• Journal of the Korean Arthroscopy Society
• /
• v.16 no.1
• /
• pp.1-8
• /
• 2012

Purpose: To evaluate clinical and radiologic outcomes of transphyseal anterior cruciate ligament (ACL) reconstruction in patients with open physes who were selected with authors' new operative indications. Materials and Methods: We evaluated 15 patients with open physes who underwent a transtibial ACL reconstruction and were followed up for 4~6 years after surgery. Our operative indications involved 1) choronologic age of ${\geq}$ 16 in male and ${\geq}$ 14 in female, 2) open physes of ${\leq}$ 2 mm width, and 3) Risser sign and Tanner stage of ${\geq}$ 3. Tibialis anterior tendon allograft was used in all patients, and endobutton and bioscrew were used for femoral and tibial fixations, respectively. Functional outcomes were evaluated using Lysholm Knee Scoring scale, Tegner activity scale, and International Knee Documentation Committee (IKDC) 2000 subjective score. Physical examinations to evaluate stability involved Lachman and pivot shift tests. For radiographic results, we evaluated side to side differences of anterior displacement in stress views. In addition, with use of scannograms taken at last follow-up, we examined side to side differences of femorotibial angles, anatomical and mechanical lateral distal femoral angles, mechanical medial proximal tibial angles and leg lengths. Results: The mean Lysholm Knee score was 51(40-61) points preoperatively and 97(94-100) points at last follow up. The mean Tegner activity score was 2.6 points preoperatively and 7.1 points at last follow up. The mean IKDC score was 32.6 points preoperatively and 88.3 points at last follow up. The mean anterior displacement of the tibia was improved from 6.7(${\pm}1.0$) mm to 1.9(${\pm}0.9$) mm. There were no leg length discrepancies over 5 mm and no statistically significant differences in all the radiographic variables representing growth disturbance. Conclusion: This study suggests that patients with open physes who selected by authors' new indication would safely undergo transphyseal ACL reconstruction with successful outcomes.

• Journal of the Korean Arthroscopy Society
• /
• v.6 no.2
• /
• pp.101-108
• /
• 2002

Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction and to know the results of physeal injury by transphyseal tunnel in adolescents who had remaining growth potential. Materials and Methods : This study involved 12 patients under 19 years old out of 445 patients, who underwent ACL reconstruction between 1993 and 2001. The mean age at the time of operation was 15.9 $(13.1\~16.9)$ years and fellow-up period was 45.1 $(24\~120.6)$ months in avrarge. Autologous quadrupled hamstring tendon was used as graft in 11 cases and bone-patellar tendon-bone in 1 case. Clinical results were evaluated by Lysholm Knee Scoring Scale, range of motion and return to preinjury sports activities. Radiologic results were evaluated by $Telos^{\circledR}$ device. Bone maturity were analyzed by chronological age, standing height and the width of growth plate in AP and lateral view of knee joint at preoperatively. The growth disturbances were evaluated by measuring femorotibial angle, anatomical and mechanical lateral distal femoral angle, mechanical medial proximal tibial angle and leg length and by comparing those of uninjured site in last follow-up teleoroentgenogram. Results : The mean Lysholm Knee score was 51 $(25\~63)$points preoperatively and 98 $(94\~100)$ points at last follow up. The mean anterior displacement of the tibia by using $Telos^{\circledR}$ device was improved from 13.5 $(6\~27)$ mm to 2.9 $(1\~4)$ mm and there were no significant instabilities of the knee in all cases. There were no leg length discrepancies over 1 cm and no statistically significant abnormal alignment of the knee joint in all cases. Conclusion: ACL reconstruction using transphyseal tunnel for restoring stability and knee function is assumed as a good mettled of treatment without significant leg length discrepancy and abnormal alignment of the knee joint.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.3
• /
• pp.276-284
• /
• 2008

Purpose: The purpose of this study was to observe the effect of calcium and vitamin D to the titanium implant osseointegration in the osteoporosisinduced animal model. Material and method: Thirty-two rats, 10 weeks of age, were divided into two groups: experimental group was ingested additional calcium and vitamin D, and a control group was not. Titanium screw implant(diameter, 2.0 mm; length, 3.5 mm; pitch-height 0.4 mm) were placed into tibia of 32 rats, 16 in the control group and 16 in the experimental group. The rats were sacrificed at 1, 2, 4 and 8 weeks after implantation for histopathologic examination, histomorphometric analysis and immunohistochemistry with fibronectin and collagen type I antibody. Result: In histopathological findings, newly formed bone was seen at 2 weeks and became lamellar bone at 4 weeks, and mature trabecullar bone was seen at 8 weeks in experimental group. In control group, thickness of regenerated bone increased till 4 weeks gradually and trabecullar bone was seen at 8 weeks. In histomorphometric analysis, marrow bone density increased significantly in experimental group compared to control group. Fibronectin immunoreactivity was strong at 2 weeks in experimental group and reduced after 4 weeks gradually. But it was maintained continuously from 2 to 8 weeks in control group. Collagen type I immunoreactivity was very strong from 2 to 4 week in experimental group. And the amount of Collagen type I expression was more abundant in experimental group. Conclusion: The results of this study suggest that calcium and vitamin D supplementation promote bone healing around titanium implants in osteoporosis induced animals.

• The korean journal of orthodontics
• /
• v.38 no.5
• /
• pp.328-336
• /
• 2008

Objective: The purpose of this study was to compare the torque resistance to removal of sandblasted large grit and acid etched (SLA) surface treated orthodontic mini-implants and smooth surface orthodontic mini-implants as well as performing histologic observations. Methods: Two groups of custom screw shaped orthodontic mini-implants (C-implant, 1.8 mm outer diameter $\times$ 9.5 mm length, Cimplant, Seoul, Korea) were designated. 22 SLA treated C-implants (SLA group) and 22 machined surface C-implants (machined group) were placed in the tibia metaphysis of 11 adult New Zealand white rabbits. Following a 6-week healing period, the rabbits were sacrificed. Subsequently, the C-implants were removed under reverse torque rotation with a digital torque measuring device and independent t-test was performed. Selected tissues were prepared for histologic observation. Results: The SLA group presented a higher mean removal torque value (6.286 Ncm) than the machined group (4.491 Ncm) which was statistically significant (p < 0.005). Histologic observation revealed a trend of more new bone formation in contact with the screw surface in the SLA group than the smooth group. Conclusions: The results of this study suggested that SLA surface treatment can enhance the osseintegration potential for C-orthodontic mini-implants.

• The Journal of the Korean bone and joint tumor society
• /
• v.17 no.1
• /
• pp.36-43
• /
• 2011

Purpose: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system ($MUTARS^{(R)}$) used in patients with a malignant bone tumor. Materials and Methods: Thirty one cases which used $MUTARS^{(R)}$ tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. Results: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. Conclusion: Our results suggest limb salvage with the $MUTARS^{(R)}$ endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.

• Asian-Australasian Journal of Animal Sciences
• /
• v.17 no.8
• /
• pp.1080-1087
• /
• 2004

A trial with twenty-four newly weaned Awassi lambs (initial body weight=21.5$\pm$0.8 kg) was conducted using a 3$\times$2 factorial design to study the effect of feeding three sources of protein supplements (soybean meal (SBM), sunflower seed meal (SSM), and cottonseed meal (CSM)), either untreated or formaldehyde-treated on the growth performance and carcass traits of Awassi lambs. Lambs were randomly assigned to one of the six diets (4 lambs/treatment diet) and were individually fed for a period of 107 days. Experimental diets were isonitrogenous and isocaloric. Final live weight and average daily gain (ADG) were affected by both source of protein and formaldehyde treatment (undegradable protein). Lambs fed untreated diets had better (p<0.01) daily gain compared to those fed formaldehyde-treated diets. Similarly total feed intake per animal was significantly (p<0.05) affected by protein source and formaldehyde treatment. Formaldehyde treatment caused a significant decrease (p<0.01) in feed intake compared to lambs fed untreated diets. Feed requirement per unit of gain was not affected by formaldehyde treatment during all periods of the experiment except for the second period (the second 28 day period), whereby untreated SBM, SSM and CSM had better feed conversion ratio (FCR) than the treated groups. Source of protein had a moderate effect (p<0.10) on FCR but had a significant effect (p<0.05) on hot and cold carcass weight, digestive tract empty weight and liver weight, with lambs fed SBM having higher values than lambs fed SSM and CSM diets. Supplementation with undegradable protein had a significant effect (p<0.05) on dressing-out percentage (p<0.05), final live weight, and hot and cold carcass weight (p<0.01). The lower values pertain to lambs fed treated diets compared to lambs fed untreated diets. In general, there were no significant differences among all carcass linear dimensions, carcass cut weights and dissected loin tissue weights for both treatments (protein source and formaldehyde treatment). Supplementation with undegradable protein but not the source of protein resulted in significantly higher dissected leg total bone weight (p<0.05), tibia and femur weight (p<0.05), and femur length (p<0.01) at the same carcass weight. Results suggest that the treatment of SBM, SSM and CSM with formaldehyde did not improve efficiency of feed utilization, lamb performance or carcass traits and that the SBM diet resulted in an increase in lamb performance compared to other experimental diets.

• Asian-Australasian Journal of Animal Sciences
• /
• v.20 no.6
• /
• pp.976-982
• /
• 2007

This study investigated whether supplemental Cu, Fe, Zn, and Mn are needed in a practical diet for pullets. Four hundred and twenty females of an egg-laying strain (1-d-old, Lohmann Brown Layer) were randomly distributed into 4 groups, consisting of 7 replicates of 15 birds each. During the 18-week experimental period, chicks were given three basal diets in sequence, each with single or multiple Mn, Zn and Cu supplementation to improve the mineral balance gradually. In the Control, no Mn, Zn, and Cu were added; in the single Mn supplemented group (sMn) Mn was added to 120, 60, and 60 mg/kg for 1-6, 7-12, and 13-18 weeks of age, respectively; in the multiple Mn and Zn supplemented group (mMnZn), Mn was added to 180, 90, and 90 mg/kg and Zn was added to 120, 105, and 105 mg/kg for 1-6, 7-12, and 13-18 weeks of age, respectively; in the multiple Mn, Zn, Cu supplemented group (mMnZnCu), Mn, Zn, and Cu were added to the same multiple of basal Fe concentration relative to NRC (1994) recommendations. Energy and protein metabolizability were determined by subtracting energy/protein intake by energy/protein excretion (from both feces and urine) and dividing by energy/protein intake. There were no statistically significant differences between groups in terms of feed intake, final body weight or tibia length throughout the experiment. Optimal growth performance was observed in the Control, while adding trace minerals to basal diets tended to result in decreased productive performance. Protein metabolizability was increased by mMnZn and mMnZnCu treatments, but energy metabolizability was not affected. Concentrations of Mn, Zn, Cu in excreta varied greatly related to dietary content, and the retentions of Cu, Fe, Zn and Mn were all increased due to the improvement of mineral balance. Based on these results, it is suggested that the concentrations of Cu, Fe, Zn and Mn in typical basal diets used in this study were adequate for normal growth for pullets from 1 to 18 weeks of age.

• The Journal of the Korean bone and joint tumor society
• /
• v.11 no.1
• /
• pp.100-104
• /
• 2005

Osteosarcoma is the most common tumor in malignant bone tumors. The peak age incidence in osteosarcoma is between 10 to 14 years of age. This tumor rarely develops under 6 years of age and the youngest patient in the previous literature was a 13 months old girl who had an osteosarcoma involving the second metacarpal bone. We report a case of an 8 month old male infant, who had an osteosarcoma involving the right proximal tibia. This patient was treated by wide excision with transepiphyseal resection and reconstruction with allograft. At 20 months after operation, the varus deformity was developed at the proximal junctional site of allograft. Thereafter, the revision was performed with correction of deformity and augmentation with the proximal fibula transfer. At 51 months after operation, he has been remained as free of disease, and he has recovered the knee motion ranged from 15 degree to 75 degree. The osteosarcoma in infant is very rare but it should be considered the osteosarcoma in the differential diagnosis of any bone lesion. Instead of amputation, the limb sparing operation and the solutions for limb length inequility in growing period should be carefully considered in the infantile osteosarcoma.

• The Journal of Korean Academy of Prosthodontics
• /
• v.42 no.5
• /
• pp.556-571
• /
• 2004

Statement of problem: Surface texture of the implant is one of the important factors of the implant success, especially in the immediate implant loading. Many methods of the surface treatment of implant have developed and introduced. Purpose : This study was to evaluate the effects of the Ca-P coating implant crystallized the hydroxyapatite on the surface by the removal torque test and the histomorphometric analysis in vivo. Material and methods: 135 screw type implants, 4.0mm in length and 3.75mm in diameter were used in this study. Implants were divided into 3 groups and treated in the different mothods. Group I was not treated, Group II was treated in the SLA method, and Group III was treated in the Ca-P coating with the anodizing method and the hydroxyapatite was crystallized on the surface with the hydrothermal treatment. Firstly, the surface roughness of each group was measured, 45 rabbits were used in this experiment. Two implants were inserted on right tibial metaphysis and one implant was inserted on left side with the alternating order. After the healing periods of 3, 5, and 12 weeks, the rabbits were sacrificed to evaluate the osseointergration by the removal torque test and the histomorphometric analysis. Results : 1. In the analysis for the surface roughness, Group II showed the highest roughness. And Group III showed higher secondly. There was a significant difference one another statistically 2. In the removal torque test, Group III and II were significantly higher than Group I. There was no statistical difference between Group III and Group II. 3. For all Groups, the removal torque values at 12th week were significantly higher than at 3rd and 5th week. 4. In histomorphometric analysis, the bone implant contact rates of Group III and II were higher than that of Group I at 3rd and 5th week. There was a significant difference at 5th week. 5. In histomorphometric analysis, the bone implant contact rate of Group III and II increased from 3rd week to 5th week, but decreased at 12th week. In Group I, the contact rate at 12th week was significantly higher than at 3rd week and 5th week.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.5
• /
• pp.386-395
• /
• 2011

Introduction: Osteoporosis is a major health problem in the elderly that involves changes in the properties of bone as well as impaired bone healing around a titanium implant in both humans and animals. This study examined effect of low intensity pulsed ultrasound (LIPUS) on the bone healing process around a titanium implant in osteoporosis-induced rats. Materials and Methods: Sixteen rats were divided into two groups. A control group with osteoporosis induced by removing both ovaries and an experimental group of rats that were applied with LIPUS after osteoporosis had been induced. A screw type titanium implant (diameter, 2.0 mm: length, 3.5 mm, Cowell-Medi, KOREA) was placed into the tibias of 16 rats. The control and experimental group contained 8 rats each. The rats were sacrificed at 1, 2, 4, and 8 weeks after implantation to examine the histopathology and immunochemistry. Results: The histopathology examination revealed earlier new bone formation in the experimental group than the control group. In particular, at 1 week after implantation, more new bone matrix and collagen were observed around the implant of the experimental group compared to the control group. Immunochemistry analysis showed that the level of OPG expression of the experimental group was higher in the early stages than in the control group. After 8 weeks, the levels of OPG expression were similar in both groups. The expression level of receptor activator of nuclear factor kB ligand (RANKL) was stronger in the experimental group than the control group. After 4 weeks, the level of RANKL expression was similar in both groups. Conclusion: These results suggest that the application of LIPUS to implantation can promote bone healing around titanium in osteoporosis animals.