Comparison of Patella Retention Versus Resurfacing in Total Knee Arthroplasty: Preliminary report / 대한정형외과학회잡지

There is a controversy in patella retention or resurfacing in total knee arthroplasty (TKA) till today. Authors studied 52 cases of 45 patients recieved total knee arthroplasty with patella retention (Group 1, twenty-five cases) or patella resurfacing (Group 2, twenty-seven cases) in patients with osteoarthritis. All operations were done by senior surgeon and the implants used were LCS type (33 cases), AMK type (12 cases), Genesis type (5 cases) and Tricon M type (2 cases). The indications of patella retention were small patella, nearly normal articular cartilage, minimal pre-operative patellofemoral pain, poor patellar bone quality and young patients. Patella retention were performed only with LCS prosthesis, which patella groove of the femoral component is deep and anatomical. The operative approaches used were medial parapatella approach in neutral or varus knee and lateral parapatella approch for severe valgus knee and tilting or lateral subluxation of the patella. The mean follow-up period was 24 months (range 12 months to 5 years). The method for clinical evaluation was Hospital for Special Surgery (HSS) knee scoring (consisted of pain, function, range of motion). The method for radiographical evaluation was Knee societys radiologic evaluation system for tibial and femoral alignment, and Keblishs method for patello-femoral congruence. The clinical HSS knee score was average 90.9 points in both groups, and 91.9 points in group 1, 90.0 points in group 2, and there was no statistically difference in HSS knee score between the two groups (P<0.05). The radiologic results had no significant difference in alignment and patello-femoral congruence between the two groups (P<0.05). But the complications were one case of patella fracture, one patella tendon rupture, one anterior instability and two cases of infection in group 2. In conclusion, the results of both groups were satisfactory. We think that it have relation to strict selection of the patients for patella retension and the use of prosthesis that the patella groove of femoral component is deep and anatomical.

Roentgenographic Study on Shape and Size of the Femoral Head of Normal Korean Adults / 대한정형외과학회잡지

In order to provide the basic data about the hip joint arthroplasty, we measured the femoral head diameter, offset and position in normal 150 males and 150 females using a standardized roentgenographic technique that provided views perpendicular to the plane of the femoral neck in which the focus centered on the lesser trochanter of the femur. We obtained 11.4% of magnification rate by comparing the real size of femoral marker with radiologic size. The result of this study are as following: The mean femoral head diameter was 46.4 ±4.1mm in male and 45.1±3.8mm in female. The mean femoral head offset was 39.2±4.8mm in male and 37.8±4.6mm in female. The mean femoral head position was 48.9±3.2mm in male and 47.6±3.6mm in female.

Arthroscopic Management of Osteoarthritic Knee / 대한정형외과학회잡지

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.

Reconstruction of the Anterior Cruciate Ligament by Patellar Tendon and Artificial Trevira ligament: Comparison between mini-arthrotomic and arthroscopic technique / 대한정형외과학회잡지

Rupture of the anterior cruciate ligament is a serious injury that can cause severe degenerative change if untreated, and there are many controversies in its treatment. The authors experienced 126 patients of the anterior cruciate ligament rupture in the Department of Orthpaedic Surgery, Chung-Ang university from May 1985 to December 1992. Among them, we performed 36 anterior cruciate ligament reconstructions using bone-patellar tendon-bone autograft reinforced with Trevira ligament, an assumption that the artificial ligament acts as an internal splint during the vulnerable period of healing. Bone-patellar tendon-bone autograft was passed through the transosseous hole in the tibia, then across the knee and through the isometric path of lateral femoral condyle through a bone tunnel. Thereafter, the Trevira ligament was passed through the same tibial tunnel, but over the top route to the lateral femoral condyle. Of the 36 cases, 28patients (Group I: 15 cases of Mini-arthrotomy,Group II: 13 cases of Arthroscopic technique) with average follow up of 23.5 months (minimum 12 months, maximum 40 months) were analyzed. According to the Mullers criteria, the result were excellent in 12 cases (Group I: 5 cases; Group II: 7 cases), good in 14 cases(Group I: 9 cases ; Group II: 5 cases and fair in 2 cases (Group I: 1 case; Group II: 1 case). On stress roentgenograms by Telos arthrometer, the average difference of anterior displacement between the injured and normal sides were decreased to 2.3mm from average 9.1mm preoperatively (Group I: from 9.3mm to 2.6mm; Group II: from 8.8mm to 2.1mm). And subjectively, there was no difference between the injured and normal sides in 8 cases (Group I: 4 cases, Gruop II: 4 cases).

A study on the repair of osteochondral defects of rabbit knee jointusing carbon fiber

No abstract available.

Intraspinal Synovial Cyst: A Case Report / 대한정형외과학회잡지

A 25 year old patient who had low back pain and sciatica was diagnosed as having a lumbar intraspinal extradural synovial cyst adjacent to a facet joint between the third and fourth lumbar vertebrae. The extradural defects defined with positive contrast myelography and postmyelographic computed tomographic scanning were posterolateral to the dural sac. Biopsy revealed the findings compatible with synovial cyst. Treatment consisted of laminectomy and surgical excision of the cyst.

Surgical Treatment in Congenital Ulnar Drift of Fingers / 대한정형외과학회잡지

The Congenital Ulnar Drift of the fingers is a relatively uncommon and has symmetrical malformations of hand, face and foot characterized by MP joint flexion contracture and ulnarward deviation of the fingers and microstomia, In tarsal deformity, there are clubfoot and congenital vertical talus with rocker bottom deformity. In treatment, the report of the surgical treatment was rare. We experienced congenital ulnar drift of fingers in 2 patients in one family, which were treated by dome resection corrective osteotomy of the metacarpals. Therefore remarkable symptomatic improvement was obtained.

Glomus Tumor / 대한정형외과학회잡지

Glomus tumor is a painful small subcutaneous mass as described by William Wood in 1812. Although seen infrequently and difficult to diagnose, the tumor has been interest to the profession for many years. The normal glomus is an end-organ apparatus which is a remarkable arteriovenous anastomosis functioning without an intermediary capillary bed. Distributed widely over the surface of the body in the deepest layer of the corium or in the stratum reticuiare of the skin, it is most abundant at the distal ends of the extremities. The main function of the glomus body is to aid in the regulation of the skin circulation and, therefore, the peripheral blood pressure and temperature. Glomus tumor represents a hypertrophy of the normal glomus. The gross appearance is that of small soft encapsulated tumor, pink or purple in color, almost always less than one centimeter in diameter if it is located subungually. The microscopic appearance of the tumor closely resembles that of normal glomus, the principal difference being a marked increase in the number of glomal cells (epithelioid cells) and nonmyelinated nerves. Glomus tumor may occur at any age but is most frequent in the middle age of life. Pain, tenderness and temperature sensitivity are the classic triad of symptoms. Complete surgical excision is the treatment of choice for the glomus tumors. Successful removal of the tumor leads to complete relief of pain and return to normal function. This paper is aimed to report on our experience with 3 cases of subungual glomus tumor which were successfully treated by complete excision and to review the literature.