Early Results of MIS-QS Total Knee Arthroplasty: A Comparison with Conventional Procedure for the Same Patient / 대한정형외과학회잡지

PURPOSE: This study assessed the early clinical and radiological results of Minimally Invasive Surgery- Quadriceps sparing total knee arthroplasty (MIS-QS TKA), and compared these results with those of conventional TKA. MATERIALS AND METHODS: Between August 2004 and March 2005, 17 patients with bilateral TKA on their one side using a regular procedure and the other using the MIS-QS technique were evaluated and compared. The clinical assessment was performed by measuring the range of motion, Knee Society Score, and a radiological evaluation by standing anteroposterior, supine lateral, and Merchant view preoperatively, 2 weeks, 6 weeks, 3 months and 1 year after surgery. Statistical analysis was performed using a paired t-test. RESULTS: The average range of knee motion was slightly larger in the MIS-QS group at all periodsbut there was no statistical difference between the two groups. The Knee Society Score was similar at the 3 month and 1 year periods. The alignment of the implants was satisfactory in both groups and postoperative patellar alignment checked in the Merchant view was better in the MIS-QS group at all periods. CONCLUSION: There were no differences in the clinical aspects at 1 year period between the two groups. However, the MIS-QS group showed better patellar alignment than the conventional group for up to 1 year.

Measurement of the Posterior Condylar Angle in Koreans : Comparison between Three Dimensional Computed Tomography Study and Magnetic Resonance Imaging Study

PURPOSE: This study is to measure the posterior condylar angle (the angle between the femoral epicondylar axis and the femoral posterior condylar axis) which is commonly used for determining the degree of femoral component rotation during total knee replacement with magnetic resonance imaging (MRI) and three dimensional computed tomography (3D CT) and to assess the difference of this angle in Koreans. MATERIALS AND METHODS: We examined the 257 knee MRIs and 118 knee 3D CTs. And we measured the clinical posterior condylar angle in MRIs, and the clinical and surgical posterior condylar angle in 3D CTs. RESULTS: The clinical posterior condylar angle on MRI was male, 5.56degrees and female, 5.81degrees (mean, 5.66degrees). The clinical posterior condylar angle was male, 5.48degrees and female, 5.85degrees (mean, 5.55degrees), and the surgical posterior condylar angle was male, 3.68degrees and female, 4.02degrees (mean 3.74degrees) on 3D CT. There was no statistical difference in clinical posterior condylar angle between MRI and 3D CT (p>0.05) and between male and female(p>0.05). CONCLUSION: There was no difference in clinical posterior condylar angle between MRI and 3D CT. We suggest that 3degrees external rotation of femoral component from posterior condylar axis may not be enough in Koreans during total knee replacement.

Treatment of Periprosthetic Femoral Fractures with Cable Plate

PURPOSE: To evaluate the results of Cable plate fixation for the treatment of periprosthetic femoral fracture after hip arthroplasty. MATERIALS AND METHODS: We reviewed 10 cases of periprosthetic femoral fractures after hip arthroplasty between Nov. 2002 and May 2004. The mean follow up periods were 20 months. The fractures were classified according to Vancouver classification. Seven cases of type B1, one case of type B3 and two cases of type C were treated with open reduction and internal fixation with Cable plate. Evaluation of results was based on mean union time, postoperative complications and Harris hip score. RESULTS: The mean time for bony union was 4.8 months in type B1, 6 months in type B3 and 8 months in type C fracture. As for complications, there were refracture, metal breakage and nonunion. The postoperative mean Harris hip score was 91.5 points for type B1, 85 points for type B3 and 72.5 points for type C fracure. CONCLUSION: Cable plate can be useful for treatment of periprosthetic femoral fractures after hip arthroplasty, but the selection of treatment methods should be cautiously made according to the type of fracture and status of patients.