The Clinical Results of ACL Reconstruction with the Bio-Transfix(R) Technique

PURPOSE: We wanted to evaluate the clinical results of ACL reconstructions with using four strands of an auto-hamstring tendon graft and a bioresorbable-Transfix device (Arthrex, Naples, FL) for femoral fixation. MATERIALS AND METHODS: From May 2005 to May 2007, a total of 108 cases that underwent arthroscopic ACL reconstruction with using hamstring tendons and a bioresorbable-Transfix device were followed-up for more than 1 year (Range: 12~32 months) postoperatively. The clinical results were evaluated by the preoperative and postoperative Lysholm knee scores, the International Knee Documentation Committee (IKDC) scoring system and a KT-1000 arthrometer. The radiological results were evaluated by the measurement method described by L'Insalata. RESULTS: Preoperatively, the mean Lysholm knee score was 70.8+/-6.8 (Range: 52.0~81.0) which improved to 94.2+/-4.8 (Range: 76.0~98.0) at the last follow up (p<0.05). According to the IKDC scoring system, 104 cases (96%) were categorized as normal or nearly normal and no case was categorized as severely abnormal at the last follow up (p<0.05). KT-1000 arthrometer instability was statistically improved from 8.8 mm (Range: 3~17 mm) to 2.1 mm (Range: 1~7 mm) (p<0.05). The femoral and tibial tunnels were statistically widened 22.7% and 12.7% on the AP view, respectively, and 17.4% and 8.4% on the lateral view, respectively, at the last follow up (p<0.05). CONCLUSION: ACL reconstruction using auto-hamstring tendons with a bioresorbable-Transfix device showed satisfactory results on the physical examination and functional evaluation.

Comparison of Results Between Immediate Fixation Group and Delayed Reconstruction Group in Displaced Mid-shaft Fractures of the Clavicle

PURPOSE: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. MATERIALS AND METHODS: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. RESULTS: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. CONCLUSION: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options

Comparative Analysis between Patellar Resurfacing and Retention in Total Knee Arthroplasty: 5-year Follow-up Result / 대한정형외과학회잡지

PURPOSE: To compare the clinical and radiological results between patellar resurfacing, group and patellar retention group in total knee arthroplasty. MATERIALS AND METHODS: Of the 74 patients who underwent total knee arthroplasty on due to knee osteoarthritis since March 1996, and followed-up for at least for 5 years, there were 42 and 32 cases in the patellar retention and patellar resurfacing groups respectively. These subjects were evaluated preoperatively and at 1 and 5 years postoperatively using the pain score, Hospital for Special Surgery (HSS) knee score, walking and stair-climbing in knee function score and radiological analysis. The radiological evaluation was achieved by measuring the patellar tilt angle and displacement with a 45degreesmerchant view. The results were analyzed using the student's t-test. RESULTS: There were no significantly differences between the patellar resurfacing and patellar retention groups in the pain score, HSS knee score, walking in knee function score and radiological analysis (p>0.05), but the patellar retention group achieved superior results in stair-climbing (p<0.05). CONCLUSION: The clinical and radiological results were similar in the patellar retention and patellar resurfacing groups. The use of selective indications of patellar resurfacing is required in order to achieve better results for total knee arthroplasty.

Correlation Between Patients 'Satisfaction and Objective Measurement after ACL Reconstruction

PURPOSE: The aim of this study was to correlate patients 'satisfaction with the objective measurement of the knee stability after a ACL reconstruction using a patellar tendon autograft. MATERIALS AND METHODS: Contact was made with 120 patients who a ACL reconstruction using a patellar tendon autograft on unilateral ACL rupture between January 1995 and April 2002 by single surgeon. Assessment was made by the KOOS score, Tegner score, Lysholm score, patients 'satisfaction, IKDC score, manual physical examination, one leg hop test and radiologic AP translation. Paired t-test, Pearson product moment correlation(PPMC) and Spearman 's rank correlation test were used to test the correlation between the parameters. RESULTS: Radiologic AP translation showed a statistically significant correlation with manual lachman and pivot shift tests. The Lysholm score had a high correlation with the patients 'satisfaction and one leg hop test. The final IKDC evaluation system showed the highest correlations with the Lysholm score, the patients 'satisfaction, the Tegner score, the manual lachman test, one leg hop test. Resumption of sports and work according to the Tegner score correlated with the patients 'satisfaction but had a very low correlation with manual lachman test. The knee laxity measurement using manual lachman test correlated with neither one leg hop test nor the patients 'satisfaction. The one leg hop test correlated with the Lysholm score, the patients 'satisfaction, the final IKDC evaluation system. CONCLUSION: We conclude that the final IKDC evaluation system is a very reliable tool and the patients 'satisfaction is important for evaluating the results after ACL reconstructiuon. And the one leg hop test also appear to be a reliable way of evaluating the functional outcome of the ACL reconstruction.

Clinical evaluation of endoscopic injection sclerotherapy(EIS) in patients with liver cirrhosis / 대한내과학회지

No abstract available.