Ambulatory Care of the Osteoarthritis

No abstract available.

Deep Vein Thrombosis after Joint Arthroplasty in Lower Extremity: Venography versus Color Doppler Ultrasonography / 대한정형외과학회잡지

PURPOSE: Deep vein thrombosis (DVT) after joint arthroplasty in the lower extremity has been a major cause of death postoperatively. However, there is few reports on incidence and risk factors of DVT in Korea. We evaluated the incidence of DVT, correlation between the DVT, and risk factors and effectiveness of color doppler ultrasonography for diagnosis of DVT after joint arthroplasty in the lower extremity. MATERIALS AND METHODS: One hundred and six cases (99 patients) of total hip or knee arthroplasties from March 1996 to August 1997 were included in this study. There were forty-four total hip arthroplasties and sixty-two total knee arthroplasties. No patients received prophylactic agents for DVT. Venogram and color doppler ultrasonogram were obtained within 7 days preoperatively and in 7 to 14 days postoperatively. Only venography was performed in 45 cases and both venography and color doppler ultrasonography were performed in 61 cases. RESULT: On venogram, there were no evidence of thrombi in all cases preoperatively but thrombi were observed in 9 cases (8.5%) postoperatively. Among these positive cases, eight cases showed thrombi in the calf vein and one case in the femoral vein. Color doppler ultrasonography could not detect any thrombi among 3 cases which had positive findings with venogram. In contrast to other reports, we did not identify a correlation between DVT and so-called risk factors such as age, tourniquet time, BMI (body mass index), diastolic blood pressure, operation time and coagulation assay (platelet, PT, aPTl, Anti-thrombin III, fibrinogen) CONCLUSIONS: We concluded that color doppler ultrasonography may not be an effective method in the diagnose is of DVT of calf vein in asymptomatic patients and that so-called risk factors had no relation to DVT.

Parapatellar Complications after ACL Reconstruction Using Bone-Patellar Tendon-Bone Autograft / 대한정형외과학회잡지

PURPOSE: To evaluate clinical and radiological results and to analyse the parapatellar complications after endoscopic anterior cruciate ligament reconstruction using central one-third bone-patellar tendon-bone autografts. MATERIALS AND METHODS: 66 cases among 158 consecutive cases from Feb 1990 to May 1996 were reviewed and evaluated with regard to patellofemoral pain, crepitus, quadriceps atrophy, graft donor site complication, Lysholm knee scoring system and radiological assessment. The average period of follow up was 23 months (range, 12-57 months) and the average age at operation was 31 years old (range, 18-58 years). RESULTS: The average Lysholmn knee score improved from 57.5 points preoperatively to 91.3 points at follow up. The instrumented anterior laxity test showed that excellent anterior stability was regained in most patients. There were many cases of parapatellar complications, 7 cases (10.6%) of anterior knee pain, 21 cases (32.8%) of crepitus, 43 cases (65.1%) of quadriceps weakness, 29 cases (45.3%) of graft donor site paresthesia and 15 cases (23.4%) of pain on kneeling. CONCLUSIONS: Although endoscopic ACL reconstruction using central one-third bone-patellar tendon-bone autografts had good clinical results, many parapatellar complications were noted. In order to prevent these complications, different reconstruction techniques and graft materials should be considered

Subtrochanteric Varization Osteotomy with Open Wedge Technic in a Legg-Calve-Perthes Disease / 대한정형외과학회잡지

Subtrochsnteric varization osteotomy with open wedge technic was performed for the Legg-Calve-Perthes disease patients of 6 years to 9 years of age. Open wedge technic is less complicated with unwilling effect of postoperative leg shortening than closed wedge technic, but has seldom performed for the patients over 5 years of age because of possible delayed or nonunion of osteotomy site. Authors trial of this technic in a older patient(6 to 9 years of age) showed excellent post-operative result with noneventual post-operative course including delayed or nonunion.