• Title/Summary/Keyword: Knee surgery

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The Clinical Analysis of Lateral Discoid Meniscus in Adults Over 40 years old (40세 이상에서 발견된 외측 원판형 연골의 임상분석)

  • Lim, Hong-Chul;Noh, Kyoung-Sun;Jung, Hyo-Sub
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.77-82
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    • 2006
  • Purpose: The purpose of this study was to analyze the clinical results of symptomatic lateral discoid meniscus found in adults over 40 years old. Materials & Methods: From March 1994 to March 2004, 53 cases treated for lateral discoid meniscus in 48 patients aged over 40 years with the mean age $48.4(40{\sim}62)$ who were followed up more than 1 year, were analyzed by physical findings, simple X-ray, MRI and arthroscopic exam. Results: Most of the cases (42 cases, 79.2%) had symptoms for less than 1 year duration. 26 cases(49.1 %) out of 53 had trauma history. Simple radiologic evaluation showed that lateral condylar abnormality such as the flattening of lateral femoral condyle, marginal osteophytes, and subchondral sclerosis was seen in 37cases(69.8%). Also medial condyle showed degenerative changes in 16 cases (30.2%). Tear of discoid meniscus in 45 cases(84.9%) were examined by arthroscope and tear was not detected in 8 cases(15.1%). Type of tear was complex(18 cases), longitudinal(12 cases), horizontal(11 cases) and transverse(4 cases). Concomitant medial meniscal rupture was found in 7 cases(13.2%). The simple procedure done was reshaping(46 cases), subtotal resection(5 cases), total resection(1 case) and meniscal repair after reshaping in 6 cases, and arthroplasty was performed after arthroscopic examination in 1 case. Conclusion: Onset of symptom in adult lateral discoid meniscus is usually traumatic in origin. Most cases showed radiologic abnormality such as degenerative change in lateral condyles as well as medial condyles and the results of preservative surgical treatment was the most preferred option in most patients.

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Tumors of the Foot (족부의 종양)

  • Shin, Duk-Seop;Park, Sung-Hyuk;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.69-76
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    • 2003
  • Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

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Comparison of Clinical Results in Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft and Tibialis Anterior Tendon Allograft (자가 슬괵건과 동종 전경골건을 이용한 전방 십자 인대 재건술의 임상적 결과 비교)

  • Lee, Hee-Young;Choi, Chul-Jun;Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.109-114
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    • 2009
  • Purpose: The purpose of this study is to compare the clinical results of ACL reconstruction between two groups using hamstring tendon autograft and tibialis anterior tendon allograft. Materials and Methods: Between January 2006 and June 2007, we analyzed 68 cases of ACL reconstruction, 32 cases using hamstring tendon autograft and 36 cases using tibialis anterior tendon allograft, with a minimum follow-up of 24 months. For the clinical evaluation, we evaluated the Lysholm score, anterior laxity by Telos device and KT-2000 arthrometer. Results: The mean diameter of graft were 8.0 mm (7.0~9.0 mm) in autograft group and 9.1 mm (8.0~10.0 mm) in allograft group. In all cases, the range of motion was above 135 degrees. The average side to side difference in Telos stress test decreased from $7.3{\pm}1.0$ mm to $2.4{\pm}1.1$ mm in autograft group and from $7.4{\pm}1.2$ mm to $2.3{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from $72.6{\pm}3.4$ to $92.3{\pm}3.5$ in autograft group and from $72.3{\pm}3.5$ to $91.6{\pm}3.3$ in allograft group. There was no significant difference between two groups in clinical results. Conclusion: Both hamstring tendon autograft and tibialis anterior tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. We suggest that both hamstring tendon autograft and tibialis anterior tendon allograft will be considered as acceptable graft for anterior cruciate ligament reconstruction.

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Surgical Repair of Coxofemoral Joint Luxation in a Wild Black-Crowned Night Heron (Nycticorax nycticorax) (야생 검은댕기해오라기에서 대퇴관절 탈골의 수술적 교정)

  • Kim, Eun-Ju;Lee, Jong-Hyun;Kim, Min-Su;Lee, Ki-Chang;Kim, Nam-Soo;Shin, Gee-Wook;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.49-52
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    • 2013
  • A wild black-crowned night heron (Nycticorax nycticorax) with dehydration and a non-weight bearing lameness of the left leg was rescued. On physical examination, the left knee was displaced laterally at almost a $90^{\circ}$ angle with firm swelling and crepitus in the area of the coxofemoral joint. Radiographs confirmed cranio-dorsal coxofemoral luxation. A closed reduction attempt failed. The coxofemoral joint luxation was reduced surgically by placement of the femoral neck next to the pelvis with a suture. Ten days after surgery, radiographs and computed tomography showed the femoral neck and head were positioned well within the acetabulum. At 20 days, the bird was using the affected limb normally, and could hunt and forage for food in a rehabilitation housing unit with a small pond. The bird was successfully released into the wild. The placement of the femoral neck adjacent to the pelvis with a suture can be successfully performed for cases of avian coxofemoral joint luxation. Furthermore, this procedure can provide sufficient stabilization of the coxofemoral joint and acceptable limb function.

Pre-seasonal Physical Examination of Professional Soccer Team (프로 축구팀의 시즌 전 체력검사)

  • Lee, Kyung-Tai;Choi, Byung-Ok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.129-134
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    • 2006
  • Purpose: In the professional soccer team, we performed pre-seasonal physical examination and analyzed the results to establish a standardization data in relation to their position. Materials and Methods: We performed physical examination to the professional soccer team, consisted 34 player's average age 24.9 years. The examination performed were questionnaire on history, musculoskeletal examination, muscle power test, physiologic test, functional test. Results: According to the relationship between player position and injury pattern,. Knee injuries are most frequent on history. Physical examination outcome was that forward were prone to flexor hallucis longus tendinitis, midfielder for chronic ankle instability, defender for achilles tendinitis. Isokinetic test was done at dominant side, Peak torque to body weight ratio was 55.1%. Physiologic test checked body fat percentage was midfielder was superior as 19.8 (SD 2.9). Functional test out-come was that back strength 125 N. sergeant jump 59.6 cm, reaction time 208.5 sec, flexibility 19.2 m/s, side step 39.9 cm. Conclusion: Pre-seasonal physical examination gave us the standardization data and preventive measurement could be advocated from this results.

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DA-7911, $^{188}Rhenium-tin$ Colloid, as a New Therapeutic Agent of Rheumatoid Arthritis

  • Shin, Chang-Yell;Son, Miwon;Ko, Jun-Il;Jung, Mi-Young;Lee, In-Ki;Kim, Soon-Hoe;Kim, Won-Bae;Jeong, Jae-Min;Song, Yeong-Wook
    • Archives of Pharmacal Research
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    • v.26 no.2
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    • pp.168-172
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    • 2003
  • Radiation synovectomy is one of the most useful methods for treating patients with refractory synovitis because of its convenience, long-term effects, repeatability and the avoidance of surgery. In this study, we investigated the toxicity, stability and biodistribution of a rhenium-188 ($^{188}$Re)-tin colloid to evaluate its suitability as a synovectomy agent. Twenty four hours after injecting the $^{188}$Re-tin colloids (74 KBq/0.1 mL) into the tail vein of ICR mice, most of the $^{188}$Retin colloidal particles was found in the lungs. In addition, there were no particle size changes at either room temperature or at $37^{\circ}C$ after injecting the $^{188}$Re-tin colloids in human plasma and synovial fluid. In vitro stability tests showed that the $^{188}$Re-tin colloid remained in a colloidal form without a critical size variation over a 2-day period. We investigated the leakage of $^{188}$Retin colloids from the intraarticular injection site with gamma counting in New Zealand white rabbits. The $^{188}$Re-tin colloids (55.5 MBq/0.15 mL) were injected at the cavum articular and the mean retention percentage of the $^{188}$Re-tin colloid was 98.7% for 1 day at the injection site, which suggests that there was neither change in the particle size nor leakage at the injection sites. In the biodistribution study with the SD rats, the liver showed the highest radioactivity (0.0427% ID/organ) except for the injected knees (99.49%). In the SD rats, mild toxicities including the skin or a synovium inflammation were observed as a result of a radioactivity of 15 mCi/kg at the intraarticular injection site. However, there was no systemic toxicity. In the Ovalbumin (OVA)-induced arthritic rabbits, the $^{188}$Re-tin colloid improved the macroscopic, the histological score and reduced the knee joint diameter when compared to the arthritic control. In conclusion, a $^{188}$Re-tin-colloid is considered as a strong candidate for radiation synovectomy with a superior efficacy and safety.

Experience with the Application of Magnetic Resonance Diagnostic $Analyser^{(R)}$ -A case of reflex sympathetic dystrophy- (자기공명분석기에 의한 반사성 교감신경성 위축증의 치험)

  • Kim, Jin-Soo;Kwak, Su-Dal;Kim, Jun-Soon;Ok, Sy-Young;Cha, Young-Deog;Park, Wook
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.275-279
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    • 1993
  • Reflex sympathetic dystrophy is a syndrome characterized by persistent, burning pain, hyperpathia, allodynia & hyperaesthesia in an extremity, with concurrent evidence of autonomic nervous system dysfunction. It generally develops after nerve injury, trauma, surgery, et al. The most successful therapies are directed towards blocking the sympathetic intervention to the affected extremity by regional sympathetic ganglion block or Bier block with sympathetic blocker; other traditional treatments include transcutaneous electrical stimulation, immobilization with cast & splint, physical therapy, psychotherapy, administration of sympathetic blocker, calcitonin, corticosteroid and analgesic agents. The purpose of this report is to evaluate and describe the effects of magnetic resonance following unsatisfactory results with traditional treatments of RSD. A 17 year old female patient, 1 year earlier, had received excision and drainage of pus at the right femoral triangle due to an injury caused by a stone. Afterwards, she experienced burning pain, knee joint stiffness, and muscle dystrophy of the right thigh, especially when standing and walking. Despite a year of number of traditional treatments such as: lumbar sympathetic block, continuous epidural analgesia, transcutaneous electrical stimulation, & administration of predisolone, her pain did not improve. Surprisingly, the patients was able to walk free from pain and difficulty after just one application of magnetic resonance. The patient has been successfully treated with further treatment of two to three times a week for approximately ten weeks. More recently, magnetic resonance has been demonstrated to produce effective results for the relief of pain in a variety of diseases. From our experiences we recognize magnetic resonance as a therapeutic modality which can provide excellent results for the treatment of RSD. It has been suggested that polysynaptic reflex which are disturbed in RSD may be modulated normally on the spinal cord level through the application of magnetic resonance.

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Functional analysis of isolated posterior cruciate ligament deficient subjects (후방 십자 인대 단독 손상 환자의 기능적 분석)

  • Kim Jin Goo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.66-72
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    • 2004
  • Purpose: To evaluate the compensatory mechanism in vivo and develop the treatment guide by performing the comprehensive functional tests of the posterior cruciate ligament (PCL) deficient subjects. Material and Methods: 10 PCL deficient subjects and 10 healthy control group were evaluated. Performed functional tests were range of motion, posterior drawer test, Telos, 30$^{\circ}$ flexion wt-bearing view, KT-1000 arthrometer, gait analysis, EMG test and isokinetic tests. Results: Physical, KT-1000, Telos posterior tests showed significant differences, but 300 full weight bearing lateral view, muscle strength test revealed no difference between two groups. Less knee flexion at initial contact and reduced maximum valgus moment were observed in PCL deficient group. In vertical drop landing, PCL group had increased plantar flexion angle at initial contact. Conclusion: Compensatory mechanisms such as reduced unstable components and absorbing the maximal load of the joint were occurred after PCL insufficiency, which result in good clinical and functional outcomes. Further investigations would be needed to understand the functional adaptations of PCL deficient subjects.

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The Effects of Coordinative Locomotor Training Program for Life-Care Promotion on Balance of Obese Elderly Women (라이프케어 증진을 위한 협응적 이동훈련 프로그램이 비만 여성노인의 균형에 미치는 영향)

  • Lee, Dong-Ryul
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.1
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    • pp.17-25
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    • 2020
  • The purpose of this study was to examine the effects of coordinative locomotor training (CLT) program on the balance for the promotion of life care of elderly obese women. Ten participants of elderly obese women who were able to walk independently without surgery experience of lumbar, hip or knee joint within the past year were recruited and under went the pretest, CLT (20 sessions), followed by the post-test. The test included BMI test using In-body, joint kinematics using myoVIDEO, muscle activation using surface EMG test (erector spinae (ER), external oblique abdominalis (EO), quadriceps femoris (Quad), hamstring muscle (Ham)) and balance tests including dynamic balance test using forced treadmill, Berg balance scale (BBS) and timed up go (TUG). The CLT program was conducted 60 minutes a day, 5 days a week, over 4 weeks period. As a result of this study, The the trunk and hip joints kinematics during the stance and swing phases of gait were a statistical significance levels were set at p <0.05. The ER and EO muscle activation were significantly improved after intervention (p <0.05). The length of gait line and single support line of change of center of pressure (COP) were significantly increased after intervention (p <0.05). The BBS and TUG were also significantly enhanced after intervention (p <0.05). The results of this study showed that CLT program for the improvement of life care had significant effects on improving postural instability, muscle weakness, reduced balance ability and falling risk of obese elderly women. Therefore, it is recommended to apply CLT program to improve life-care through improving balance ability and preventing fall of obese elderly women.

The Effect of Cyclic Load on Different Femoral Fixation Techniques in Anterior Cruciate Ligament Reconstruction (전방십자인대 재건시 이식건의 대퇴골측 고정에 대한 주기성인장부하의 효과)

  • Song Eun-Kyoo;Kim Jong Seok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.28-36
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    • 2003
  • Purpose: To determine and to compare the effects of cyclic loading on the fixation strength of different femoral fixation methods in ACL reconstruction. Materials and Methods: Biomechanical test using an Instron(R) machine (Model No.5569. Mass, U.S.A) were carried out to compare the pull out strength of six different femoral fixation techniques after a cyclic loading in 72 Yorkshire pig knees. The graft-bone complex was cyclically loaded between 30N and 150N at 50 mm/min rate for 1000 cycles and maximal tensile testing was performed. A preload of 30N was applied to the graft along the axis of the tunnel 15 minutes. ANOVA and the Duncan multiple comparison test was used for the statistical analysis. Results: The mean maximum tensile strength of femoral fixation before and after the cyclic loading test were 1003.4$\pm$145N and 601.1$\pm$154N in hamstring-LA screw(R) group, 595.5$\pm$104N and 360.7$\pm$56N in hamstring-Bioscrew(R) group, 1431.7$\pm$135N and 710.7$\pm$114N in hamstring-Semifix(R) group, 603.6$\pm$54N and 459.1$\pm$46N in hamstring-Endobutton(R) fixation group, 1067.4$\pm$145 and 601.8$\pm$134N in the BPTB-Titanium interference screw group, and 987.1$\pm$168N and 588.7$\pm$124N in the BPTB-Bioscrew(R) group. And these data illustrated that cyclic loading reduces the maximum tensile strength by 40 $\%$, 39 $\%$, 50 $\%$, 24 $\%$, 44 $\%$, 40 $\%$ respectively. Conclusions: With the results of these experiments it should be emphasized that rehabilitation exercises after anterior cruciate ligament reconstruction should be executed with precaution as the repetitive flexion and extension of the knee would compromise the maximum tensile strength of the graft tendon.

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