Meniscal Ossicle in the Knee: 2 Case Reports

A meniscal ossicle is an ossified structure embedded in the meniscus of the knee, and it very rarely occurs in human. We present here two cases of meniscal ossicle. The two patients were men in their thirties. They had intrameniscal ossicles from the torn posterior horn of the medial meniscus without having any history of trauma. Both cases were treated by arthroscopic excision.

Mortality arter Treatment of Hip Fracture over 80 years old

Purpose: The purpose of this study was to evaluate the mortality of patients over eighty years old with femoral neck fractures that have been treated with bipolar endoprostheses. Materials and Methods: We retrospectively studied 37 patients out of a total of 83, who suffered from hip fractures and were treated with surgery from 2000 through December 2004. We attempted to distinguish the differences between the 8 patients who died (Group A) and the 29 patients who lived (Group B). The variables that we analyzed, were: age, sex, operative time, the time period from admission to surgery, the time period from admission to discharge, the ASA score, and any medical comorbidities. Results: In Group A, 2 patients died within 1 month, 2 died between 1 and 6 months, 1 died between 6 and 12 months, and 3 died after 1 year. There were statistical differences between Group A and Group B with respect to two variables: the time period from admission to, and medical comorbidities. Conclusion: There were significant correlations with an increase in the mortality rate among patients with lung disease, female patients in general, and delays in surgery. Therefore, particular care should be paid to patients with these variables.

Chorpart's Dislocation: A Case Report / 대한족부족관절학회지

The midtarsal joint which consists of the talonavicular and calcaneocuboid joints lies transversely across the medial and lateral arches of the foot. Complete dislocation of this joint unassociated with fracture is extremely rare. A 36 year-old male who was injured by motor vehicle accident came to help for his left midfoot pain and deformity. We misdiagnosed as subtalar dislocation. Closed reduction was performed. We reviewed initial and post-reduction X-rays, and then we diagnosed as Chopart's dislocation. CT scan was taken; it showed fracture of the anterior process of the calcaneous.

The Effect of Fluid Flow Induced Shear Stress on the Prostaglandin E2 and Nitric Oxide Production of Osteoblast / 대한정형외과연구학회지

It has been generally known that bone tissue responds to the mechanical stress with an adaptative change in the mass and the structure. Recently, the signal transduction pathways involved in fluid flow have been reported, and several mechanotransduction products were suggested. This study was designed to verify the prostaglandin E2(PGE2) and nitric oxide(NO) involving as the biomechanical transducing material of the osteoblast to the fluid flow stimuli. We have checked changes in PGE2 and NO production after applying fluid flow-induced shearing stress to the primary high-density monolayer cultures of chicken fetus osteoblasts. PGE2 and nitrite which is the stable end-product of nitric oxide oxidationas are measured spectrophotometrically, the former using enzyme immunoassay system and the latter using Griess reaction. As a result, PGE2 and NO production by osteoblast was increased after applying the fluid flow-induced shear stress: PGE2 production was increased accumulatively in response to the duration of stress. There were no significant changes in NO production after 6 hours of the stress, but production of NO was markedly increased only after 24 hours. From the above findings, it was confirmed that osteoblast increased the production of PGE2 and NO in respond to the fluid flow-induced shearing stress and that PGE2 production is an earlier response to mechanical stimuli than the production of NO.

Prediction of Rotationally Neutral State of the Femur by Comparing with the Shape of Contra-lateral Lesser Trohanter / 대한정형외과학회잡지

PURPOSE: To evaluate the accuracy and reliability of method for prediction of rotationally neutral state of the femur by comparing with contra-lateral lesser trochanter. MATERIALS AND METHODS: The rotationally neutral state of the femur was measured by comparing the shape of the opposite side of the lesser trochanter in a normal group of 100 adult. Each examination was performed independently by three observers. The observers predicted a position presumed to be neutral by comparing the shape of lesser trochanter with that of contra-lateral side previously recorded by the C-arm image intensifier. We evaluated the mean angular discrepancy that is different from the neutral point and assessed the inter-observer variations. RESULTS: The mean angular discrepancy (SD) was 3.4 degree(+/-2.4); 3.5 degree(+/-2.4) by observer-1,3.5 degree (+/-2.8) by observer-2, 3.2 degree(+/-2.2) by observer-3. There was no inter-observer variation (p=0.87). 77% of all observers indicated below 4 degree and no one over 15 degree. CONCLUSIONS: The method of comparing the shape of both lesser trochanters is considered to be effective in determining the rotational status of the femur. It could be used as a practical method in the operation of the femoral fracture for prevention of rotational deformity intra-operatively

Bone SPECT, Simple Radiography , and Operative Findings in Osteoarthritic Knee with or without Anterior Cruciate Ligament Injury / 대한정형외과학회잡지

In so-called primary osteoarthritic knees, there may be secondary osteoarthritis due to the instability from chronic cruciate ligament and/or meniscal tear. The purpose of this study is to compare the findings of bone single-photon emission computed tomography(SPECT) and those of simple radiography in osteoarthritic knees which we consider as primary on the status of anterior cruciate ligament(ACL). We reviewed the preoperative bone SPECT and simple radiography of forty-three osteoarthritic knees in 23 patients who underwent total knee arthroplasty between 1995 and l996. We divided the cases into two groups on the status of ACL: thirty intact ACLs(Group I), thirteen insufficient ACLs(Group II). Meniscal tear and/or ACL insufficiency were found in 38 of 43 knees, As regards with presence of osteophytes and sclerotic changes on simple radiograph, there was no significant differences between group I and II. Joint space narrowing was more prominent and diffuse in group I(medial 29, lateral 24) than group II(medial 7, lateral 6). Bone SPECT showed diffuse uptake in group I(medial 30, lateral 23), but less uptake on the lateral compartment(medial 13, lateral 3) in group II. In ACL-intact osteoarthritic knees, joint space narrowing on simple radiograph and hot uptake on bone SPECT were more prominent and diffuse than in ACL-insufficient knees. Clinical relevance is still uncertain and further investigation is needed.