No abstract available.
Posterior Cruciate Ligament*

PURPOSE: To compare the results of posterior cruciate ligament reconstruction by open and arthroscopic method. MATERIALS AND METHODS: From 1995 to 1997, 18 reconstructions of posterior cruciate ligament were performed. Group 1 (open method) was composed of 9 cases and group 2 (arthroscopic method) was consisted of 9 cases. After 21-month follow-up, The two groups were compared by clinical and radiologic methods. RESULTS: Clinically, Lysholm knee score was 80 points in group 1 and 83 points in group 2 after operation. Post operative results by Hughston's criteria were good in 5, fair in 2 and poor in 2 cases (group 1) and good in 6, fair in 2 and poor in 1 cases (group 2). Radiologically, post operative average of posterior drawer stress view was 5.2 mm (group 1) and 5.0 mm (group 2). Almost double the operation time was taken to reconstruct posterior cruciate ligament by arthroscopic method than open method. There were technical errors in 2 cases performed by arthroscopic method. CONCLUSIONS: The results of both methods had no significant difference. We think that the reconstruction of PCL using patellar tendon by open method is a recommendable treatment method together with arthroscopic method, if the merits or demerits of both methods are considered carefully. But more long-term follow-up is necessary to compare the results of PCL reconstruction by open and arthroscopic methods.
Follow-Up Studies ; Knee ; Patellar Ligament ; Posterior Cruciate Ligament

STUDY DESIGN: A prospective study OBJECTIVES: To analyze the serial results of selective nerve root blocks in herniated lumbar disc patients. LITERATURE REVIEW SUMMARY: To our knowledge there has been no study demonstrating the serial efficacy of root blocks for patients with a herniated lumbar disc only. MATERIALS AND METHODS: Selective nerve root blocks were performed in 36 patients who had a lumbar disc herniation only, with radiculopathy, between November 2002 and April 2003. The diagnoses were made by CT or MRI, which agreed with the symptoms and physical examinations. There were 31 men and 5 women, with a mean age of 28.2 years. The mean interval between the onset and procedure was 7.6 weeks, ranging from 1 to 26 weeks. Mono- and double-segment injections were used in 18 cases, respectwely. The straight leg raising angle, visual analogue pain scale, and motor and sensory functions were investigated before, immediately, 2 days, and 1 and 3 months after the procedure. RESULTS: The mean straight leg raising angle improved significantly, from 28+/-9 degrees to 53+/-18 degrees, immediately, and was maintained until 3 months after the procedure (P<0.001). The visual analogue pain scale was also improved, from 4.6+/-0.9 to 2.0+/-1.5, immediately, and was maintained until 3 months after the procedure (P<0.001). Two of ten patients with motor weakness, and six of eighteen with sensory deficit were improved. There was no procedure related complication; however, surgical treatment was performed in two patients who showed no improvement until 3 months. CONCLUSIONS: Selective nerve root block is a safe and effective treatment method to obtain a rapid and remarkable improvement of radiculopathy in herniated lumbar disc patients.
Diagnosis ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Pain Measurement ; Physical Examination ; Prospective Studies ; Radiculopathy ; Sensation

STUDY DESIGN: A prospective study OBJECTIVES: To analyze the serial results of selective nerve root blocks in herniated lumbar disc patients. LITERATURE REVIEW SUMMARY: To our knowledge there has been no study demonstrating the serial efficacy of root blocks for patients with a herniated lumbar disc only. MATERIALS AND METHODS: Selective nerve root blocks were performed in 36 patients who had a lumbar disc herniation only, with radiculopathy, between November 2002 and April 2003. The diagnoses were made by CT or MRI, which agreed with the symptoms and physical examinations. There were 31 men and 5 women, with a mean age of 28.2 years. The mean interval between the onset and procedure was 7.6 weeks, ranging from 1 to 26 weeks. Mono- and double-segment injections were used in 18 cases, respectwely. The straight leg raising angle, visual analogue pain scale, and motor and sensory functions were investigated before, immediately, 2 days, and 1 and 3 months after the procedure. RESULTS: The mean straight leg raising angle improved significantly, from 28+/-9 degrees to 53+/-18 degrees, immediately, and was maintained until 3 months after the procedure (P<0.001). The visual analogue pain scale was also improved, from 4.6+/-0.9 to 2.0+/-1.5, immediately, and was maintained until 3 months after the procedure (P<0.001). Two of ten patients with motor weakness, and six of eighteen with sensory deficit were improved. There was no procedure related complication; however, surgical treatment was performed in two patients who showed no improvement until 3 months. CONCLUSIONS: Selective nerve root block is a safe and effective treatment method to obtain a rapid and remarkable improvement of radiculopathy in herniated lumbar disc patients.
Diagnosis ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Pain Measurement ; Physical Examination ; Prospective Studies ; Radiculopathy ; Sensation

PURPOSE: The purpose of this study was to provide the basic data for the anatomy of distal femur by real measurement, to determine the morphologic fit between the distal femur of Koreans and the femoral prostheses in total knee arthroplasty. MATERIALS AND METHODS: For 173 knees of 117 patients who underwent total knee arthroplasty, we measured the mediolateral width and the anteroposterior height of the distal femur during operation. RESULTS: The average mediolateral width of the distal femur was 68.4+/-4.3 mm, and the average anteroposterior height of the medial and lateral condyle were 59.0+/-4.7 mm and 60.8+/-4.0 mm respectively. the distal femurs of Koreans are smaller on average than the femoral prostheses used in Korea. The average ratio of height to width of the distal femur is 0.86+/-0.07, but the ratios of the five different kinds of femoral prostheses were not constant. So discrepancy between the ratio of the distal femur and the femoral prosthesis results in poor bony coverage. CONCLUSION: A more adequate femoral prosthesis is required to improve the compatibility to the distal femur. These results should contribute to the development of new model of femoral prosthesis for Koreans.
Arthroplasty* ; Femur* ; Humans ; Knee* ; Korea ; Prostheses and Implants*

PURPOSE: This study was evaluated to find out meaning of patellofemoral alignment related to anterior knee pain using computed tomographic image. MATERIALS AND METHODS: This study include 32 cases, 21 persons as a patient group which had been treated due to anterior knee pain related to tight lateral retinaculum from Jan. 1999 to Dec. 1999 and 36 cases, 18 persons as a control group which had no history of anterior knee pain and no abnormal finding malalignment by physical examination. Patellofemoral alignment was evaluated by measuring sulcus angle, congruence angle and lateral patellofemoral angle using computed tomographic images in 0 degrees and 20 degrees knee flexion patellofemoral alignment of the patient group was compared with that of the control group statistically. All 32 cases of the patient group had an arthroscopic lateral release and the patellofemoral alignment was rechecked on computed tomographic images. RESULTS: There was statistically difference between the average measurement of patient group and that of the control group on the computed tomographic images in 0degree and 20degree flexion of the knee. Also the average measurement after lateral release in patient group was corrected significantly. CONCLUSION: Laterally aligned patella during 0 degrees and 20 degrees knee flexion in computed tomographic should not be considered as normal variation but as pathologic condition related to anterior knee pain.
Humans ; Knee ; Patella* ; Physical Examination

PURPOSE: Up to now, there are several controversies in many aspects of osteochondritis dissecans. In this paper, we have intended to evaluate the frequent location and the etiology of the osteochondritis dis-secans of the femoral condyles, and to assess the adequate modality of operative treatment and its results according to the modality. MATERIALS AND METHODS: We reviewed retrospectively forty-four knees in forty patients. We analysed their clinical and radiological finding to take the incidence at both condyles and its etiology and to estab-lish the modality of applied operative methods according to the status of the lesion. The performed operative methods were multiple drilling(1 case), fragment fixation(2 cases), curettage & multiple drilling(36 cases), osteochondral autotransplantation(5 cases). The majority of these operation was proceeded under arthroscopy. Its clinical results were assessed by Aichroth's result grading system after an average follow-up of two-years and eleven months(range, one year and two months to six years and one month). RESULTS: Twenty one cases were medial femoral condylar lesions, and 23 cases were lateral. 91% patients had had the history of the definitive trauma(20 cases) or the minor repetitive trauma in their envi-ronments(20 cases). After operative treatment, seven knees had an excellent result; twenty-nine, a good result; six, a moderate result; and two, a poor result. Satisfactory result was 82%. CONCLUSIONS: On the basis of this review, we suggest that there is no difference in incidence between both femoral condyles, and that the trauma is seemed to play a major role as an etiologic factor. Majority of operated patients showed satisfactory results after application of our treatment modality.
Adult* ; Arthroscopy ; Curettage ; Follow-Up Studies ; Humans ; Incidence ; Knee ; Osteochondritis Dissecans* ; Osteochondritis* ; Retrospective Studies

Avulsion of the pectoralis major muscle is a rare injury, with only about 20 cases reported in literature. Most cases occur in a younger, more athletic population. The object of this paper is to report our experience of a complete avulsion of the pectoralis major muscle from the insertion site of the proximal humerus and we obtained excellent result with immediate surgical repair and rehabilitation.
Humerus ; Rehabilitation ; Sports ; Tendons*

PURPOSE: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. MATERIALS AND METHODS: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. RESULTS: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. CONCLUSION: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.
Classification ; Curettage ; Follow-Up Studies ; Humans ; Joints ; Knee ; Magnetic Resonance Imaging ; Radiography ; Talus* ; Transplants*

PURPOSE: The purpose of this study was to compare the arthroscopic findings between autograft group and allograft group minimal 1 year after anterior cruciate ligament reconstruction. MATERIALS AND METHODS: From Jul. 1999 to Feb. 2002, we performed second look arthroscopy to 55 patients(60 knees), who had already received anterior cruciate ligament reconstruction minimal 1 years ago(average 16 months) in our hospital. All patients visited our hospital just for removal of tibial hardware. Among 60 knees, 24 cases had operated using bone-patellar tendon-bone autograft(group 1), 36 cases using Achilles tendon allograft(group 2). We evaluated the clinical results by instability, subjective complaint and level of activity. Also we analyzed the second look arthroscopic findings by graft revascularization, fissuring, laxity and intraarticular general status. RESULTS: There was no differene in clinical results except 2 patients who complained mild anterior knee pain in group 1. At second look arthroscopy, well vascularized cases were 13 cases(54%) in group 1 and 15 cases(41%) in group 2 respectively. Fissuring of graft was more prominent in group 2(5 cases, 14%) rather than group 1(3 cases, 9%). Fibrous tissue formation around graft was found in 3 cases(14%) of group 1 and 7 cases(20%) of group2. According to Outerbridge grading system of articular cartilage, more than grade II change in patellofemoral joint were detected more prominently in group 1(7 cases, 32%) than group 2(7 cases, 21%). CONCLUSION: In clinical results, there was no difference between Achilles allograft and Bone-Patellar tendon-Bone autograft used for reconstruction of anterior cruciate ligament. On second look arthroscopy, patellofemoral arthrosis was more prominent in autograft group, but revascularization of graft and the change of perigraft tissue showed more favorable result.