Short-term Results of Cementless Ceramic-on-ceramic Articulation Total Hip Arthroplasty

PURPOSE: This study evaluated the short-term results of ceramic articulation total hip arthroplasty in cementless total hip arthroplasty. MATERIALS AND METHODS: 142 hips were followed-up for more than 2 years after cementless total hip arthroplasty using ceramic-on-ceramic articulation. The mean age and follow-up period was 58.3 years and 3.0 years, respectively. The Harris hip score and postoperative hip pain were analyzed clinically. The radiological results were assessed using various radiological indices. RESULTS: At the last follow-up, the Harris hip score improved from 58.1 points preoperatively to 93.2 points postoperatively. There were 4 cases (2.8%) of significant hip pain. Radiologically, all the stems demonstrated stable fixation. The inclination of the acetabular cup was changed significantly in 2 cases (1.4%), which were diagnosed as being loosened. A radiolucent line was observed around the stem in 9 cases (6.3%), and around the cup in 3 (2.1%). Endosteal new bone formation was observed around the stem in 50 cases (35%), and around the cup in 55 (38.5%). No osteolysis was observed around the stem and the cup. CONCLUSION: The short-term results of ceramic on ceramic articulation hip arthroplasty were excellent without osteolysis.

Overgrowth Following TibialShaft Fractures in Children / 대한정형외과학회잡지

PURPOSE: To assess the comparative growth of the four long bones of the lower extremities after the tibial shaft fractures in children. MATERIALS AND METHODS: Thirty-eight children (age, 8.2+/-2.6) with tibial shaft fractures treated with a closed reduction and a long leg cast were enrolled in this study. The mean follow-up was 54.4 months (range, 24-96). The medical records and Bell-Thompson images were retrospectively reviewed. RESULTS: The clinical results were excellent in all cases. The fractured tibia showed overgrowth (4.4+/-3.3 mm) compared with the contralateral side. The ipsilateral femur showed mild over-growth (0.9 mm+/-3.7), and the final leg length discrepancy was 5.3 mm+/-5.4. Four ipsilateral femurs showed overgrowth >10 mm. Gender, the level of the fractures and associated fibular fractures did not affect the overgrowth of the fractured tibia (p>0.05). However, age might affect the amount of overgrowth (p=0.005). CONCLUSION: Tibial shaft fractures in children treated with a long leg cast showed variable overgrowth. The final leg length discrepancy was influenced by the overgrowth of the ipsilateral femur as well as by overgrowth of the tibia.

Subtalar Arthrodesis using Cannulated Screws and Morselized Bone Graft / 대한족부족관절학회지

PURPOSE: To analyze the clinical and radiological outcome of subtalar arthrodesis using cannulated screws and morselized bone graft. MATERIALS AND METHODS: Twenty one patients with follow-up of more than 1 year after subtalar arthrodesis were included in this study. Mean age was 40.8 years, and mean follow-up duration was 38 months. Underlying diseases were 19 cases of posttraumatic arthritis (18 calcaneal fractures and 1 talar fracture) and 2 cases of tarsal coalition. Clinically AOFAS ankle-hindfoot score, operation time, complication and satisfaction of patients were analyzed. Radiologically time to union, arthritis of surrounding joints, preoperative and postoperative talar declination angle were analyzed. RESULTS: AOFAS ankle-hindfoot score was improved from preoperative 33 points to postooperative 79 points. Eighteen patients (86%) were satisfied with the results. Mean operation time was 91 minutes. All cases were fixed with 1-2 cannulated screws and morselized bone graft. Mean time to radiologic union was 12.1 weeks. There was 1 case of delayed union. There was no significant perioperative changes in talar declination angles. CONCLUSION: Subtalar arthrodesis using cannulated screws and morselized bone graft seems to be relatively simple and effective treatment method for subtalar arthritis.

Short-term Results of Cementless Total Hip Arthroplasty Using Ceramic on Ceramic Articulation / 대한정형외과학회잡지

PURPOSE: The authors evaluated the clinical and radiological short-term results of ceramic on ceramic articulation of cementless total hip arthroplasty. MATERIALS AND METHODS: One hundred fourteen patients, with a total of 130 hips were followed for more than 2 years after cementless total hip arthroplasty using ceramic on ceramic articulation (Lima. SPH-C2). The mean age was 58 years, and the mean follow-up period was 3.0 years. The Harris hip score and postoperative hip pain were analyzed clinically. The radiological results were assessed using various radiological indices such as subsidence, cup inclination angle, radiolucent line, endosteal new bone formation and osteolysis. RESULTS: At last follow-up, the average Harris hip score improved from 57.5 points preoperatively to 93 points postoperatively. There were 4 cases (3.0%) of significant hip pain. Radiologically, all stems demonstrated stable fixation. The inclination of the acetabular cup was significantly changed in 4 cases (3%), and was diagnosed as loosened. A radiolucent line was observed around the stem in 5 cases (3.8%), and around the cup in 7 cases (5.4%). Endosteal new bone formation was observed around the stem in 47 cases (36.2%), and around the cup in 52 cases (40.0%). Osteolysis was not observed around the stem and the cup. CONCLUSION: With a minimum follow-up of 2 years, ceramic on ceramic articulation hip arthroplasty demonstrated excellent results on the stem side. However, 4 cases (3.0%) of cup loosening suggest that there is a fixation problem due to the design of the cup.

Availability of Intradiscal Injection of Marcaine as a Pain Relief Test for Diagnosis of Internal Disc Disruption / 대한척추외과학회지

STUDY DESIGN: A retrospective study. OBJECTIVES: To investigate the availability of an intradiscal injection of marcaine as a pain relief test to enhance specificity in the diagnosis of IDD. SUMMARY OF LITERATURE REVIEW: The diagnosis and treatment of IDD have been controversial. A discography, which has been widely used for the diagnosis of IDD, has many problems that might result in a faulty diagnosis. MATERIALS AND METHODS: Twenty nine patients, with an average age and duration of symptom of 36.9 years (22 to 46 years) and 5 years 1 month (6 months to 10 years), respectively, were reviewed. After the discography, the marcaine was injected. Based on the responses after the injection, the group was sub-divided into a further two groups. Group A (n=19): transient pain relief and surgical treatment was performed. Group B (n=10): no pain relief and conservative treatment was performed. An analysis to examine the correlation between the response to marcaine and age, duration of symptom, subjective pain level, number of disc degeneration and high intensity zone was also performed, and the clinical results quantified. RESULTS: The agreement rate between the discography and response to marcaine was 55.2%. The longer the symptom duration, the more meaningful were the responses to the marcaine injection (p<0.05). The result of surgical treatment was important statistically, as the pain was relieved from 8.6 +/- 0.97 to 1.8 +/- 0.42 points, and the ODI decreased from 68 +/- 16.92 to 30 +/- 9.97% (p<0.05). CONCLUSIONS: An intradiscal injection of marcaine, as the pain relief test, can enhance the specificity for the diagnosis of IDD.