Synovial Impingement after Total Knee Replacement Arthroplasty: A Case Report

A thickened soft tissue impingement after total knee replacement arthroplastyis a complication that causes pain and is usually developed between patella and femoral component such as patellar clunk syndrome. But we experienced a case that medial and lateral synovial tissues were impinged between femoral component and polyethylene liner after total knee replacement arthroplasty with medial pivot prosthesis for degenerative arthritis and were treated with arthroscopic excision. We report this case with literature review.

Tuberculosis of the Lower Lumbar Spine with an Atypical Radiological Presentation: A Case Mimicking a Malignancy

A 65-year-old woman was treated for an atypical radiological presentation of spinal tuberculosis. Compared with previously reported cases, the following two different radiographic features were found. 1) Although there was multiple and skipped involvement of the vertebral body, the intervertebral disc was relatively preserved. 2) The presence of an epidural granuloma indicated an epidural extension of the lesion of the adjacent vertebral body. These findings strongly mimicked bone marrow infiltrative disease such as a malignancy. Tuberculosis was confirmed through an open biopsy and the patient was treated successfully with antitubercular chemotherapy. This case highlights the importance of being aware that spinal tuberculosis has many different radiographic features and can mimic a spinal malignancy.

Effect of Leukotriene B4 and Thromboxane B2 on Lumbar Nerve Roots in Rat / 대한척추외과학회지

STUDY DESIGN: The motor impairment and sensory dysfunction were evaluated in twenty-eight rats after dropping of leukotriene B4 and thromboxane B2 on lumbar nerve roots. OBJECTIVES: To evaluate the effects of inflammatory products on lumbar nerve roots of the rats without mechanical compression. MATERIALS AND METHODS: Twenty-eight Sprague-Dawley rats were evenly divided into four groups (7 rats in each group) according to the substances applied: In group I (sham operation), even dropping of normal saline on left 4th, 5th and 6th lumbar nerve roots: In group II, leukotriene B4; In group III, thromboxane B2: In group IV, leukotriene B4 and thromboxane B2. All rats were tested at 1st, 3rd, 5th, 7th, 10th and 14th postoperative day for motor impairment and sensory dysfunction to the heat. RESULTS: Hypersensitivity to the heat started to appear at 1st postoperative day in group IV and at 3rd day in groups II and III and was Maximum at 5th day in group III and 7 th day in groups II and IV compared with the control group. The histological study also showed moderate to marked necrosis of ganglion cells and infiltration of the inflammatory cells compared to the control group. CONCLUSION: These results suggest that leukotriene B4 and thromboxane B2 produce inflammatory reactions in or around the nerve roots and lead to thermal hyperalgesia in rats without mechanical copmpression, therefore these results may apply to human lumbar nerve roots.

Comparison of results between conservative treatment and operative treatment for clavicle fractures in adults / 대한정형외과학회잡지

PURPOSE: The conservative treatment in the clavicular fractures is the gold standard. However, we found that there were some complications including angulation of clavicle and shortening of clavicular length, long-period immobilization, and nonunion in conservative treatment. This study was undertaken to evaluate union period, nonunion rate, and clinical results between conservative treatment and surgical treatment in clavicular fractures. MATERIALS AND METHODS: We evaluated 67 clavicular fractures in adults with conservative treatment (42 cases) and operative treatment (25 cases) from 1991 to 1996 and followed up for at least 1 year. RESULTS: Nonunion occurred in 4 cases (9.5%) in conservative treatment and 1 case (4.0%) in operative treatment (p>0.05) . The excellent results were 12 cases (28.6%) in conservative treatment and 12 cases (48.0%) in operative treatment (p>0.05) . CONCLUSION: We concluded that the early surgical treatment of displaced, low contact area of fracture segments of the clavicle fracture with internal fixation, even though not statistically significant, provides clinical results that are superior to those obtained with conservative care in view of early exercise of the shoulder joint, union period, rate of nonunion, correction of angular deformity and cosmetic problem. We thought that it leaves much room for consideration about the early surgical treatment for these fractures.

Bilateral apophysitis of ischial tuberosity in a Taekwondo practitioner: A Case Report / 대한정형외과학회잡지

Ischial tuberosity pain in athletes may be caused by bony avulsions or apophysitis. Apophysitis of the ischial tuberosity is a rare condition observed in adolescents who participate in sports, it causes gradual increasing functional and palpable pain at the ischial tuberosity without any major trauma at the beginning of the symptoms. Bilateral apophysitis is very rare, and the reason that Taekwondo practitioners may develop it is due to stretching exercises of both lower extremities. Repeated traction can cause an apophysitis at 15-17 ages when the ossification process of the apophysis is ongoing. Conservative treatment is adequate for apophysitis. We report the clinical and radiologic findings in detail.

Solitary Osteochondroma of the Clavicle associated with Congenital Muscular Torticollis: A Case Report / 대한정형외과학회잡지

Congenital torticollis, or wryneck, is caused by fibromatosis within the sternocleidomastoid muscle. It may invlove the muscle diffusely, but more often it is localized near the clavicular attachment of the muscle. An osteochondroma is a benign lesion that is often considered to be the most common type of bone tumor and this lesion rarely occurs in the clavicle. We report a case who had congenital muscular torticollis with solitary osteochondroma on the clavicular attachment site of sternocleidomastoid muscle of medial clavicle.