PURPOSE: To investigate the clinical and radiological results after primary or revision total knee arthroplasty using fresh frozen femoral head strut allograft for severe bone defect. SUBJECTS AND METHODS: Seventeen patients (18 cases) with severe bone defect were taken primary or revision TKA from 1997 to 2001 using fresh frozen femoral head allograft. 12 cases of revision TKA and 6 of primary TKA were conducted. The average age was 66 years old(55~74) and the follow up period was 29 months(12~63 months). Bone defects were found at proximal tibia in 10 cases, distal femur in 2 and both sites in 6 cases. PCL substituting TKA with extension rod were 15, and PCL retaining TKA were 3. The clinical result was assessed with the knee score of Hospital for Special Surgery(HSS) and for assessment of allograft, simple X-ray film was employed. RESULTS: Average range of motion was increased from 71 degrees to 103 degrees and HSS score was increased from 46(18 ~68) to 83(68 ~91). With 17 of 18 femoral head strut allograft, union was seen and no clinical collapse was present. In one, partial allograft absorption was occured. The preoperative alignment was an average of 7 degrees varus(range 5 degrees~15 degrees) and postoperative alignment was averaged 6.1 degrees valgus(range 3 degrees ~7 degrees). No radiolucent lines were 2 mm or more in width, and there was no case of infection or fracture of allograft. CONCLUSIONS: Femoral head strut allograft was a satisfactory method of managing severe bone defect in primary or revision TKA.
Absorption ; Allografts* ; Arthroplasty* ; Femur ; Follow-Up Studies ; Head* ; Humans ; Knee* ; Range of Motion, Articular ; Tibia ; X-Ray Film

STUDY DESIGN: Prospective analysis was based on radiographic appearance in 80 cases of spondylolisthesis taken in positional change. PURPOSE: The aim of the study was to investigate the flexion-extension lateral radiographs about the difference between decubitus and upright position and the measurement method of displacement in spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Although the flexion-extension lateral radiographs of spine were known the most preferable diagnostic method for spine instability, there are some debates about the difference of displacement according to the patient position and measurement methods. MATERIALS AND METHODS: The radiographs of 80 patients with spondylolisthesis were taken in the decubitus and upright position. Extent of the displacement were measured by Taillard, DuPuis, modified Qunnell & Stockdale method and Ferguson angle, slip angle, lordosis angle and vertebral centroid measurement of lumbar lordosis(CLL) were measured, according to position. RESULTS: Significant difference between the positions was shown on the CLL and lordosis angle. Differences between positions analyzed from Taillard, DuPuis, modified Qunnell & Stockdale method, Ferguson angle and slip angle had no statistical significance. Differences between positions analyzed from the pathologic movement of translation(>4 mm) had a clinically significance in the upright position rather than the decubitus. CONCLUSION: The lateral flexion-extension radiographs on upright position rather than decubitus position are considered as the more useful diagnostic method.
Animals ; Humans ; Lordosis ; Prospective Studies ; Spine ; Spondylolisthesis*