The Influence of Androgen Deficiency and Osteopenia on Fracture Healing in Orchiectomized Rats / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the effect of testosterone deficiency and osteopenia on fracture healing using orchiectomized adult rats. MATERIALS AND METHODS: Fifty-two 3 month old male rats were used. Animals were divided into 3 groups. Group 1 received sham operations and groups 2 and 3 were orchiectomized. At 4 weeks, right tibial shaft fractures were administered in all animals. Afterwards in group 3, testosterone was injected intra-peritoneally for 4 weeks. After 8 weeks of breeding, animals were sacrified for morphometrical, histopathological and biomechanical testing. RESULTS: No nonunion or delayed union was observed. Differences in tibial volumes and circumferences between the fracture site and the corresponding contralateral site were less in groups 2 and 3 than in group 1, with statistical significance. The yield strength and the trabecular area of the fractured tibiae were significantly lower in group 2, but group 3 and group 1 were similar. CONCLUSION: Even though there was no evidence of compromised fracture healing, both of the androgen deficiency and osteopenia induced by orchiectomy negatively influenced callus volume and strength. But osteopenia did not influece callus strength. The above results demonstrate the positive effect of testosterone injection on fracture healing.

Fixation with Biodegradable Interference Screw and Bone Block to Femoral Tunnel in Arthroscopic ACL Reconstruction using Autogenous Hamstring Tendon

PURPOSE: The purpose of this study is to report the postoperative clinical results after arthroscopic ACL reconstruction using quadrupled hamstring autograft fixed with biodegradable interference screw and bone block in the femoral tunnel. MATERIALS AND METHODS: Between January and December 1997, we performed an arthroscopic ACL reconstruction with quadrupled hamstring autograft in twenty one patients. To enhance the mechanical stability in the femoral tunnel the graft was fixed with a biodegradable interference screw and cortical bone block which was harvested from the proximal tibial metaphysis. The tibial side of graft was tied at the post of an AO cortical screw. Postoperatively the patients were permitted an accelerated rehabilitation with motion brace. The results were evaluated with IKDC form, complications and radiologic findings. The average follow-up was 36 months. RESULTS: Patient subjective assessment was graded normal in 4, nearly normal in 8, abnormal in 7, severe abnormal in 2. Ligament evaluation was graded normal in 16, nearly normal in 3, abnormal in 1, severe abnormal in 1. Harvest site pathology was graded normal in 16, nearly normal in 4, abnormal in 1. Functional test was graded normal in 6, nearly normal in 8, abnormal in 4, severe abnormal in 3. Radiologic findings showed an average 22% increase in the tibial tunnel diameter. Postoperative complications were one recurrent patholaxity, deep infection and arthrofibrosis required operation in each. CONCLUSION: Arthroscopic ACL reconstruction using quadrupled hamstring autograft fixed with biodegradable interference screw and bone block in the femoral tunnel provided with excellent ligament stability and permitted the early accelerated rehabilitation.