Biologic Changes of Xenograft ( LUBBOC ) in the Surgical Treatment of Calcaneal Fractures / 대한정형외과학회잡지

PURPOSE: To evaluate the biologic changes of xenograft (Lubboc, Transphyto S. A., Clermont-Ferrand, France) applied in the surgical treatment of calcaneal fractures. MATERIALS AND METHODS: Xenograft were used in twenty-five calcaneal fractures, as bone substitutes for mechanical support of the articular surface from March 1994 to December 1996. Twenty-four cases had obtained clinical and radiological bony union without complications. We performed biopsy at the xenograft area in eight cases when the hardware was removed. And then we took a magnetic resonance imaging of the calcaneus after the biopsy in three cases. RESULTS: The pathologic findings of the xenografts showed dead bony trabeculae with inflammed fibrous tissue. There was no osteoblastic activity but some osteoclastic activity was seen in the graft-host junctional area. MRI findings showed that there was well-circumscribed, low-signal intensity in the xenograft area contrast to the normal bony signal intensity. Its lesion was equal to the sclerotic finding in the calcaneal radiograph. CONCLUSIONS: Xenograft (LUBBOC'), which is used in the mechanical support of the articular surface, apparently lacks osteogenic capacity.

Anterior Spinal Instrumentation in Treatment of Spinal Tuberculosis / 대한정형외과학회잡지

OBJECTIVES: We performed anterior spinal fusion and instrumentation in treatment of spinal tuberculosis. The clinical results of this operation and metal-related complications were evaluated to determine the rationale of anterior instrumentation in active tuberculous lesion. METHODS: From July 1989 to February 1993, we treated twenty-one patients with spinal tuberculosis by radical resection of the tuberculous lesion and bone grafting, followed by anterior instrumentation using Zielke rod system. The changes in spinal deformity were measured from lateral spinal radiographs obtained preoperatively and postoperatively at 3 months, 6 months, 1 year, 2 years and final follow-up. The recurrence of infection and possible complications were also observed clinically and radiologically. RESULTS: The mean kyphotic angle was decreased preoperatively from 21 degrees to 16 degrees at final follow-up in patients with thoracolumbar tuberculous lesions. The mean deformity angle was corrected 7 degrees in thoracolumbar tuberculosis and 12 degrees in lumbar tuberculosis compared with the preoperative deformity angle. There was not any persistence or recurrence of infection possibly related to the instrumentation. All patients were allowed early ambulation with the aid of a light brace. CONCLUSION: The clinical and radiological results suggested that the anterior instrumentation seemed to be one of the rational approaches for providing immediate stability in treating severe spinal tuberculosis without any significant risk of persistence or recurrence of infection.