An Extradural En-Plaque Meningioma Involving Thoracic Spine / 대한정형외과학회잡지

Reports of extradural spinal meningioma are rare, and differentiation from a metastatic lesion is important. We treated a case of thoracic extradural meningioma with surgical excision and obtained a favorable outcome without recurrence during one-year follow-up. Thus, we report on a case with review of the literature.

A Vessel Injury by Trocar of Closed Suction Drainage after Hip Hemiarthroplasty: A Case Report / 대한고관절학회지

Vascular complication of hip arthroplasty is relatively rare, and usually involves iatrogenic injury or thrombus formation of main vessels. No case of vascular injury associated with closed suction drainage has been reported. The current report describes an injury of a branch from the lateral circumflex femoral artery caused by a trocar of closed suction drainage in a 72-year-old man who had been treated with bipolar hemiarthroplasty because of a femoral neck fracture. We report on this case with a review of the literature in order to avoid similar complications.

Injury of the Superficial Femoral Artery Secondary to an Unstable Intertrochanteric Fracture: A Case Report / 대한고관절학회지

Injury of the femoral artery with a femoral intertrochanteric fracture is rare, and usually occurs on the deep femoral artery during surgery. We experienced a case of preoperative injury of the superficial femoral artery by a lesser trochanteric fragment. We repaired the femoral artery through an anterior approach before internal fixation.

Leg Length Discrepancy after Total Hip Arthroplasty

Restoration of the hip biomechanics, including the femoral offset and leg length, are the desired goals when performing total hip arthroplasty. A leg length discrepancy following total hip arthroplasty is a significant source of back pain and sciatica, gait disorders, general dissatisfaction and dislocation. Significant lengthening of the leg can be a risk factor for nerve injury and it is a relatively common cause of litigation. There is a fundamental interrelationship between leg length and stability when performing hip arthroplasty. There are a multitude of situations in which achieving both stability and perfectly equal leg lengths is simply not possible. Stability is the primary objective, and the surgeon may need to sacrifice leg length equality on the altar of stability. Although a leg length discrepancy cannot be eliminated after hip arthroplasty, it can be minimized through a series of steps, including a physical examination, radiographic evaluation, preoperative templating and intraoperative confirmation of the preoperative plan.

The Total Knee Arthroplasty with PFC Sigma RP-F(R): Two Year Short-term Results / 대한정형외과학회잡지

PURPOSE: This study compared the results of PFC Sigma RP-F(R) total knee arthroplasty with those of conventional total knee arthroplasty using PFC Sigma PS(R) in order to assess the clinical results including the maximal flexion angle after a follow up of at least 2 years. MATERIALS AND METHODS: Forty one cases of total knee arthroplasty were performed with PFC Sigma RP-F(R), and the clinical results were analyzed after a follow up of at least 2 years. The patients were compared with a control group consisting of 41 cases, who underwent total knee arthroplasty with PFC Sigma PS(R) using the following parameters: gender, preoperative diagnosis, and preoperative range of motion, and postoperative range of motion. RESULTS: The mean follow up period was 26.7 months. The KSS score improved from 53.2 preoperatively to 95.6 postoperatively. The KSFS score also improved from 49.7 preoperatively to 96.1 postoperatively. The range of motion increased from 124.3degrees to 128.2degrees. The subjective pain score using visual analogue scale improved from 7.6 preoperatively to 1.4 postoperatively. The group with the PFC Sigma RP-F(R) showed similar clinical results to the PFC Sigma PS(R) except for the range of motion. CONCLUSION: Total knee arthroplasty with PFC Sigma RP-F(R) showed similar clinical results to other models, as well as excellent and predictable results of range of motion at the short-term follow up. A long term follow up study will be needed to demonstrate its effects on increasing the longevity.

Arthroscopic Reconstruction of the Posterior Cruciate Ligament : Comparison of Tibial Inlay and Tibial Tunnel Techniques / 대한정형외과학회잡지

PURPOSE: To compare the results of posterior cruciate ligament reconstructions by tibial inlay and tibial tunnel techniques. MATERIALS AND METHODS: Despite of conservative treatment, all patients (31 cases) had pain and grade 2 or more posterior instability. Posterior drawer test and posterior drawer stress radiography were performed. Clinically, Lysholm knee score and Tegner activity score were evaluated. RESULTS: In the tibial tunnel group, posterior drawer test demonstrated grade 1 instability in 7 cases, grade 2 in 4 cases, and grade 3 in 1 case at the last follow-up. In the tibial inlay group, there was grade 1 instability in 14 cases and grade 2 in 5 cases. On posterior drawer stress radiography, the mean side-to-side difference in measurement of the tibial tunnel group improved from 12.4 mm preoperatively to 4.0 mm at follow-up, and that of the tibial inlay group improved from 11.8 mm to 2.9 mm. Lysholm knee score and Tegner activity score improved to 86.8 points and 5.83 points, respectively, in the tibial tunnel group, and to 88.2 points and 5.84 points, in the tibial inlay group. CONCLUSION: PCL reconstruction with the tibial inlay technique tends to maintain better posterior stability, but there is no statistically significant difference between the two techniques. Further study may be required.

Comparision of the pulmonary function between open anterior release and thoracoscopic anterior release / 대한척추외과학회지

STUDY DESIGN: Retrospective study OBJECTIVES: To evaluate the results of a serial pulmonary function test in severe scoliosis that required an anterior release and posterior fusion SUMMARY OF LITERACTURE REVIEW: There are a few reports on the pulmonary function after an anterior release and posterior fusion in severe scoliosis. MATERIALS AND METHODS: Twenty two cases of severe scoliosis requiring an anterior release and posterior fusion were followed up more than 2 years. The patients were divided into two groups (group 1: 10 cases of open thoracotomy and posterior fusion, group 2: 12 cases of thoracoscopic release and posterior fusion). The forced vital capacity (FVC), forced expiratory volume 1 (FEV1), total lung capacity (TLC), the predicted FVC, predicted FEV1 and predicted TLC in the preoperative, 3 month, 6 month, 1 year, 2 year postoperative period in the two groups were compared. Statistical analysis was performed using a paired T-test. RESULTS: The average preoperative FVC in groups 1 and 2 were checked as 2.20 L and 2.30 L, respectively. The postoperative 3 month FVC were checked as 1.60 L and 1.81 L, respectively, which were the lowest levels throughout the serial follow-up. The postoperative 6 month FVC were 1.70 L and 2.15 L, respectively. The postoperative 2 year FVC were 2.17 L and 2.18 L, respectively, which were 98.6% and 94.8% of the preoperative FVC. The average preoperative FEV1 of group 1 was 1.95 L. The post-operative 3 month FEV1 were at the lowest level and the postoperative 2 year FEV1 was 1.80 L (92.3% of preoperative value). The average preoperative FEV1 of group 2 was 2.05 L. The postoperative 6 month FEV1 was 1.90 L (92.7% of preoperative value). The TLC of group 2 showed a faster recovery than that of group 1. The predicted FVC, FEV1 and TLC of both groups at 2 years after surgery were 2 ~4% lower than the baseline. The recovery pattern in group 1 was steady for 2 years. The postoperative 6-month value was similar to the postoperative 2-year value in group 2. CONCLUSIONS: In severe scoliosis with a decreased pulmonary function, those undergoing thoracoscopic anterior release had a faster pulmonary function recovery than those undergoing an open thoracotomy.

Popliteal Artery Occlusion after Total Knee Arthroplasty: A Case Report / 대한정형외과학회잡지

Popliteal arterial occlusion after total knee arthroplasty is a rare complication, and for now various treatment methods have been tried. The authors report a case of acute popliteal artery occlusion after total knee arthroplasty that was treated by thrombectomy.