Bony Landmarks for Determining the Mechanical Axis of the Femur in the Sagittal Plane during Total Knee Arthroplasty

BACKGROUND: There is no accepted landmark for the mechanical axis of the femoral axis in sagittal plane in conventional total knee arthroplasty. METHODS: As palpable anatomic landmarks of the femur, lateral epicondyle, and anterior margin of the greater trochanter were identified. The line connecting these two landmarks was defined as the "palpable sagittal axis". The mechanical axis of the femur was compared with the palpable sagittal axis and the distal femoral anterior cortex axis. These axes were also compared with sagittal bowing of the femur. RESULTS: The distal femoral anterior cortex axis and the palpable sagittal axis were flexed by 4.1degrees and 2.4degrees more than the sagittal mechanical axes, respectively (p < 0.05). However, the palpable sagittal axis was not correlated with sagittal bowing of the femur (Spearman's rs, 0.17; p = 0.14). CONCLUSIONS: The palpable sagittal axis showed a consistent relationship with the sagittal mechanical femoral axes regardless of the severity of the sagittal bowing of the femur.

The Significance of Arthrocentesis on Transient Synovitis of the Hip in Children / 대한정형외과학회잡지

PURPOSE: To evaluate the significance of arthrocentesis on transient synovitis of hip in children with a moderate degree of limping and large joint effusion. MATERIALS AND METHODS: 119 cases of transient synovitis of the hip were evaluated retrospectively between January 1999 and December 2003, with respect to age (mean age: 5.6 years), sex (M: F=89: 30), location (Right: Left=68: 51), chief complaints (limping: 72; hip pain: 39; knee pain: 37), physical examination (limited internal rotation: 98), sonography of capsule neck distance (mean 5.9 mm), duration of hospitalization and morbidity. Among them, 47 cases with greater than 8 mm in capsule neck distance on sonography were compared, based on the duration of hospitalization, morbidity, and the change of capsule bulging between 18 cases in the arthrocentesis group and 29 cases in the non-arthrocentesis group. RESULTS: The mean duration of hospitalization and morbidity were 1.7 days, 4.7 days in the arthrocentesis group and 2.1 days, 6.6 days in the non-arthrocentesis group, the distance of the capsule bulging decreased from 9.2 mm to 4.5 mm in the arthrocentesis group and from 9.0 mm to 7.6 mm in the non-arthrocentesis group. The duration of hospitalization, morbidity, clinical course and decrease in capsule bulging were more effective, statistically in the arthrocentesis group than in the non-arthrocentesis group. CONCLUSION: Arthrocentesis for transient synovitis can be effective method of treatment in cases of moderate degrees of limping and large joint effusions, in spite of the disadvantage of the invasiveness of the procedure.