were treated with the transglenoid technique and 20 with the transglenoid suture technique and capsular shrinkage. The clinical results were excellent in 45 cases. All 11 cases of mid-capsular tear were treated with its combined lesion, and the clinical results proved to be excellent in 8 cases. Of the 4 cases of HAGHL lesions, all cases were treated with the direct suture technique, and 2 had excellent clinical results. CONCLUSION: In the case of anterior shoulder instability, various pathologic lesions as well as Bankart lesion can be found. Therefore, the evaluation of the exact pathologic lesion causing instability and its appropriate treatment are important for satisfactory surgical outcomes. The arthroscopic transglenoid suture technique is one of the most useful methods of reconstruction in various pathologies of shoulder instability.

Correlation among Magnetic Resonance Images, Electron Microscopic Findings, Light Microscopic Findings and Clinical Symptom of the Degeneration of Lumbar Intervertebral Disc / 대한척추외과학회지

STUDY DESIGN: A retrospective study was performed in patients who had undergone any operation with removal of lumbar intervertebral disc at Chungnam National University Hospital. OBJECTIVES: To evaluate relationship among magnetic resonance image, electron microscopic findings, light microscopic findings and clinical symptoms in degenerated intervertebral disc. SUMMARY OF LITERATURE REVIEW: Degenerative changes and disc herniations in the intervertebral disc have been shown to be accompanied by changes in the water and proteoglycan content of the tissue. MATERIALS AND METHODS: Our study followed by any operation with removal of intervertebral disc was carried out on 60 patients at Chungnam National University Hospital from January 1998 to December 1999. In radiographic evaluation we used a criteria from Frymoyer. In clinical evaluation we classified clinical symptom according to scale of Kirkaldy-Willis. And we classified of electron microscopic findings into five grades according to degrees of denudation of proteoglycan from hyalunonic acid. In light microscopic findings, we classified by cell nest formation, noevascularization and amount of muccopolysaccharide. RESULTS: In radiologic evaluation there were 11 cases in grade III, 28 cases in grade IV, and 21 cases in grade V. There were no grade I, II in our study. In clinical symptom, there were 20 cases in Good, 18 cases in Fair, and 22 cases in Poor. In electron micro-scopic findings, there were 4 cases in grade 3, 35 cases in grade 4, and 21 cases in grade 5. There were no grade I, II in this study. There was a relationship between magnetic resonance image and electron microscopic findings and clinical symptom (p<0.05). CONCLUSION Our study of electron microscopic findings of degenerated intervertebral disc may be a help to understand of pathogenesis of disc prolapse.

Relapsing polychondritis / 대한내과학회지

No abstract available.