Avulsion Rupture of Quadriceps Tendon in Chronic Renal Failure Patients: Two Case Report

No Abstract Available.

Arthroscopic ACL Reconstruction Using Quadrupled Hamstring Graft-Result of Stump Preserving Technique: Follow-up More Than 3 Years

PURPOSE: This article describes the technique for ACL reconstruction using hamstring grafts and looped sutures to preserve the tibial remnant of injured ACL effectively and reports the clinical results. MATERIALS AND METHODS: From Feb. 1995 to May 1996, fourteen injured ACL knees were treated with arthroscopic reconstruction using a quadrupled hamstring autograft. At the last follow-up(average 41 months), subjective and OBJECTIVE assessments were evaluated. Two proprioceptive function tests(motion and position sense) were performed and statistically analysed(paired t-test). Clinical results were recorded by HSS rating scale. RESULTS: Average HSS score was improved from 56.2(preoperative) to 92.1(last follow-up). At the last follow-up, the average anterior displacement(side to side difference) was measured 3.1mm on stress x-rays and 3.4mm on KT-1000 arthrometer(maximum manual force). No significant differences in mean proprio-ceptive values were found between both knees(p<0.05). CONCLUSTION: The clinical results were satisfactory and we suggest the possibility of preservation of the proprioception is increased if integrity of tibial stump of the ACL is preserved. Further supportive studies for the proprioception will be needed.

Mechanisms of Increase in Renal Blood Flow During Partial Ureteral Obstruction in Dogs / 대한신장학회잡지

Although tubuloglomerular feedback (TGF) is involved in ureteral obstruction-induced increase in renal blood flow (RBF), its contribution to RBF is not well established due to the concommitant increases in prostaglandin (PG) and renal interstitial fluid pressure (Pisf), both of which affect RBF one way or the other. Since Pisf and TGF are closely affected by renal hemodynamics, RBF will respond differently to increases in ureteral pressure depending on renal hemodynamic conditions. Therefore, the purpose of the present study was to investigate how the changes in renal hemodynamics affect the response of RBF to increases in ureteral pressure. The effect of PG on RBF was assessed by comparing the effects obtained before and after indomethacin, a cyclooxygenase inhibitor. Six anesthetized dogs were prepared with flow probes and inflatable silastic occluder around the renal artery, the ureteral catheter with its free end attached to a water reservoir, and the arterial and venous catheters. RBFs were obtained at ureteral pressures of 0, 15, and 40cmH2O during the maintenance of the renal artery pressure (RAP) at the level of systemic arterial pressure, 10mmHg above and below the lower autoregulatory limit of RBF (65+/-4 mmHg) both before and after indomethacin administration (10mg/kg). In response to the ureteral pressure of 40cmH2O, RBF increased from 172+/-6 to 185+/-10ml/min when RAP's were equal to systemic arterial pressure and decreased from 162+/-10 to 120+/-9 ml/min when RAP's were 55+/-4mmHg. Indomethacin pretreatment, depending on the level of RAP either prevented an increase or augmented a decrease in RBF in response to ureteral pressure elevation. This suggests that RAP-dependent changes in susceptibility of the renal venous system to compression by increased Pisf is the main mechanism by which the changes in renal perfusion pressure modulate the response of RBF to ureteral pressure elevation.

Arthroscopic Treatment of the Localized Pigmented Villonodular Synovitis of the Knee

Pigmented villonodular synovitis (PVNS) is a relatively rare condition. The disorder almost always involves a single joint and the knee is most commonly affected. We report on three cases of localized PVNS that involved the patella fat pad and synovium. Diagnostic and therapeutic arthroscopies were performed, and typical findings of localized PVNS were found. Complete resection of the lesions were performed arthroscopically. Arthroscopy can be used as an effective diagnostic and therapeutic tool for identification and resection of intraarticular localized PVNS of the knee.

Pull - out Strength of Different Multiple Suturing Method of the Cruciate Ligament / 대한정형외과학회잡지

The aim of this study was to measure the immediate pull-out strengths by increasing the number of suture loops and to compare the immediate pull-out strengths of three different suturing techniques. In one group, the number of suture loops increased from 2 to 9 and the suturing technique of multiple loops through the proximal ligament stumps was used. The other group, the three different techniques were transverse, vertical, and criss-cross suture. The ultimate strength for the 2 loops was 16.62 (+/-6.7)N, for the 3 loops was 34.45 (+/-12.5)N, for the 4 loops was 54.80 (+/-17.7)N, for the 5 loops was 74.30 (+/-21.4)N, for the 6 loops was 102.49 (+/-13.5)N, for the 7 loops was 105.05 (+/-24.8)N, for the 8 loops was 129.50 (+/-76.1)N, for the 9 loops was 229.50 (+/-48.7)N. The transverse suture had a mean ultimate strength of 47.38 (+/-14.8)N, where-as the vertical suture failed at 76.94 (+/-26.4)N and the criss-cross suture at 101.82 (+/-25.7)N. Consequently, their strength can be improved by increasing the number of loops and we suggest that the criss-cross suture technique is reliable method for clinical use, because of high failure strength and wider apposition area of bone to ligament.

Bilateral Fractured of the Fabella / 대한정형외과학회잡지

The fabella is the seasmoid bone occurring in about 10–30% of individuals and is located in the head of the lateral tendon of the Gastrocnemius muscle. Fracture of the fabella is a very rare condition. Since first reported by Jacob Sagel in 1932, only 5 cases of fabella fracture had been reported. However, there has been no bilateral case. We report a first case of bilateral fracture of the fabella with review of literature. This case was combined with rupture of anterior cruciate ligament and lateral collateral ligament on the right knee.

Ganglion Cysts of the Anterior Cruciate Ligament: Three cases report / 대한정형외과학회잡지

Ganglion cysts of the cruciate ligament are quite rare. Ganglion cysts on the anterior cruciate ligament(ACL) should be suspected in any patient having pain and clicking sensation during terminal knee extension. A few cases have been reported concerning ganglion cysts present on the surface of the anterior cruciate ligament. We report three cases of a ganglion cysts on the ACL that was treated with arthroscopic excision.

Disassembly of Polyethylene Liner in Cementless Metal-Backed Cup: A case report / 대한정형외과학회잡지

In 1971, for purpose of reduction of peak stress occuring in cement and trabecular bone of the acetabulum, Harris reported a series of metal-backed acetabular components with removable polyethylene liners that could be replaced if excessive wear occured. Modular designs of hip prostheses have become popular recently, but they introduce the risk of disassembly of the components postoperatively. And introduce of loosening and infection of femoral or acetabular components by debris of polyethylene liner. We report a case of mechanical disassembly of polyethylene liner in cementless metal backed cup, and review previously reported articles.