• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.119-123
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• 2011

This article has reviewed the alignment of the ankle and hindfoot in varus ankle osteoarthritis. The indication and surgical technique of the supramalleolar osteotomy has been reviewed. Alignment of tibial plafond and hindfoot is variable in early stages of ankle osteoarthritis. Supramalleolar osteotomy is indicated for the treatment of ankle osteoarthritis in patients with minimal talar tilt and neutral or varus heel alignment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.30-36
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• 2012

Purpose: We compared the clinical and radiological results of meniscectomy with HTO or without HTO for degenerative medial meniscus posterior horn with varus deformity. Materials and Methods: Forty-two patients who had medial meniscus degenerative root tear with varus deformity more than 3 degrees were included for this study. Among them, 30 patients were performed meniscectomy combined with open wedge HTO and 12 patients were performed only meniscectomy without HTO. The mean follow-up period was 52.5 months. The clinical results were evaluated based on symptom improvement, patients' subjective satisfaction for surgery and HSS score. We also compared the osteoarthritic progression between the group on preoperative and at the final follow up radiographs. Results: Symptom improvement was achieved in 83.3% (25 cases) with HTO group and 66.7% (8 cases) without HTO group at final follow up with a significant difference. Patients' satisfaction was achieved in 83.3% (25 cases) with HTO group and 58.3% (7 cases) without HTO group which has a significant difference. The HSS score was improved in both group (90.8: with HTO group, 89.0: without HTO group) at the final follow up without significant difference. WOMAC score was improved in both groups at the final follow up without significant difference. There were no significant differences in the osteoarthritic progression between two groups. Conclusion: The good clinical result for treatment of patient who have medial meniscus degenerative root tear with varus deformity, proximal high tibial osteotomy is considered absolutely necessary. However, the progression of degenerative arthritis, its effect on long term follow up will be needed.

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.18-28
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• 2005

Purpose: The purpose of this study is to evaluate the clinical, radiological and histopathological results after microfracture surgery for degenerative arthritis of the knee. Materials and Methods: From Oct. 1997 to Dec. 1998, 48 knees in 46 patients were treated by microfracture technique. Their mean age at the time of operation was 56 years(range, 40-75 years) and mean period of follow-up study was one year(range, 7-20 months). For 24 knees in 22 patients, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens of 24 cases were stained with H-E, Safranin-O, and Masson's trichrome. Eighteen of 24 cases were stained immunohistochemically and the Western blotting test was performed on 12 cases for type II collagen. We analyzed the relationship of the Western blotting for type II collagen with clinical score, preoperative varus deformity, joint space widening in radiological result, extent of repaired articular cartilage in '2nd-look' arthroscopic findings, patient's age and weight. Results: Clinical results were excellent in 90% and good in 10%. Among the 24 knees, more than 80% of areas of chondral defect were covered with regenerated cartilage in 21 knees Histologically, the repaired tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Repaired cartilage contains variable amounts of type II collagen with immunohistochemical staining. The results of the Western blotting test were similar. The amounts of type II collagen formation had positive correlation with the extent of repaired cartilage and preoperative varus deformity. Conclusion: 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Articular cartilage repair was confirmed with histological and immunohisto-chemical study qualitatively, and the amount of type II collagen was calculated with the Western blotting test quantitatively. The exact nature and fate of repaired cartilagenous tissues need further long term follow-up study. The results of this study provide the rationale to select osteoarthritic patients indicated for microfracture surgery.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.37-43
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• 2012

Purpose: This study is to evaluate the clinical results of pull-out suture for root tear of posterior horn of medial meniscus. Materials and Methods: Between March 2006 and February 2011, We studied 40 cases with the root tear of posterior horn of medial meniscus which follow up more than 1 years. Mean age was 49.5 years old. We excluded osteoarthritis or varus deformity patients more than 5 degrees. pull-out suture was performed to the patients with grade 0-2 of Kellgren and Lawrence classification. According to Outerbridge classification, evaluation of cartilage damage was performed during arthroscopy. Evaluation of clinical result was used the Lysholm score. Results: The mean pre-operation Lysholm score was 63.9 and post-operation score was 86.3. The complete failure rate was 3 of 40 cases (7.5%). Twenty of 40 cases (50%) showed cartilage lesions in weight bearing portion of medial femoral condyle which were 12 cases in grade 1, 5 cases in grade 2 and 3 cases in grade 3 according to the Outerbridge classification. Conclusion: In the treatment of pull-out suture for root tear of posterior horn of medial meniscus, exclusion of more than moderate arthritis or varus deformity is very importment. Pull-out suture seems to be a useful treatment of the root tear of posterior horn of medial meniscus in mild osteoarthritis or varus deformity of middle ages.

• Korean Journal of Veterinary Research
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• v.42 no.3
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• pp.411-418
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• 2002

Thirty rabbits underwent femoral lengthening using monolateral external fixator to evaluate results and complications of limb lengthening. Twenty rabbits survived until consolidation of callus formed at the lengthening site after finishing lengthening. Ten rabbits were sacrificed during femoral lengthening because of complications. Survived 20 rabbits were classified to two groups according the amount of lengthening: group I (10% lengthening of the femoral length); group II (20% lengthening). There was no significant difference of consolidation time between two groups (p=0.25). Varus angulation at the lengthening site occurred in 60% of two groups and the amount of varus angulation in group II was larger than that of group I. Degenerative change of articular cartilage at the medial condyle of the distal femur was found in 30% of group II. Of sacrificed ten rabbits, 5 had pin loosenings with pull an of pins from the femur, 2 had fermoral fractures around the pin-tract site, and 3 had severe osteomyelitis of the femur around the pin-tract site.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.153-159
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• 2012

Purpose: This study aims at evaluating our results with a 5-year follow up of arthroscopic pull-out suture repair of posterior root tear of the medial meniscus. Materials and Methods: This study enrolled 30 cases who underwent a arthroscopic pull-out suture repair to treat the posterior root tear of the medial meniscus from January 2001 to May 2005 and followed up at least 5 years. The average follow-up period was 76 months (range, 60-90 months). Clinical results by use of the Lysholm knee score and radiographic grade by use of the Kellgren-Lawrence classification were evaluated and second-look arthroscopy was done in all cases. The clinical results were compared with trauma history, obesity, varus deformity and time to operation. Results: At the last follow up, the Lysholm knee score improved from 55 points to 86 points. For the radiological results, 23 cases displayed maintenance or improvement of the medial joint space on the follow up X-ray, but 7 cases displayed decrease of the medial joint space, and 1 case was lately performed total knee replacement due to progressive osteoarthritic change. Conclusion: Arthroscopic pull-out suture repair has a good result at 27 cases (90%) in minimum 5 years follow-up. The clinical improvement was significantly reduced in more severe varus angle.