Micro-Structural Profiles of Trabecular Bone at the Ankle Joint / 대한족부족관절학회지

PURPOSE: This study aimed to investigate and compare the micro-structural profiles of trabecular bone from different facets at the ankle joint. MATERIALS AND METHODS: In a fresh cadaver ankle, four cored 10 mm of diameter cylindrical specimens of trabecular bone were harvested from the distal tibia, the talar dome, the medial malleolus, and the lateral malleolus. Using a micro-computed tomography, two-dimensional and three-dimensional micro-structural indices of the trabecular bone were analyzed. RESULTS: Each specimen from the tibia, talus, medial malleolus, and the lateral malleolus showed unique micro-structural pattern. Tibia versus talus, the talus was seen a higher bone volume fraction and a wider supporting zone subchondrally whereas the tibia was seen a relatively lower bone volume fraction and a much narrower supporting zone subchondrally. Lateral malleolus versus medial malleolus, the lateral malleolus was seen the thicker but sparse trabeculae pattern whereas the medial malleolus was seen the thinner but more compact trabecular pattern. CONCLUSION: Each four locations from the different facet at the ankle joint have distinct own micro-structural patterns of the trabecular bone, suggesting different mechanical properties.

Difference of the Sagittal Configuration of the Ankle Joint between the Lateral and the Medial Segment / 대한족부족관절학회지

PURPOSE: Anatomic configuration of the ankle joint is useful information during various ankle procedures. This study was prospectively designed to investigate the sagittal inclination pattern of the ankle joint. MATERIALS AND METHODS: Lateral standing ankle radiographs from one-hundred people (age: 17~68, M:F=45:55) and magnetic resonance (MR) sagittal ankle images from twenty-four people (age: 16~65, M:F=14:10) were studied. Post-traumatic, arthritic, or grossly deformed ankles at any reason were excluded. The posterior inclination angle (PIA) of the distal tibia was measured and compared between the lateral and the medial segment. RESULTS: On plain radiographic data, the average PIA of the distal tibia was 6.14 degrees +/-3.56 degrees (range 0 degree to 14 degrees) in the lateral segment and 13.16 degrees +/- 3.05 degrees (range 6 degrees to 22 degrees) in the medial segment. On MR imaging data, the average PIA of the distal tibia was 5.08 degrees +/- 4.26 degrees (range 1 degree to 10 degrees) in the lateral segment and 10.16 degrees +/- 4.87 degrees(range 5 degrees to 17 degrees) in the medial segment. The PIA between two segments was significantly different. CONCLUSION: The sagittal configuration of the medial area ankle joint and the lateral area ankle joint has difference in the degree of posterior inclination and shape of curvature.

Apoptosis of Chondro cytes and Its Regulation in Pathogenesis of Osteoarthritis / 대한류마티스학회지

No abstract available.

Clinica Efficacy and Safety of Hyruan (Sodium Hyaluronate) in Patients with Osteoarthritis of the Knee / 대한류마티스학회지

OBJECTIVES: To assess the clinical efficacy and safety of Hyruan(sodium hyaluronate) in patients with osteoarthritis of the knee. METHODS: A 12-week open study of Hyruan was conducted in 48 patients with osteoarthritis(OA) of the knee. Hyruan was injected into knee joints weekly for 5 weeks. Clinical evaluations were performed using visual analog scale(VAS) for pain, Lequesne's index, tenderness and swollen joint counts weekly for the first 5 weeks and then monthly up to 3 months post-injection. RESULTS: Significant improvements in VAS, Lequesne's index, tenderness and swollen joint counts were noted from the first week and maintained until the end of 3 month follow-up period. At 3 months post-injection, 68.8% of patients had >20mm reduction in the VAS. The patients with Kellgren stage lIl showed significant response in VAS and Lequesne's index as patients with Kellgren stage I and II. The clinical improvement after treatment was slower in patients(n=16) with late(>5 years) OA than in patients(n=32) with early(<5 years) OA, but it was statistically significant in either groups, compared to baseline. There were no severe adverse reactions to Hyruan therapy and laboratory examinations revealed no evidence of toxicity. CONCLUSION: Hyruan has been shown to be effective and safe in the treatment of patients with osteoarthritis of the knee.

Bilateral Congenital Absence of the Long Head of Biceps Brachii Tendon in Shoulder Joints: A case report / 대한정형외과학회잡지

The role of the long head of biceps brachii tendon in the stahilization of the head of the humerus is a highly interesting issue in recent studies. But, it is not well understood. Congenital absence of biceps long head tendon ot the hilateral shoulder joint is very rare and on review of literatures, we could not find any case reported. We experienced one case which was confirmed by magnetic resonance imaging and arthroscopic examination of the shoulder, and report it with review of literatures.

Spontaneous Regeneration of the Lateral Malleolus after Traumatic Loss in a Three-Year-Old Boy: A Case Report with Seven-Year Follow-Up / 대한정형외과학회잡지

The high osteogenic potential in children can lead to the spontaneous regeneration of a significant bone loss, however, the site documented in the previous reports was limited to the diaphysis in long bones. We report an exceptional case of a spontaneous regeneration of the whole lateral malleolus, including epiphysis, physis, and metaphysic, after traumatic loss in a three-year-old boy. This case emphasizes the importance of attempts to save as much of the cartilaginous tissues and the periosteum as possible, which have a great osteogenic potential, in themanagement of open would in childrhood.

Treatment of Langerhans Cell Histiocytosis / 대한정형외과학회잡지

Histiocytosis X patients present with a variety of clinical manifestations and outcomes. The principal difficulty in the establishment of a definite protocol for treatment is based on the poor understanding of the basic nature of this disease, the absence of reliable prognostic criteria, and the problems with nomenclature. The objectives of this study were to analysis the course of the disease and the results of treatment in patients who had Langerhans cell histiocytosis and to suggest prognostic factors and guidelines for management. We reviewed the thirty patient who had Langerhans cell histiocytosis for past ten years. These patients were followed for an average 4.8 years (range, excluding patients who died of the disease, two to eleven years). The patients were divided into tow group; eighteen patients who Langerhans cell histiocytosis localized in skeleton (group I) and twelve patients who had Langerhans cell histiocytosis disseminate in both skeleton and extra-skeleton (group II). Methods of treatment included curettage with or without bone graft, radiotherapy, or watchful observation alone in group I; chemotherapy, chemotherapy and radiotherapy, or curettage in group II. All eighteen patients in group I had a complete response to the therapy. Seventeen of these eighteen patients had not a recurrence by the time of the latest follow-up examination; one had a recurrence. Four of twelve patients in group II had a complete response to the therapy, four had a partial response, and four had no response. Eight of these twelve patients had a recurrence; four did not. Two patients in group II died of the disease. The significant prognostic factor was the extent of the disease, limited to the skeleton or not, and the age of onset was an indirect prognostic factor predictin multiple organ involvement.