Implant Overhang after Unicompartmental Knee Arthroplasty: Oxford Prosthesis versus Miller-Galante II Prosthesis

PURPOSE: The purpose of the present study is to compare the prevalence of implant overhang between the Oxford and the Miller-Galante II (M-G II) unicompartmental knee arthroplasty (UKA) prostheses and determine whether overhang is associated with postoperative clinical results. MATERIALS AND METHODS: We retrospectively reviewed one hundred and seven UKAs which consisted of 37 Oxford UKAs and 70 M-G II. Overhang was considered present if > or =3 mm overhang was observed in any zone. The range of motion, the Knee Society scores and the Western Ontario and McMaster scores were compared after a mean follow-up duration of 48 months. RESULTS: Thirty three of 107 knees (30.8%) had overhang in at least one zone of the femoral or tibial component. In the tibial side, there were no significant differences between the groups in component overhang in each zone. In the femoral side, the Oxford UKA group showed a significantly higher prevalence of the posterior overhang of the femoral component (19/37, 51.4%) than did the M-G II UKA group (3/70, 4.3%; p<0.001). However, no significant differences in clinical results were observed between the two groups. There were also no significant differences in clinical results between the overhang and the non-overhang groups. CONCLUSIONS: Posterior overhang of the femoral component was highly prevalent in Oxford UKA patients. However, posterior overhang of the femoral component had no significant relationship with postoperative clinical results in both Oxford and M-G II UKAs at a mean of 48 months follow-up.

Cystic Tuberculosis in Olecranon, Mimicking the Bone Tumor: A Case Report

Authors report a case of cystic tuberculosis of left olecranon in a 44 year-old woman, which mimicked the bone tumor at initial presentation. She complained mild discomfort in the left elbow over a month. On examination there were no local redness, swelling, tenderness and deformity. There was no limitation of left elbow motion. After open curettage of the lesion, bone tuberculosis was confirmed by histological study. Postoperative triple chemotherapy of 12 months (Rifamcpicin, ethambutal, INH) could cure the disease.

The Evaluation of Bony Union after Posterior Occipitocervical Fusion / 대한척추외과학회지

STUDY DESIGN: The results of posterior occipitocervical fusions were analyzed retrospectively based on the results of post-operative radiographs. OBJECTIVES: To investigate subjective methods for the evaluation of occipitocervical stabilization by posterior fusion. SUMMARY OF LITERATURE REVIEW: Few studies have been performed that describe the methods utilized for the evaluation of the union of the instrumented segments. MATERIALS AND METHODS: Occipitocervical fusions were performed in 16 patients from 1995 to 2004. The patients underwent occipitocervical fusions with autogenous iliac bone grafting and wire fixation (5), loop and sublaminar wire fixation (3), C-D occipitocervical rod (2), and contoured reconstruction plate (6). The stability and failure of the instrumentation in the fusion sites were evaluated with flexion/extension lateral radiographs. The stability was evaluated by a change in the degrees and distances between the occiput and cervical vertebrae. RESULTS: Two of five patients who had undergone wire fixation with autogenous bone grafting were considered to have a nonunion because of persistent segmental instability: greater than 2 degrees and 2 mm three months postoperatively. In the other patients, we were unable to determine the presence of a solid fusion mass at the fusion site, because of overlapping of the instrumentation devices and graft bones. However, since there was no definite motion that indicated segmental instability and instrumentation breakage or loosening on flexion and extension radiographs, we considered these as stable fixations. CONCLUSION: It was difficult to evaluate whether or not the grafts were incorporated into the recipient sites, due to the complexity of the occipitocervical junction and the overlapping of the instrumentation. After removal of the external immobilization 3 months postoperatively, although flexion/extension radiographs taken 6 months postoperatively, demonstrated no motion at the fusion site, the occipitocervical fusions were judged to be stabilized rather than fused.