• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.65-72
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• 2011

Purpose: We evaluated the complications of allograft reconstruction after a bone tumor resection, and reviewed literatures to overcome such complications. Materials and Methods: We retrospectively reviewed clinical records and radiographs of fifteen patients in whom reconstruction with allograft after bone tumor resection. Results: Eight patients were men and seven were women with a mean age of 27.1 years (1-56 years) and a mean follow-up period of 89.5 months (33-165 months). All postoperative complications related to the allograft were recorded. Twenty patients (80.0%) obtained a radiologic bony union at a mean of 8.35 months (4-12 months). The mean Musculoskeletal Tumor Society score was 73.5% (46.6-93.0%). Nine patients (60.0%) experienced one event and 3 (20.0%) patients experienced multiple events during the follow-up period. Recorded events were infection (3), fracture (2), nonunion (2), limb length discrepancy (2) and varus deformity (2). The mean event free survival period was 60.8 months (6-144 months). The mean allograft survival period was 80.2 months and the 5 year survival rate of the allografts was 83.0%. Conclusion: In order to overcome complications, the combination of an allograft and vascularized fibular graft is highly recommended. In the near future, the tissue engineering technique, the application of the stem cell and PRP, could reduce the complication of allograft such as resorption and nonunion.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.132-136
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• 2005

Purpose: The purpose of this study was to compare the clinical results of the arthroscopic anterior cruciate ligament reconstruction used by Bone-Patella tendon-Bone autograft and Achilles tendon allograft. Materials and Methods: We reviewed the results of patients who had been managed with arthroscopic anterior cruciate ligament reconstruction using different graft such as Bone-Patella tendon-Bone autograft and Achilles les tendon allograft. 60patients (average age, 33.5 years)were retrospectively evaluated. The one group(average age, 33.4 years) was 32 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Bone-Patella tendon-Bone autograft. The other group(average age, 32.1 years) was 28 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Achilles tendon allograft. 2 groups were evaluated subjectively by Lysholm knee scoring scale and objectively by KT-2000 arthrometer. The follow-up period was more than a year(average, 18 month). An early rehabilitation protocol was instituted. Results: On Lysholm knee scoring scale, the final evaluation was nearly normal in all patients. We could not find statistical difference among the two groups by KT-2000TM arthrometer. Conclusion: The use of allografts may be an acceptable choice for ACL reconstruction.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.1
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• pp.19-26
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• 2007

최근에 스포츠 손상이 증가하고 관절경을 이용한 치료가 발전하면서 조기에 더 적극적인 치료를 하는 추세이다. 또한 방사선 소견에 비하여 관절경하에서는 연골이 불안정하거나 분리되어 있는 경우도 있으므로 기존의 수술 적응증보다는 좀 더 광범위하게 관절경 검사 및 수술적 치료가 요구된다고 생각한다. 치료 방법을 하면 $1.5cm^2$ 이하의 병변을 가진 50세 이하의 환자는 관절경을 이용하여 변연 절제술, 연골하 천공, 연마, 미세 골절술, 소파술 등의 방법으로 치료할 수 있다. 같은 방법으로 50세 이상의 $3cm^2$ 이하의 병변을 가진 환자 중 mosaicplasty와 자가 연골 세포 이식술을 적용할 수 없는 환자에서 시도해볼 수 있다. $1.5\sim3cm^2$의 병변을 가진 50세 이하의 환자, 그전의 관절경적 치료로 실패한 경우에는 자가골 연골 이식 또는 자가 연골 세포 이식술을 이용하여 치료해야 한다. $3cm^2$ 이상의 병변을 가진 50세 이하의 환자는 자가 연골 세포 이식술이나 동종 골 연골 이식을 이용하여 치료하며, 50세 이상의 환자는 관절 고정술이나 족근 관절 인공치환술을 고려하는 것이 바람직하다.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.22-30
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• 2007

Purpose: We describe clinical, radiographic, MRI and pathologic findings as well as final outcome after simple curettage and bone graft of cystic fibrous dysplasia (FD) in the long bone, which has been rarely documented in the literature. Materials and Methods: Clinical records, radiographs, MRI and histologic slides of 11 patients with cystic FD in the long bone were retrospectively analyzed. Results: Six patients complained pain for several months, 4 patients presented pain after trivial injury event, and 1 patient suffered pathologic fracture. The mode of involvement was monostotic in 10 patients and polyostotic in l patient. The femur was affected in 7 patients, the humerus in 3, and the radius in 1. Radiography showed prominent, expansive lysis associated with ground-glass density of FD. MRI revealed 2 different signals of FD and cyst. Microscopic examination revealed classic findings of FD and non-specific cystic degeneration. The final outcome was satisfactory in every patient. Local recurrence was not observed. Conclusion: Cystic FD in the long bone seems not as rare as the scarcity of reported cases would indicate. MRI features provide a basis for differential diagnosis between benign cystic change and malignant transformation. Cystic FD would be an indication for surgery and simple curettage with allo-chip-bone graft is effective.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.57-61
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• 2012

Pretibial cyst formation is a rare complication after anterior cruciate ligament (ACL) reconstruction and there are only few cases reported. Pretibial cyst can be caused by variable reasons. Foreign body reaction due to breakdown of bio-absorbable screw for fixation, graft necrosis at tibial site, joint fluid leakage to tunnel and incomplete incorporation of graft to bony tunnel. The authors experienced one case of massive pretibial cyst after arthroscopic ACL reconstruction using bio-absorbable interference screw in 38-year-old male patient. Thus, authors report this rare case with literature view.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.360-365
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• 1999

This study was aimed to suggest to better treatment method of jaw cyst that the maximum diameter was wider than 3cm, using different treatment and clinical and radiographic result. We divided the 60 patients into three groups, group A(20 patients) were treated with cyst enucleation and Decalcified Freeze-Dried Allogeneic Bone(DFDB) graft, group B(20 patients) were treated with cyst enucleation and autogenous bone graft, group C(20 patients) were treated with only cyst enucleation. Each group was evaluated with panoramic radiograph and clinical sign & symptom at pre-op and post-op(immediate, 6, 12, 24, 36 month). Bone density was evaluated with disital densitometer. The result was as follows : 1. Post-Op infection was higher in group C(4 pts.) than in group A(1 pt.) and B(1 pt.) 2. Post-Op gingival recession was higher in group C(3 Pts.) than in group A(1 pt.) and B(1 pt.) 3. Anatomic distortion was higher in group C(3 Pt.) than in group A(1 Pt.), and B(1 pt.) 4. Reoperation was done in two patients who were in group C 5. There were donor site morbidity in two patients 6. There was no significant difference between group A and B in their bony density in their follow up period(p>0.05). 7. There were significant differences between group A, B and group C in their bony density until post-op 24 months but a little differences at post-op 36 months(P<0.01)

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.54-61
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• 1999

The current treatment of extensive meniscal injuries has resulted in numerous investigations and clinical trials to restore normal meniscal functions. A cryopreserved meniscal allograft transplantation is one of the successful methods available to restore the meniscus. All the procedures of 26 cases were performed in an minimal open fashion, though initial four cases were done with the aid of arthroscope. In all of the grafts, we used a bone bridge which was attached to meniscus for better stability and healing. Anterior cruciate ligament reconstructions were also performed simultaneously with the meniscal procedures. We attempted to minimize articular cartilage by employing so called the "Key-hole technique" for the medial meniscus transplantation. First, the meniscal cartilage bone bridge was shaped into a cylinder and a bone tunnel was made just beside the medial border of the anterior criciate ligament insertion of the recipient knee joint, and the bone bridge of the meniscal cartilage was push to press-fit. The inserted meniscal cartilage was sutured by the usually employed technique under arthroscopic control. The lateral meniscus was shaped different to the medial meniscus in that the bone bridge was semicylindrical and the bone trough was made beside the lateral border of the anterior criciate ligament insertion of the recipient knee joint. The meniscus was put into the bone trough and the leading suture was extracted anterior to the tibia and tied the knot. The inserted meniscus was sutured in the same manner as the medial meniscus transplantation. By the above described method, the authors were able to minimize the articular cartilage invasion and transplant the meniscus with relative accuracy.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.7-13
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• 2002

Purpose : Preliminary report of the technique and trial of double bundle PCL reconstruction using Achilles allograft. Materials and Methods : From May 1999 to July 2000, 8 cases of PCL insufficient patients were treated with Achilles allograft reconstruction using the double bundle and double femoral tunnel technique. The tibial tunnel was prepared anteromedially. All other combined injuries within the knees were treated accordingly. Minimal follow-up period was 1 year. The results was assessed from the point of function and stability using Lysholm knee score and KT-2000 arthrometer. Results : Up to present follow up. 8 patients showed good sign of recovery with no instability (translation less than 2 mm) except olio that has been grafted-ligament rupture. In addition, none showed any sign of infection nor ROM limitation. Two complications were seen, which one had grafted-bone fracture and the other grafted-ligament rupture. The former occurred during operation and the latter occurred due to improper protection. Conclusion : Presently the follow up period is too short to draw any conclusive opinion but it is essential to select healthy and well sterilized allografts fur successful outcome. Double femoral tunnel technique seems to be more physiologic in PCL reconstruction. With these prerequisites, it seems to be a good alternative to use Achilles allografts fur the reconstruction of PCL. However, a longer follow-up is needed.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.14-25
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• 2021

Several factors need to be considered for a successful anterior cruciate ligament (ACL) reconstruction, such as preoperative planning, operation technique, and postoperative rehabilitation. Graft choice, fixation, preparation method, maturation, incorporation to host bone, and graft tension should also be considered to achieve a good outcome after an ACL reconstruction. Factors to consider when selecting a graft are the graft strength, graft fixation, fixation site healing, and donor site morbidity, as well as the effects of initial strength, size, surface area, and origin of the graft on its potential for weakening during healing. There are two types of graft for an ACL reconstruction, autograft or allograft. Several autografts have been introduced, including the bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon-bone. On the other hand, each has its advantages and disadvantages. The recent increased use of allografts for an ACL reconstruction is the lack of donor site morbidity, decreased surgical time, diminished postoperative pain, and good availability of source. Despite this, there are no reports suggesting that an allograft may have a better long-term outcome than an autograft. Allografts have inherent disadvantages, including a longer and less complete course of incorporation, remodeling, biomechanically inferiority to autograft, the potential risk of an immunogenic reaction and disease transmission. Higher long-term failure rates and poorer graft maturation scores were reported for allografts compared to autografts. An autograft in an ACL reconstruction should remain the gold standard, although the allograft is a reasonable alternative. If adequate length and diameter of autograft can be obtained for an ACL reconstruction, an autograft with adequate graft fixation and postoperative rehabilitation should be chosen instead of an allograft to achieve better results.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.1
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• pp.13-21
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• 2004

Purpose: We analyzed the result of autologous bone marrow stromal cell transplantation with or without cancellous chip bone allograft for benign long bone lesions. Materials and methods: Since July 1996, eight benign bone lesions treated by curettage, cancellous chip bone allograft and bone marrow or marrow stromal cell transplantation were observed for resolution of clinical symptoms, new bone formation and consolidation. There were 6 males and 2 females. Average age was 24 (range 8 to 47) years old. Histologic diagnoses were 5 fibrous dysplasia, 2 simple bone cysts and one chondroblastoma and fibrous cortical defect each. Mean follow-up period was 16.3 (range 3 to 84) months. Results: In all four symptomatic patients, the pain was subsided in two weeks after surgery. New bone formation in the lesion was observed at 4 weeks, which incorporated into surrounding normal bone around 8 weeks. There were one pathologic fracture through the lesion at 3 weeks and one recurrence of simple bone cyst at 5 months postoperatively. Conclusion: Bone marrow or marrow stromal cell transplantation for bone defects from curettage of benign bone lesions, with or without cancellous chip bone allograft revealed rapid healing. Though it was the result of short-term follow up, it supports that bone marrow stromal cell transplantation will be very useful for the treatment of benign long bone cysts or other lesions. The complete curettage of inner cystic wall is important to prevent later recurrence, and the rigid internal fixation is also needed in selected high risk lesions of fracture.