Early Clinical Outcomes of a New Posteriorly Stabilized Total Knee Arthroplasty Prosthesis: Comparisons with Two Established Prostheses

PURPOSE: We sought to determine whether early clinical performance of new posterior stabilized (PS) knee system, the Vega-PS (Aesculap), is better than that of two established total knee arthroplasty (TKA) prostheses, the E.motion-PS (Aesculap) and the Genesis II (Smith & Nephew) in terms of functional outcomes, patient satisfaction, and incidence of adverse events. MATERIALS AND METHODS: We compared the clinical outcomes of 206 consecutive TKAs using Vega-PS with those of 205 TKAs using E.motion-PS and 216 TKAs using Genesis II at 2 years of follow-up. RESULTS: Overall, the knees with the Vega-PS had better functional outcome scores than the knees with the E.motion-PS, but had similar outcome scores to the knees with the Genesis II, as evident from the American Knee Society knee score (94.2 vs. 92.5 vs. 93.2), Western Ontario McMaster Universities Osteoarthritis (WOMAC) stiffness index (1.8 vs. 2.3 vs. 2.0), WOMAC function index (11.8 vs. 16.8 vs. 18.5), Short Form 36 (SF-36) physical component summary score (41.9 vs. 39.3 vs. 41.6), and SF-36 mental component summary score (50.0 vs. 45.8 vs. 46.9). Patient satisfaction was higher in the Vega-PS and Genesis II groups than the E.motion-PS group. No notable group differences were found in terms of the incidence of adverse events. CONCLUSIONS: The Vega-PS, a newly developed PS fixed bearing prosthesis, had comparable or superior clinical performance in comparison with the two established fixed or mobile bearing PS prostheses.

Late Pyogenic Spondylitis after Vertebroplasty with PMMA-filled Adjacent Segments: A Case Report

OBJECTIVES: To report a rare case of late pyogenic spondylitis around the cement mass in T12 that developed 4 years after vertebroplasty with L1-3 bodies already filled with cement due to previous vertebroplasty. SUMMARY OF LITERATURE REVIEW: Pyogenic spondylitis after vertebroplasty is a rare complication, but very difficult to manage. MATERIALS AND METHODS: A 56-year old female visited us with pyogenic spondylitis around the T12 body. The bodies of L1-L3 had been filled with cement eight years previously, followed by another vertebroplasty for T12 four years previously in a local clinic. At first, conservative management with intravenous antibiotics was attempted for 8 weeks, without clinical improvement. Therefore, anterior surgery for T12 corpectomy, removal of the cement, and fusion was performed. RESULTS: The infection was cured and anterior fusion was achieved, and the patient was able to return to her previous activities. CONCLUSIONS: Though previous vertebroplasty of the adjacent vertebral body seemed to be a major obstacle to achieving fusion, anterior surgical treatment was the ultimate solution to this complex problem.

Psoas and Thigh Abscess Caused by Perforated Retrocecal Appendicitis: A Case Report

STUDY DESIGN: A case report. SUMMARY OF LITERATURE REVIEW: The symptoms of psoas abscess are fever, low back pain, and spasm of the psoas muscle. OBJECTIVES: To report a case of psoas and thigh abscess caused by ruptured appendicitis. MATERIALS AND METHODS: A 53- year old male patient visited the complaining of fever, low back pain and thigh pain. Imaging studies revealed psoas abscess and thigh abscess, accompanied by ruptured appendicitis. Therefore, surgical treatment with percutaneous drainage was performed. RESULTS: The patient recovered and returned to his normal life after 2 months. CONCLUSIONS: It is necessary to identify the cause of the infection using physical examination as well as abdominal and pelvis computed tomography when a patient has fever, psoas abscess and thigh abscess. It is also important to be aware that the cause of psoas abscess may also be gastrointestinal tract disease with non specific symptoms.

Clinical Effect of Surgical Treatment within 12 Months for Ankylosed Elbow Associated with Heterotopic Ossification / 대한정형외과학회잡지

Five patients presented with a limited range of motion in their elbow associated with heterotopic ossification. All of these patients underwent surgery within one year. Removal of heterotopic ossification and a posterior capsular release was performed within ten months on average after the initial injury. Each patient postoperatively received prophylaxis consisting of a single-shot radiation of 700 cGY and administration of nonsteroidal anti-inflammatory drugs (NSAIDs) for four weeks on average. With a median follow up period of 21 months, five patients had no radiographic evidence of recurrence. The arc of flexion-extension increased from an average of 64 degrees preoperatively to 133 degrees at the latest follow up. A 12- to 18-month period is generally recommended as necessary for an operation on an ankylosed elbow associated with heterotopic ossification. However, the operative treatment, together with radiation therapy and NSAIDs administration, showed good results within 12 months.

Peroneal Artery Perforator-Based Propeller Flaps for Reconstruction of Soft Tissue Defect around the Ankle Joint: A Report of Four Cases / 대한족부족관절학회지

Four patients with soft tissue defects around the ankle joint were covered with peroneal artery perforator-based propeller flaps. Using color Doppler sonography, the flap was designed by considering the location of the perforator and soft tissue defects. The procedure was then performed by rotating the flap by 180o. Additional skin graft was required in a patient due to partial necrosis, and delayed wound repair was performed in another patient with poor blood circulation at the distal part of the flap. The remaining patients did not have any complications and results were considered excellent. Good outcomes were eventually obtained for all patients.