Comparison of Posterior Cruciate Retaining & Substituting Total Knee Arthroplasty in Varus Deformity of Knee

PURPOSE: To evaluate the effect of posterior cruciate ligament retaining total knee arthroplasty on its clinical results in patients with varus deformity. MATERIALS AND METHODS: We analyzed clinical and radiologic results of the 61 cases (39 patients) with varus deformity more than 15 degrees retrospectively. The average follow up period was 6.1 years (range, 5~8 years old). The cases were divided into posterior cruciate ligament retaining group A (42 cases) and substituted group B (19 cases). RESULTS: There was no statistically significant difference between two groups in Knee Society knee score (A group: 88.1, B group: 88.9), functional score (A group: 79.3, B group: 75.6) activity level (A group: 67.5, B group: 62.5), flexion contracture (A group: 4.5 degree, B group: 4.9 degree), tibiofemoral angle (A group: 4.7 degree, B group: 5.2 degree) and roentgenographic findings. Patients with PCL retaining knees showed significantly increased activity levels in going up and down stairs, and walking. CONCLUSION: It is considered that the preservation of the posterior cruciate ligament is better than the substitution of the ligament if technical problems are solved.

Condylar Lift Off in Fixed and Mobile Bearing Total Knee Arthroplasty

PURPOSE: To compare the performance of a total knee arthroplasty with either a PFC Sigma fixed bearing or a rotating platform in the same patient. MATERIALS AND METHODS: 48 cases (24 patients) that received a PFC Sigma fixed bearing and a rotating platform in both knees, one in each knee. The knee score, functional score, activity level, radiologic analyses through fluoroscope , varus/valgus stress, and subjective satisfaction evaluation were performed at the last follow up in the same patient. RESULTS: There were no significant differences in the knee score, functional score, activity level, radiological findings through fluoroscope, and subjective satisfaction. In the varus/valgus stress views, 3 cases of lateral femoral condylar lift-off were observed in the fixed bearing type and 6 cases of lateral femoral condylar lift-off were observed in the rotating platform type. CONCLUSION: In cases of total knee arthroplasty with PFC Sigma fixed bearing and with rotating platform performed in the same patient, there were no significant differences in the clinical, radiological and subjective satisfaction. However, it is considered that the fixed bearing is more stable in terms of medial and lateral femoral condylar lift-off with varus and valgus stress than rotating platform. Therefore long term follow-up would be necessary.

Factors Influencing Angular Deformity of Tibia Fracture below Isthmus Treated with Interlocking Nails / 대한정형외과학회잡지

This study analyzed the factors causing the angular deformity as the tibia fracture below isthmus were treated with interlocking nails. For this purpose, we observed 70 cases of tibia fractures in the Gil General Hospital as subjects. Of the 70 cases under the treatment, 32(45.7%) showed the angulation of over one degree, and 11(15.7%) showed that of 5-10 degrees in any plane. According to the outcomes of this studies, the degree of angulation seemed to have close relation to the length of fracture line. Also, if the fracture line reached to the isthmus, angulation was apt to be caused. Even though most angulated cases had concomitant fibular fracture, fibular fracture, itself, seemed to have no direct relation to angulation. In consequence, the intramedullary interlocking nailing needs special carefulness in the case of breakage of cortical buttress such as long fracture line, butterfly fragment and fracture including isthmus.