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Anterior Cruciate Ligament Reconstruction: Comparison of Bone-Patellar tendon-Bone Grafts with Hamstring Tendon Grafts (자가 슬개건과 자가 슬괵건을 이용한 전방십자인대 재건술의 비교)

  • Choi, Sung-Wook;Oh, In-Suk;Kim, Ryuh-Sup;Kim, Myung-Ku;Bae, Joo-Han;Park, Hae-Bong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.1-6
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    • 2008
  • Purpose: The purpose of this study is to compare the results of the arthroscopic reconstruction of ACL using autologous hamstring tendon and autologous bone-patellar tendon-bone. Materials and Methods: From January, 2000 to December, 2004, 120 patients underwent arthroscopic ACL reconstruction using autologous hamstring tendon(60 cases) and autologous bone-patellar tendon-bone(BPTB)(60 cases). The mean followed up period of hamstring tendon group was 42 months(range $24{\sim}69$ months) and patellar tendon group was 52 months(range $24{\sim}84$ months). At the time of the final follow up, sixty patients in each group were evaluated the results of physical examination, activity level, patients' satisfaction, functional status, and objective anteriror stability using KT-2000 arthrometer. Results: At the time of the final follow up we compared the two groups who had ACL reconstruction using either autologous hamstring tendon or BPTB, and the final results of the Lachman test showed negative, or mildly positive in 85%(51 cases) of the hamstring tendon group and 90%(54 cases) of the BPTB group. Pivot shift test indicated positive in both groups, 8%(5 cases) and 5%(3 cases) respectively and showed no statistically significant difference. The evaluation of the anterior laxity using the KT-2000 arthrometer revealed no significant difference in the hamstring and BPTB groups: differences less than 3 mm compared to the healthy side were 85%(51 cases) and 90%(54 cases)(p>0.05). The Lysholm score improved from a preoperative score of 51 to a postoperative score of 79.1 in the hamstring groups and from 52 to 82.2 in the BPTB groups. According to the IKDC rating system, 87%(52 cases) were normal or near normal in the hamstring group. In the BPTB group, 83%(50 cases) were normal or near normal. The Tegner score for the hamstring groups was 4.8 preoperatively and 7.1 at the final follow up, and the Tegner score for the BPTB groups was 4.5 preoperatively and 7.3 after the last follow-up. The anterior knee pain was found in 7%(4 cases) in the hamstring tendon group and 10%(6 cases) in the patellar tendon group. Conclusion: Arthroscopic ACL reconstruction using both the autologous hamstring tendon and the patellar tendon during their mid term follow up period demonstrated excellent results. However, the final results during their last follow up showed no statistically significant difference between the two groups.

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Conservative treatment of Osteoporotic Compression Fractures in Thoracolumbar spine (골다공증성 흉요추부 압박 골절에서의 보존적 치료)

  • Kang, Kyu-Bok;Koh, Young-Do
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.107-111
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    • 2005
  • Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.

Effect of Bee Venom Pharmacopuncture Complex Therapy on Peripheral Facial Paralysis (말초성안면신경마비에 대한 봉약침 복합치료 효과)

  • Yang, Ka-Ram;Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.26 no.4
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    • pp.29-37
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    • 2009
  • Objectives : This study was to investigate the effectiveness of Bee Venom Pharmacopuncture complex therapy on peripheral facial paralysis. Methods : We investigated 30 cases of patients with Peripheral Facial Paralysis, and devided patients into two groups : We treated one group by complex oriental medical treatment with Bee Venom Pharmacopuncture therapy, and did the other group by complex oriental medical treatment without Bee Venom pharmacopuncture therapy. To investigate the effectiveness of treatment applied for two groups, we used Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System at baseline, 3 weeks and final. Results : 1. Male, Female is same ratio in distribution of sex, the number of left side is more than that of right side in distribution of lesion, the average age is 49.33. 2. Pain back of the ear showed the highest frequency among Bell's palsy related symptoms at onset, the overwork was a major cause of Bell's palsy in distribution of cause. 3. As a result of evaluation by using Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System, treatment score after 3weeks was marked higher than that before treatment and treatment score after final treatment was also marked higher than that after 3weeks within each group. 4. After final treatment, Bee Venom Pharmacopuncture therapy group showed signficant difference on Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System compared with Acupuncture therapy group. Conclusions : Bee Venom Pharmacopuncture therapy can be available for relieving symptoms related with peripheral facial paralysis.

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Anatomical Locking Plate with Additional K-wire Fixation for Distal Clavicle Fracture

  • Nam, Woo-Dong;Moon, Sung-Hoon;Choi, Ki-Yong
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.230-235
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    • 2017
  • Background: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation. Methods: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring. Results: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases. Conclusions: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.

Final height of Korean patients with early treated congenital hypothyroidism

  • Lee, Jiyun;Lee, Jeongho;Lee, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.61 no.7
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    • pp.221-225
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    • 2018
  • Purpose: Congenital hypothyroidism (CH) is the most common endocrine disorder in children. Thyroid hormone deprivation results not only in mental retardation but also growth retardation. This study investigates the final height (FH) in Korean patients with CH detected by newborn screening and examines factors that may affect the FH. Methods: The medical records of Korean CH patients (n=45) were reviewed. The FH was examined and target height (TH) was calculated based on mid-parental height. The FH z score (FHZ) and TH z score (THZ) were computed using the 2007 Korean National Growth Chart. The FHZ and THZ were compared with a Student t test. The impact of the etiology of CH (athyreosis, dyshormonogenesis, ectopic thyoid, hypoplastic thyroid), initial serum thyroid stimulating hormone (TSH) level, initial free thyroxine (T4) level, and time of therapy initiation based on FH was assessed. Results: The mean FHZ was $0.10{\pm}1.01$ for male patients and $-0.11{\pm}1.09$ for female patients. There were no significant differences between FHZ and THZ for both female (P=0.356) and male patients (P=0.237). No significant relationship was found between FH and the etiology of CH, initial TSH level, initial free T4 level, and the time of therapy initiation. Conclusion: Early intervention and satisfactory management do not appear to impede growth in Korean patients with CH. Thus, early detection and proper management of patients with CH detected by newborn screening program are necessary.

Open Kyphoplasty Combined with Microscopic Decompression for the Osteoporotic Burst Fracture

  • Kim, Seok-Won;Ju, Chang-Il;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.291-294
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    • 2007
  • Objective : The purpose of this retrospective clinical study was to describe a treatment for osteoporotic burst fracture in the setting of severe fractures involving fragmentation of the posterior wall and neural compromise with symptoms of cord compression. Methods : Indication for microscopic decompression and open kyphoplasty were intractable pain at the level of a known osteoporotic burst fractures involving neural compression or posterior wall fragmentation. A total of 18 patients [mean age, 74.6 years] with osteoporotic thoracolumbar burst fractures [3 males, 15 females] were included in this study. In all cases, microscopic decompressive laminectomy was followed by open kyphoplasty. Clinical outcome using VAS score and modified MacNab's grade was assessed on last clinical follow up [mean 6.7 months]. Radiological analysis of sagittal alignment was assessed preoperatively, immediately postoperatively, and at final follow up. Results : One level augmentation and 1.8 level microscopic decompression were performed. Mean blood loss was less than 100 ml and there were no major complications. The mean pain score before operation and at final follow up was 7.2 and 1.9, respectively. Fourteen of 18 patients were graded as excellent and good according to the modified MacNab's criteria. Overall, 6.0 degrees of sagittal correction was obtained at final follow-up. Conclusion : The combined thoracolumbar microscopic decompression and open kyphoplasty for severe osteoporotic fractures involving fragmentation of posterior wall and neural compromise provide direct visualization of neural elements, allowing safe cement augmentation of burst fractures. Decompressive surgery is possible and risk of epidural cement leakage is controlled intraoperatively.

Clinical Outcome after Arthroscopic Capsular Release for Adhesive Capsulitis of the Shoulder

  • Yoo, Jae Chul;Koh, Kyoung Hwan;Shon, Min Soo;Bae, Kyu Hwan;Lim, Tae Kang
    • Clinics in Shoulder and Elbow
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    • v.21 no.3
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    • pp.127-133
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    • 2018
  • Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.

Subtalar Arthrodesis Using the Cannulated Compression Screw (유관 압박나사를 이용한 거골하 관절유합술)

  • Lee, Sung-Chul;Jung, Hong-Geun;Chun, Ji-Yong;Yu, Je-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.52-58
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    • 2005
  • Purpose: To analyze the overall clinical outcome, overall assessment, and patient's satisfaction rate of subtalar arthrodesis using the cannulated compression screw. Materials and Methods: This study is based on 17 patients, 17 feet who underwent subtalar arthrodesis using the cannulated compression screw from March, 1997 to March, 2004 with at least 1 year follow-up. The average follow-up period was 33.0 months (12 to 72 months). Functional results were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS) score, and Visual Analysis Scale (VAS) pain score, patients' returning to previous occupation and patients' satisfaction rate were also evaluated. Results: The mean AOFAS scores at final follow-up were 80.4 points (range $66{\sim}92$). The satisfactory rates were as follow. Thirteen patients (76.4%) were at least satisfied with surgical result at final follow-up. Patients' VAS pain score was average 2.8 points ($1{\sim}6$). Fourteen (82.3%) patients returned to previous job at mean postoperative period of 11.3 months (range 3-18 months). Patients' work efficiency after returning to previous occupation was 68.7% (range $33{\sim}100%$). There were 9 complications which were 3 cases of sural nerve injury, 1 case of valgus malunion, and 5 cases of the hindfoot residual pain. Conclusion: We obtained the satisfactory functional results with relatively high patient satisfaction rate of 76%. So we conclude that subtalar arthrodesis using the cannulated compression screw is a reliable method for addressing the painful end-stage subtalar osteoarthritis and unreconstructible comminuted calcaneal fractures. However we also found out that average 11 months were necessary for patients to return to their job.

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Chronic Lateral Ankle Instability: Efficacy of Combination of Ankle Arthroscopic Exploration and Modified Brostrom Operation (족관절 외측 불안정성 재건 시 시행하는 탐험적 관절경의 유용성)

  • Lee, Kyung-Tai;Kim, Jin-Su;Young, Ki-Won;Park, Young-Uk;Kim, Jun-Beom;Kim, Tae-Won;Jo, Jae-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.123-129
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    • 2010
  • Purpose: To evaluate the efficacy of the arthroscopic exploration combined with modified Brostrom operation (MBO) for the treatment of chronic lateral ankle instability (CAI). Materials and Methods: Sixty patients who diagnosed a CAI were performed MBO. We divided to 2 groups, whether simultaneously inspected by arthroscopy (group B) or not (group A). The both group's results were compared according to American Orthopedic Foot and Ankle Society Ankle-hindfoot score (AOFAS), functional ankle score and visual analog scale (VAS) at preoperative and final follow-up period. Results: There were no significant differences of AOFAS, functional ankle score and VAS between both groups at final follow-up. However, in group A, 2 cases associated with medial ankle instability and syndesmotic injuries were did not diagnosed preoperatively, showed poor prognosis. In group B, one case had a permanent peroneal nerve symptom. The match rate of intra-articular lesions between preoperative diagnosis and postoperative arthroscopic diagnosis was 30% in group B. Conclusion: Combination of arthroscopic exploration and MBO is effective strategy for intra-operatively discrimination of intra-articular associated lesions for CAI.

The Development of Sugar Intake Reduction Test for Young Children (유아용 당류섭취저감도검사 도구 개발)

  • Kim, Nam-Hee;Yeon, Jee-Young;Kim, Mi-Hyun
    • The Korean Journal of Food And Nutrition
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    • v.29 no.5
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    • pp.818-827
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    • 2016
  • This study was conducted to develop and validate the Sugar Intake Reduction Test (SIRT) for young children, and included eating behaviors, attitude, and nutritional knowledge about sugars. A draft version of the SIRT was developed after literature review. The final draft of the SIRT was established after two pilot tests of 5 year old children and an expert group's review, and is comprised of a one on one test between an investigator and a child using picture tools. It contained of 20 questions which included 3 components: eating behaviors (5 items), preference for sugar sweetened food (10 items), and nutritional knowledge about sugars (5 items). The final SIRT was conducted on 181 children 5 (n=100) to 6 (n=81) years old, to examine its item and test adequacies. The passing rate of most items significantly increased with increasing age, and most of the item discrimination also differed significantly between the below and upper score groups. The content validity was given a high score by professionals (mean score 3.9 out of 4). Reliability of all the items in the SIRT was high (Cronbach's ${\alpha}=0.82$). Moreover, the total component and the sub-component scores of the SIRT correlated significantly. Our results indicate that the SIRT is a valid tool to measure sugar intake reduction in young children aged 5~6 years.