Pretwisting the patellar tendon graft has been advocated hy many authors. Lambert has described a 90 degrees pretwist to benifit the fat pad vascular supply as well as to "" simulate the helicoid course of the ACL "". This technique has also been recommended to fascilitate fixation. Jackson has recommended a 90 pretwist to decrease the possibility of abrasive wear on the tunnel edge, and also to fascilitate fixation as much as a 180 degrees pretwist has heen recommended. However, in spite of all these recommendations, little work has been done on the effect of such pretwisting on the biomechanical behavior of patellar tendon grafts. The purpose of this study is to discover, by experiment, the effects of a 360 degrees external rotation pretwist on the following tensile mechanical properties of canine central 1/3 patellapatellar tendon-tibia complex : (a) ultimate stress, (b) ultimate strain, (c) average elastic modulus, and (d) strain energy density. Five groups of each S specimens were divided as group 1 (0 degrees external rotation), group 2 (90 degrees external rotation). group 3 (180 degrees external rotation), group 4 (270 degreesexternal rotation), and group 5 (360 degrees external rotation). The direction of pretwist meant the twist of tibia around patella. The effects of pretwist were analyzed using parameter one-way analysis of variance (ANOVA)(P1) and nonparameter Kruskal-Wallis one-way analysis of variance (ANOVA)(P2) with repeated measures followed by Scheff multiple comparison test. A p values of < 0.05 was considered statistically significant. Among each groups ultimate stress (P1=0.059, P2=0.095), ultimate strain(P1=0.154, P2=0. l65), and average elastic modulus(P1=0.814, P2=0.818) were not statistically significant. Only strain energy density was the statistically significant difference between group 2 and group 5(P1=0.008, P2=0.022). As a result, there were observed that the ultimate stress and strain energy density were decreased and ultimate strain was decreased but there were not statistically significant differences hetween groups because of the small number of samples, and there will be advantages for graft to avoid ahrasive wear on the tunnel edge and lateral femoral condyle. But, more studies are needed for human being in the future.
Adipose Tissue ; Elastic Modulus ; Humans ; Patella ; Patellar Ligament* ; Tibia ; Transplants

Treatment of chronic localized osteomyelitis is the same as the other osteomyelitis, that is, curettage and debridement of all dead tissue which is called saucerization. After saucerization there leaves empty cavity and autogenous bone graft has been used for filling the cavity in lower extremity hecause of weight bearing and avoiding fracture. We treated seven cases of chronic localized osteomyelitis with one-staged saucerization and cancellous chip allograft and retrospective analysis was done. All healed without complication and no recurrence was ohserved. Most orthopaedic surgeons are not willing to use allograft on the site of osteomyelitis because of the fear of recurrence. But. we think that as far as complete removal of infected and dead tissue, allograft could he a good solution in terms of rapid remodelling and early weight hearing. Another advantages of allograft are to get a large amount of bone and no damage of iliac apophysis. In summary, one-staged saucerization and cancellous chip allograft would he very useful treatment for chronic localized osteomyelitis.
Allografts* ; Curettage ; Debridement ; Hearing ; Lower Extremity ; Osteomyelitis* ; Recurrence ; Retrospective Studies ; Transplants ; Weight-Bearing

In 1941, Jaffe and coworkers studied a lesion with histologic appearance of fibrous stroma, pigmented deposition and histiocytic infiltration as well as giant cell, for which they named pigmented villonodullar synovitis, bursitis and tenosynovitis. Thereafter many authors have disscussed etiology, clinical and radiological features, pathology and treatment regarding the disease. Recently we experienced a case of pigmented villonodular synovitis involving an hip joint which was treated by synovectomy and total hip replacement with good result.
Arthroplasty, Replacement, Hip ; Bursitis ; Giant Cells ; Hip Joint ; Hip ; Pathology ; Synovitis ; Synovitis, Pigmented Villonodular ; Tenosynovitis

Vertical and marginal fractures of the patella are uncommon injuries compared with other types of patellar fracture. It's possible that they are more common than supposed, but often remain undiagnosed as acute injuries. Vertical and marginal fractures often results in less acute disability than stellate or transverse fracture and the routine radiographs are often unhelpful. Failure to diagnose acute vertical and marginal fractures of the patella, especially when the fragments are displaced, may result in prolonged disability of the knee and possible development of degenarative changes in the patello-femoral joint later. Twelve patients of the vertical and the marginal patellar fractures treated at St. Mary's Hospital from Feb. 1982 to Dec. 1987 were analyzed in clinical and radiological aspect. The results obtained from this study were as followings. 1. Vertical and marginal fractures had 15.4% of injury rate in all patellar fractures. 2. The fracture and its displacement were always present on the tangential view of the patella. 3. The mechanism of the fracture was s direct blow to the patella in which the affected knee was flexed. 4. The location of the fracture line was related to the degree of the flexed knee at the time of fracture. 5. Large separated fragments of the patella should be accurately reduced with rigid fixation in the rationale of the intraarticular fracture.
Clinical Study ; Humans ; Intra-Articular Fractures ; Joints ; Knee ; Patella

Normal lymphocyte transfer (NLT) test is composed of two peaks of delaycd. hypersensitivity reaction of erythema and/or induration developed at the site of intradermal inoculatioa of allogenic lymphocyte. It has been suggested that NLT test is a px.siblc homograft raaction, how var tlv exact mecha.nism is remained to be resolved. In leprosy, there has been accumulating evidenc. indicating defective cell mediated. immunity detected by varioua immunological tests. The present study was undertaken to evaluate the immune capability of patients with leprosy using NLT test. A total of 20 hea,lthy volunteers, 20 lepromatous and 22 tuberculoid leprosy patients who were under antileprosy chemotherapy with DDS for varying periods, entered this study. Lymphocytes from hepatitis associati antigen (HAA) negative donor were isolated with Ficoll- Hypaque density gradient method and the cell concentration was adjusted by normal saline so as to give 2, 5 million cells per 0. 1 ml. Each recipient was given 0. 1 ml lymphocyte suspension on the flexor surface of th right forearm intrad.ermally using 1 ml tuberculi n syringe with a 26 gauge needle. The appearance and the size of induration was checked daily for 2 weeks. In this atudy, the NLT reaction pattem was classified as follows: a. normal pattem showing the first peak and second peak of reaction. b. first peak only showing the first peak, but no second peak, of reaction. c. flat pattem showing neitger the first peak nor the second peak of reaction The results were as follows: 1. There were normal pattem in sixteen persons(80%) and first peak only in 4 persons(20%) among twenty healthy human volunteers. 2. There were normal pattem in four patients(20%), first peak only in six patients(30%) and flat pattem in ten patients(50%) among twenty letromatous leprosy patients. 3. There were normal pattem in twelve patients(54.5%), first peak only in eight patients(36.4%) and flat pattem in two patients(9.1%) among twenty-two tuberouloid leprosy patients. These findings suggest that NLT test may be useful in evaluating the immune capability in leprosy and host factor in belived to be important in the development of both first and second peaks of NLT test.
Allografts ; Diatrizoate ; Drug Therapy ; Erythema ; Forearm ; Healthy Volunteers ; Hepatitis ; Humans ; Hypersensitivity ; Immunologic Tests ; Leprosy* ; Leprosy, Tuberculoid ; Lymphocytes* ; Needles ; Syringes ; Tissue Donors ; Volunteers

Bone defect occurs due to various causes, such as neoplasms, cysts, trauma, infection, congenital disease and surgical intervention. Autograft is generally considered to be the gold standard in bone graft surgery. But, allograft, xenograft and bone substitutes have been used because of complication and limited quantity of autograft. Calcium sulfate is one of the bone substitutes. We reviewed and analyzed 18 cases with bone defects that were treated with calcium sulfate from January 1997 to April 1997. We used the Osteoset' pellets that contained calcium sulfate 98%, produced by Wright Medical Technology Inc. in U.S.A., to fill defects in all cases. Except in 2 cases, autogenous cancellous bone from patients own iliac crest was mixed with calcium sulfate from 30% to 50%. Follow-up time averaged 13.7 months(range, from 12 to 15 months). The degree of absorption of calcium sulfate and new bone growth at conventional roentgenography was represented by percentage at each follow-up. The results were as follows. First, 8 weeks after operation, 93% of calcium sulfate was absorbed. Second, 6 months after operation, nearly 90% of new bone growth was observed. Third, until last follow-up, there was no noticeable complication, such as infection or foreign body reaction. We concluded that calcium sulfate might be on effective material for bone defects because of rapid absorption rate and easy recognition of new bone growth.
Absorption ; Allografts ; Autografts ; Bone Development ; Bone Substitutes* ; Calcium Sulfate* ; Calcium* ; Follow-Up Studies ; Foreign-Body Reaction ; Heterografts ; Humans ; Radiography ; Transplants

PURPOSE: To evaluate the effectiveness of core decompression according to anatomic location and extent of necrotic portion. MATERIALS AND METHODS: The authors reviewed 28 hips with a mean follow-up of 36 months. Cases were classified according to Steinberg, Ficat, Ohzono, Kerboul index, Koo's index, and lateral head index. Failure was defined radiographically as depression of the femoral head compared with the previous one , and clinically HHS lesser than 80. RESULTS: Radiographically, success rates were 15.8% (3/19) in Steinberg IIC, 15.8% (3/19) in Ficat IIA, 26.3% (5/19) in Ohzono 1C, 28.6% (6/21) in Kerboul index greater than 250, 30.4% (7/23) in Koo's index greater than 40, and 15% (3/20) in lateral head index smaller than 12%. Clinically, success rates were 26.3% (5/19) in Steinberg IIC, 26.3% (5/19) in Ficat IIA, 36.8% (7/19) in Ohzono 1C, 38.1% (8/21) in Kerboul index greater than 250, 39.1% (9/14) in Koo's index greater than 40, and 25% (5/20) in lateral head index smaller than 12%. CONCLUSION: Core decompression was ineffective in preventing the collapse of the femoral head for the lesions with diffuse involvement and located laterally at weight- bearing portion, even though in the early stage of osteonecrosis, there was no collapse of the femoral head.
Decompression* ; Depression ; Follow-Up Studies ; Head* ; Hip ; Osteonecrosis*

No abstract available.
Animals ; Linoleic Acid* ; Macrophages, Peritoneal* ; Mice*

No abstract available.
Humans* ; Ovarian Neoplasms* ; Tamoxifen*

No abstract available.
Animals ; Locomotion* ; Rats* ; Spinal Cord Injuries* ; Spinal Cord*