High Tibia Osteotomy for a Posterior Root Tear of the Medial Meniscus / 대한정형외과학회잡지

Posterior root tear of the medial meniscus which is frequently unrecognized is a common injury of meniscus that often results in serious consequences in a knee joint. After medial meniscus posterior root tear (MMPR), there is a significant increase in tibio-femoral contact pressure concomitant with altered knee joint kinematics. This injury frequently leads to meniscal extrusion, and thus the transmission of circumferential hoop stresses would be impaired, which condition is biomechanically similar to that of total meniscectomy. For these reasons, several methods (conservative treatment, meniscectomy, repair, or unicompartmental knee arthroplasty) have been developed for treatment of MMPR, many of which have shown good clinical results. However, the methods of MMPR treatment are still debatable. This article presents a review of the current strategies for treatment of common injuries to these MMPR and clinical results of high tibia osteotomy for MMPR after failed conservative treatment.

Treatment Result of Foot Amputation Stratified by Level of Amputation / 대한족부족관절학회지

PURPOSE: The purpose of this study is to evaluate the incidence and cause of reamputation with respect to the location of foot amputation. MATERIALS AND METHODS: Eighty-six patients who received amputations below the ankle level from March 2002 to September 2012 with at least 1 year follow-up were enrolled in this study. We stratified the site of the initial amputation from first to fifth ray and into either the phalanx or metatarsal bone, and investigated the cause of reamputation. RESULTS: The reamputation rate below the ankle level was 53.5%. It was highest (62.1%) in patients with first ray amputations without statistical significance. Rays were divided into two columns, first to third rays as the medial column and others as the lateral column, and reamputation was performed in 61.2% of patients with medial column amputation. Comparing the results between phalanx and metatarsal amputations, reamputation was performed in 62.1% of patients with metatarsal bone amputation. The rate of reamputation was statistically significant in both the medial column and metatarsal amputations. The most common reamputation site, in accordance to the initial site of amputation, was the adjacent ray (57.4%), which was without statistical significance. Moreover, the most common cause of reamputation was osteomyelitis and focal infection in all rays. CONCLUSION: This study showed that reamputation after amputation below the ankle level was relatively common with highest rate in medial column and metatarsal amputations. Hence, surgeons should be aware of the risk of reamputation and put more preventive effort during medial column and metatarsal amputations.