Many authors have studies to relieve the pain after arthniscopic knee surgery. We undertook a randomized, double-blind trial to compare the efficacy of intraarticular morphme and bupivacaine between arthroscopic meniscus surgery group and cruciate ligament reconstruction group. As an results, intraarticular injection of morphine-bupivacaine combination is effective to control pain after minor athroscopic surgery such as menisectomy and meniscal repair ancf intraarticu]ar injection of mor- phine-bupivacaine combination is not effective to relieve pain after major arthroscopic surgery including cru- ciate ligament reconstruction. So, more potent analgesics should be adminishated.
Analgesia ; Analgesics ; Arthroscopy ; Bupivacaine* ; Injections, Intra-Articular ; Knee* ; Ligaments ; Morphine*

No abstract available.
Tibia*

No abstract available.
Posterior Cruciate Ligament*

The most commonly used graft source for anterior cruciate ligament reconstruction is the autogenous bone- patellar tendon-bone graft unit. Despite a good success record, intraoperative technical errors and postoperative complications have been known. Author analyzed intraoperative technical errors and postoperative complications, in 44 patients who were treated at the department of orthopaedic surgery, chosun university hospital from Jan. 1994 to Jun. 1996. The most common intraoperative technical errors was screw graft divergency in 5 cases. Other intraoperative technical errors were too anteriorly location of femoral tunnel in 1 case, too anteriorly location of tibial k femora) tunne.l both in 1 case, graft tunnel mismatching in 1 case, graft pullout in 1 case and partial destruction of posterior cortex of femoral tunnel in 1 case, fracture of the bone plug in 1 case. The most common postoperative complication was patellar tendinitis in 20 cases (45.5%). Other postoperative complications were anterior knee pain in 14 case. (31.8%), patellar crepitation in 12 cases (27.3%), quadriceps atrophy in 9 cases (20.5%), arthrofibrosis in 3 cases and graft failure in 2 cases. Author concluded the causes of intraoperative complications were technical errors, and anteriorly location of graft tunnel is most influenced factor to final fuctional results. To eliminate the postoperative complications, intraoperative technical errors should be avoided and also accelerated rehabilitation should be done.
Anterior Cruciate Ligament Reconstruction ; Atrophy ; Humans ; Intraoperative Complications ; Knee ; Patellar Ligament* ; Postoperative Complications* ; Rehabilitation ; Tendinopathy ; Transplants

Arthroscopic anterior cruciate ligament reconstruction with bone-patella tendon-bone has been commonly using for ACL insufficient patients. Bone-patellar tendon-bone graft is a strong intra-articular substitute, which allows, by means of its bony end, a rigid fixation with early bone to hone healing. As a counterpart, potentially serious cornplications & donor site morbidity has been reported, such as patella fracture & patella tendon avulsion, anterior knee pain, patella tendinitis, dcmor site pain and bone defect. We suppose tightly packing the donor site bony defect with hetrograft (Lubboc) may be also useful. So, we analyzed the morphological change in bony defect and donor site morbidity between the group of non-replaced bony defect and the group of replaced bony defect using by heterograft (Lubboc). We replaceJ hetrograft into the patellar side bony defect in 15 knees and left alone in l5 knees. The average follow up period was 17 months. The results werc as follows: 1. Nearly norma1 appearance on the bony defect showed at the long tenn follow up roentgenogram in the group of replaced hetrograft, but scalloping on the pateltar bomp defect was seen in non-replaced group. 2. Donor site morbidity (pain or patellai tendinitis) was developed 8 knees in the replaced group, and 7 knees in the non-rep)aced group. 3. We conclude that the filled in the bony defect hy hone graft (heterografl:) can not decrease the donor site morbidi ty.
Anterior Cruciate Ligament Reconstruction ; Bone-Patellar Tendon-Bone Grafts ; Follow-Up Studies ; Heterografts* ; Humans ; Knee ; Patella ; Patellar Ligament* ; Pectinidae ; Tendinopathy ; Tissue Donors* ; Transplants

Segmental fracture of the femoral shaft is known as an unusual injury, usually caused by severe force and associated with marked damage to the soft tissue, and is difficult to treat due to these causes it is a controversal topic in regard to the treatment. Authors analysed 14 cases of segmental fracture of the femoral shaft, except cases associated with hip fracture, which had received operative treatment at Dept. of Orthopaedic Surgery, College of Medicine, Chosun University, from Jan. 1985 to Dec. 1990. The results are summarized as follows; 1. Of 14 cases, there were 12 cases of male and 2 cases of female: male was predominant. Most cases were at their 3rd and 6th decades of age. 2. Traffic accidents were the main causes of injury(11 out of 14 cases.) 3. There were 13 closed fracture and 1 open fracture. 4. In most cases, they accompanied injuries to other vital organ. Among 14 cases, 5 cases accompanied head injury. 5. We treated these fracture by flexible intramedullary nailing in 7 cases, open reduction and internal fixation with plate in 5 cases, locked intramedullary nailing in 2 cases. Bony union was more rapid in the distal fracture than in the proximal fracture. 6. Among 14 cases, primary bone grafting was done in 2 cases. In the group where primary bone grafting had not been done, dealyed union appeared but nonunion was not seen. 7. We could obtain rapid bony union and decreased operation time in the cases which were treated with intramedullary fixation, and thought that intramedullary fixation was a relatively good method in type of this fracture.
Accidents, Traffic ; Bone Transplantation ; Craniocerebral Trauma ; Female ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hip ; Humans ; Male ; Methods

Superoxide dismutase(SOD), catalase and glutathione peroxidase and the levels of lipid peroxide were assayed in erythrocytes and synovial fluid isolated from 17 patients with osteoarthritis of the knee joints and 7 with healthy knee joints as a control groups. In the erythrocytes, SOD, catalase and glutathione peroxidase activities were significantly increased in osteoarthritis compared with normal control groups, but the changes of malonyldialdehyde level was not significant. The activity of SOD in synovial fluid was significantly decreased in osteoarthritis compared with normal control groups, but catalase activity was significantly increased in synovial fluid of osteoarthritis. This result suggested that the increament of antioxidant enzymes in erythrocytes were probably due to increased production of oxygen radicals in osteoarthritis. In osteoarthritis, knee joints might be injured more easily by oxygen radicals because of decreased activity of SOD in synovial fluid of osteoarthritis.
Catalase ; Erythrocytes ; Glutathione Peroxidase ; Glutathione ; Humans ; Joints ; Knee Joint ; Knee ; Malondialdehyde ; Osteoarthritis ; Osteoarthritis, Knee ; Reactive Oxygen Species ; Superoxide Dismutase ; Superoxides ; Synovial Fluid

The purpose of this paper is to compare the results, complications, advantages and disadvantages of treatment by flexible intramedullary nail with those by interlocked intramedullary nail in humeral shaft fractures. The authors analyzed 42 cases of humeral shaft fractures in patients who were treated by intramedullary nailing. Nineteen patients were treated with flexible I-M nail and twenty three patients were treated with interlocked I-M nail. Fourteen cases(74%) treated with flexible I-M nail were obtained primary bone union, and twenty one cases(91%) treated with interlocked I-M nail were obtained primary bone union. Five cases treated with flexible I-M nail and 2 cases treated with interlocked I-M nail failed union and the most common cause of nonunion was distraction. Flexible I-M nailing does not solve rotational deformity and could't obtain a high union rate due to distraction. Therefore, we recommend that adequate external support is considered to prevent distraction using the flexible I-M nail. Although we obtained a satisfactory union rate using by Seidel interlocked I-M nail, we must observe the distal spreading screw loosening during the follow up period. In bones with small diameter, sufficient reaming may be necessary, because the distal spreading screw can't spread well.
Congenital Abnormalities ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans

Recently, the frequency of meniscal injury of knee has been increasing due to increase of sports activities. It has been known that bucket handle tear is the most common type of the entire injuries of the meniscus. We found 127 cases of meniscal tears and experienced 42 cases of bucket handle tears in the arthroscopic findings from Jan. 1991 to April 1994 in our hospital. We analysed 31 cases which were followed up for at least 1 year. The purpose of this study is to analyse the locking history and frequency, to discuss the several types of bucket handle tear in arthroscopic view, to introduce three portal techniques using posteormedial or posterolateral portal to resect the meniscus, and to analyse our clinical results. So we concluded as follows. 1. Among the 31 cases, 23 cases(74%) had an episode of locking. 2. We found many different types of bucket handle tears in arthroscopic view and the most common type was complete tear in a classic type(11 cases). 3. We were able to resect the meniscal fragment very easily using posteromedial or posterolateral portal. 4. We obtained satisfactory results in 24 cases(77%).
Knee ; Sports ; Tears

Serial changes of serum IgE, IgG, eosinophils were observed in 25 patients with acute myocaridial infarction and 20 ischemic heart disease without evidence of acute myocardial infarction and evaluated in terms of several parameters and its clinical significance. The results observed were as follows : 1) Serum IgE levels were propgressively elevated from the first hospital day(259+/-3IU/ml) up to peak level of the fifth hospital day(415+/-2IU/ml) and progressively lowered and returned to almost same level as the first hospital day on the twenty first hospital day. On the other hand control group showed significantly lower IgE levels throughout all hospital day and also did not showed serial change. 2) In the patient group with the initial serum IgE level above 200IU/m; showed significantly lower level of serum SGOT, CPK level than the group of below 200IU/ml group. This suggests the initial serum IgE level might have some correlation of the extent of myocardial necrosis. 3) In patients of acute myocardial infarction, ejection fraction was checked at discharge. Initial serum IgE level above 200IU/ml group showed significantly higher ejection fraction than below 200IU/ml group(59.4+/-13.5% vs 38.4+/-13.7%). 4) Serum IgE was checked concomittantly with serum IgE. It showed slightly decreasing tendency at third hospital day but not statistically significant. Eosinophil changed similar pattern as serum IgE but it was also not statistically significant. In conclusion, serial checking of serum IgE level in patient of acute myocardial infarction may give some help in prediction the clinical course and prognosis.
Aspartate Aminotransferases ; Eosinophils ; Hand ; Humans ; Immunoglobulin E* ; Immunoglobulin G ; Immunoglobulins* ; Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Necrosis ; Prognosis