• 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.9 no.2
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• pp.154-161
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• 2005

Purpose: to describe the histologic appearance of the type III bone bruise in knees which had sustained an acute anterior cruciate ligament (ACL) rupture. Materials and Method: Twenty-five patients who sustained acute ACL rupture were prospectively enrolled in this study. On MRI, 14 patients demonstrated type III bone bruise on lateral femoral condyle, and 11 patients didn't demonstrated bone bruise. Arthroscopic evaluation and biopsy of the articular cartilage and subchondral bone wert performed before ACL reconstruction. Histologic and immunohistochemical evaluations were done. Results: There was no difference between the bone bruise and control group in the hematoxylin-eosin staining for cell distribution, Masson's trichrome staining for collagen and immunohistochemical staining for type I and type II collagen (p>0.05). But in the safranin-O staining for glycosaminoglycan distribution, the bone bruise group had an evidence of decreased staining at the superficial and middle layers, compared with the control group (p<0.05). We also found fatty change of bone marrow in calcified zone of the bone bruise group with safranin-O staining. Conclusion: We suggest that the type III bone bruise found on MRI indicates a substantial damage to normal articular cartilage homeostasis, and may induce further damage of the articular cartilage.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.2
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• pp.112-118
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• 1997

Multicentric chondrosarcoma other than the mesenchymal subtype is rare separate entity. We experienced a case with nonmonomelic synchronous multicentric chondrosarcoma without any preexisting lesions of Oilier's disease or Maffucci's syndrome. To our knowledge, there was no report of synchronous nonmonomelic multicentric chondrosarcoma. A thirty-three year old man had right distal thigh pain of one and half year. Bone scan showed hot lesions on medial condyle of right femur and shaft of left femur. Plain X-ray showed osteolytic lesion on right femur and slight cortical thickening and calcific lesion was observed on left femoral shaft. Curettage and bone cement filling was done on both lesions. The pathology reports were grade I chondrosarcoma on both side of femur. At one month from operation, pathologic fracture of left femur occurred on bone cement-host bone junction. Conservative treatment and radiotherapy of 60Gy was done. At 8 months from operation, nonunion was evident. Segmental resection of left femur with contralateral fibula graft and second look operation on right condyle lesion were done. At 6 months from revision, fracture occurred at host-graft bone junction. We removed previous hardware and applied long DCP and massive autogenous bone graft. Afterwards, the patient looks good and union was progressing. But at 4 years from last operation, hypertrophic nonunion occurred. Another revision was done with condylar plate and bone graft and now he is well without any sign of local recurrence or metastasis.

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.96-102
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• 1997

The gracilis that is frequently used as a donor of free muscle trasfer is appropriate in the muscular shape and vascular position. This muscle is belonged to the second type of muscle group by the classification of the pattern of muscular nutrient vessel. The adductor branch or first perforating branch of deep femoral artery which supplies the proximal 1/3 of this muscle is a dominant one and this is used for the microscopic anastomosis of muscle or musculocutaneous flap. The minor vascular pedicles which enter the distal 1/3 of this of this muscle are branches of the superficial femoral artery and it is 0.5mm in diameter, 2cm in length with two venae comitantes. These minor pedicles supplies distal half of the gracilis muscle. This island musculocutaneous flap using distal vascular pedicle can be used to cover the defect of soft tissue around the distal femoral supra-condylar area, knee joint and proximal tibial condyle area which cause limitation of motion of knee joint, or in the cases that usual skin graft is impossible. The important operative procedure is as follows; The dissection is carried proximally and distally and the entire gracilis muscle including proximal and distal pedicle is completely dissected. After temporary blocking of the proximal vascular pedicle, the adequate muscle perfusion by the distal pedicle is identified and it is rotated to the recipient site around knee joint. The advantages of this procedure are simple, no need of microscopic vascular anastomoses and no significant functional loss of donor site. Especially in the cases of poor condition of the recipient vessel, this procedure can be used effectively. From 1991 to 1996, we performed 4 cases; complete survival of flap in 3 cases and partial survival of flap with partial necrosis in 1 case. This procedure is though to be useful in the small sized soft tissue defect of distal femoral supra-condylar area, knee joint and proximal tibial condylar area, especially in the defect of anterior aspect which expected to cause limitation of motion of knee joint due to scar contracture. But the problems of this procedure are the diameter of distal vascular pedicle is small and the location of distal vascular pedicle is not constant. To reduce the failure rate, identify the muscular perfusion of distal vascular pedicle after blocking the proximal pedicle, or strategic delay will be helpful.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.126-129
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• 2007

An irreducible dislocation of the knee joint is quite rare. Most irreducible knee dislocations are posterolateral dislocations and result from the soft tissue interposition. To the best of our knowledge, there is no report of an irreducible knee dislocation result from interposition of the detached cartilage from the medial femoral condyle. We present a case of 51 years old female with irreducible knee dislocation which was treated with an arthroscopic debridement of the detached cartilage, result in reduction of the joint, which is failed in closed reduction. And then we perform the delayed arthroscopic reconstructions for the ruptured anterior and posterior cruciate ligaments. Debridement of the interposed structure using the arthroscope allows for reduction of the joint and good result without the need for an open procedure.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.46-52
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• 2009

Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.187-191
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• 2017

Bone marrow aspirates concentrate (BMAC) transplantation is a well-known technique for cartilage regeneration with good clinical outcomes for symptoms in patients with osteoarthritis (OA). Magnetic resonance imaging (MRI) has an important role in evaluating the degree of cartilage repair in cartilage regeneration therapy instead of a second assessment via an arthroscopy. We experienced a case of hypertrophic regeneration of the cartilage and a presumed simultaneous regeneration of the posterior horn of the lateral meniscus after BMAC transplantation for a cartilage defect at the lateral tibial and femoral condyle. This report provides the details of a case of an unusual treatment response after a BMAC transplant. This report is the first of its kind to demonstrate a MR image that displays the simultaneous regeneration of the cartilage and meniscus with a differentiation ability of the mesenchymal stem cell to the desired cell lineage.

• Journal of Trauma and Injury
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• v.28 no.1
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• pp.21-26
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• 2015

Complete radial tears of the lateral meniscus are relatively rare. Once torn, the injury can be debilitating due to disruption of the circumferential fibers of the meniscus. We experienced a case of a lateral meniscus with a complete radial tear at the midbody, where the two torn ends were displaced more than 1 cm and could not be approximated during arthroscopy. Thirteen months after surgery, follow-up MRI and second-look arthroscopic findings showed that the complete radial tear has healed spontaneously. However, twenty nine months after the second-look arthroscopy, the patient complained of severe knee pain during exercise. On follow-up MRI, increased sclerosis and newly developed bone marrow edema were observed in the lateral femoral condyle, compared with previous MR images. Finally, we performed meniscal allograft transplantation due to the defective properties of the completely healed lateral meniscus.

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.84-90
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• 2021

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5-6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.89-96
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• 2002

Purpose : The purpose is to analyze the relationship between bone bruise in MRI and associated injuries after the knee joint trauma. Materials and Methods : Total 50 cases were reviewed, divided into two groups according to initial trauma energy. High-energy group (group I), such as traffic accident was 13 cases, low-energy group (group II), such as sports trauma was 37 cases. The type of the lesion was used the classification by Costa-Paz. The site of lesion was analyzed according to femoral/tibial, medial/lateral and anterior/middle/posterior site respectively. Associated injuries were confirmed by physical examination, radiograph, MRI and arthroscopy. Results : In group I there was a various distribution of the bone bruise in the knee joint according to mechanism of injury. The bone bruise with ACL injury was 38$\%$ only and the most frequent type was Costa-Paz type I (52.6 $\%$). In group II more frequent locations were the middle portion of the lateral femoral condyle and the posterior portion of the lateral tibial condyle. Bone bruise associated with ACL injury, was upto 56.8 $\%$ and the frequent type were Costa-Paz type II (48 $\%$), in order type I (42 $\%$). As a result, in the high-energy injury the bone bruise had a various location in both condyle and less frequently associated injury, but in the low-energy injury there was particularly frequent location of bone bruise, associated injury and type. Conclusions : We could assess the associated injury by analysis of the location and type of bone bruise, especially in the low-energy injury, e.g. sports injury. But further study will be necessary with more case analysis.