Reconstruction of cruciate ligament has been controversial. Autogenous grafts has been used with inconsistent success rates due to their variable strength and limited length. If any autograft could cover such drawbacks it could surpass the advantage of artificial ligaments also. Recently, we used partial Achilles tendon autograft in reconstructive operation of anterior cruciate ligament with promising result. The main advantages of this Achilles tendon autograft are its sufficient length and strength. Preliminary study was done in 11 patients who received reconstruction of the anterior cruciate ligament using partial Achilles tendon autograft. The results were as followings :l. Anterior cruciate ligament reconstructions were done in 11 patients, with follow-ups ranging from 5 to 12 months, average being 8 months. 2. Average preoperative knee score was 49.1, and it was improved up to 87.4 after operation. 3. Among the 11 patients, 6 belonged to the Excellent, 4 to good, and 1 to fair. 4. Achilles tendon autograft turned out to be a good autograft substitute for the anterior crucate deficient knee. The results were promising. Long-term follow-up is needed to confirm the final status of the operated knee.
Achilles Tendon ; Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Transplants

Cysts of the meniscus are rare lesion of the knee. They may present as a local tumor or mimic signs of an internal derangement of the knee. So it is difficult to diagnose and apt to overlook in physical examination. Also they almost always have combined pathology of the involved meniscus, such as, meniscal tear or discoid meniscus. The pathologic basis of the meniscal cyst is controversial, but rece 2. Most of the patients had tear of the involved meniscus, but the patients with discoid meniscus did not have gross tears or previous trauma history. nt works suggest the etiology is infiltration of joint fluid through micro and macro tears in the meniscus. In the past, complete excision of the meniscus as well as cyst was thought to be the treatment of choice to prevent recurrences. But nowadays, the trend is changed as preserving the involved meniscus, when no tear of the meniscus is found to prevent enevitable degenerative changes after total meniscectomy. We experienced 6 cases of meniscal cyst during recent 2 years and obtained following results. 1. Precise joint line evaluation is much more important in the diagnosis of the meniscal cyst before making special study. 2. Most of the patients had tears of the involved meniscus, but the patients with discoid meniscus did not have gross tears or previous trauma history. 3. When the cyst is located anteriorly in the joint line, it is prominent in flexed position of the knee; and when located posteriorly, prominent in extended position of the knee. 4. Excision of the cyst and reattachment of the meniscus were thought to be good method when the cyst was located in the parameinscal area without gross tear of the involved meniscus.
Diagnosis ; Humans ; Joints ; Knee ; Methods ; Pathology ; Physical Examination ; Recurrence ; Tears

The most frequent complication of the open arthrotomy for the cruciate reconstruction are quadriceps weakness and flexion contracture of the knee. Besides complications such as chondromalacia, patellar maltracking, saphenous neuralgia and patellar crepitus are not infrequent in wide open arthrotomy. We adopted an open method with smaller incision like arthroscopic maneuver to reduce these complications. The pre-requisite of this mini-incision are arranging a proper instrument and graft material. We advocate Achilles autograft which is longer and more flexible than other autografts and by taking advantage of these characteristics, we could performed reconstruction with relatively small incision. The advantages of mini-incision technique are early recovery of quadriceps function and little complication. We applied this method in ACL, PCL and simultaneous ACL & PCL reconstruction, with the result of early recovery of qudriceps function.
Autografts ; Cartilage Diseases ; Contracture ; Knee ; Methods ; Neuralgia ; Transplants

It is not infrequent to observe the reeurrence of the Bakers cyst. Recurrence of the cystic lesions are more frequent in wide based type than in pedicle type due to difficult ,identification and inadequate eradication of the cyst wall. We injected methylene blue into the cyst after aspiration of the fluid. Blue stained wall enables the surgeons to idendify the whole inner surface of the cyst, and lessens the chance of missing a portion of it. We could reduce the recurrence rate near to zero percent after adopting this technique upto now. Broad based type is more prone to recurr and the whole recurred five cases were belong to this type.
Arthroscopy ; Humans ; Knee ; Methylene Blue ; Popliteal Cyst ; Recurrence ; Surgeons

In traumatic knee dislocation, vascular injury is one of the most serious complication. After pertinent management of acute vascular problems, we should take care of the ligamentous injury involving both the ACL and PCL which are the main causes of knee instability, and consequent traumatic degenerative changes. No standard technique of reconstruction has been reported concerning these ligamentous injuries up to now as far as we know. Authors tried a new management which reconstruction was done simultaneously on both the ACL and PCL injuries. Bone-Achilles tendon autograft was used as PCL substitute in all the cases, and which turned out to be a very efficient one for the control of anterior-posterior displasement as well as rotary instability. Bone-patellar tendon-bone autograft or bone-Achilles tendon autograft was good for the reconstruction of the ACL bone-patellar tendon-bone in two cases, bone-Achilles tendon in two cases, and semitendinosus tendon also in two cases. After 6 months of operation, all the patient returned to the previous level of walking without crutches. This management showed outstanding results in terms of knee stability and subjective symptoms.
Achilles Tendon ; Autografts ; Crutches ; Dislocations ; Humans ; Knee Dislocation ; Knee Joint ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Tendons ; Vascular System Injuries ; Walking

Arthrography is an invaluable procedure in critically verifyging the concentricity of closed reduction and the optimum position of stability. And it is known to be the most accurate and certain way of demonstrating lesser degrees of incongruity. It can visualize the intrinsic obstructive fractors, such as capsular attachment, the labrum, the psoas tendon and its relationship to the joint, the pulvinar, ligamentum teres, the inferior transverse ligament, and the shape of the femoral head and acetabulum. We analyzed 20 cases of congenital dislocation of the hip in 17 patients, which had been evaluated by arthrography. The results are as follows: 1. We found the inferior approach very efficient among many kinds of arthrographic techniques. 2. Among 20 cases, 12 cases could be treated with closed reduction and 8 cases were treated by open reduction such as capsuloplasty, partial limbusectomy, and removal of space occupying lesion in acetabulum, including 2 cases of Salter's innominate osteotomy and 1 case of derotational osteotomy. 3. Among the intracapsular obstructive factors which played major role in hindering closed reduction, capsular constriction was shown in 8 case, inverted or hypertrophic limbus in 5 cases, and other space occupying lesions in 2 cases. 4. We performed combined operation including bone and soft tissue for severe extra- and intracapsular lesions and closed reduction for mild to moderate extra- and intracapsular lesions. 5. Arthrography of the hip joint was indispensable in evaluating the intracapsular osstructive lesions as well as detecting the subtle incongruent reduction.
Acetabulum ; Arthrography ; Constriction ; Dislocations ; Head ; Hip Joint ; Hip ; Humans ; Joints ; Ligaments ; Osteotomy ; Pulvinar ; Round Ligaments ; Tendons

Tuberculosis of the bone and joints is one of the genralized manifestation or solitary localized lesion. Although the incidence of the tuberculous osteomyelitis of long bone is decreasing with good neutrition, development of preventive medicine and improvment of treatment regimen, it is still one of the common diseases in Korea and must be considered in the differentil diagnosis of common orthopaedic complaints. Thirty five cases of tuberculous osteomyelitis of long bone were studied in our department from Junuary 1973 to December 1984. The results are as follows: 1. Long bone tuberculous osteomyelitis were 35 cases (6.6%) from the overall tuberculous lesion of the bone and joints. (534 cases) 2. Childrean and young adults were common age group. 3. Concomitant pulmonary tuberculosis was found in 11 cases. 4. Radiologic findings showed variable lesions including osteolytic, cystic, sclerotic and destructive forms. 5. Confirmative diagnosis could be made by smear, culture of the lesion and pathologic findings. 6. The overall results treated with curettage and bone graft as well as proper antituberculous medication were satisfactory.
Clinical Study ; Curettage ; Diagnosis ; Humans ; Incidence ; Joints ; Korea ; Osteomyelitis ; Preventive Medicine ; Transplants ; Tuberculosis ; Tuberculosis, Pulmonary ; Young Adult

No abstract available.
Anterior Cruciate Ligament* ; Autografts* ; Tendons* ; Transplants*

Hand tumorsare many and varied, although benign tumors are common. The pathology and histology of these tumors are not unlike these characteristics of the tumor when it occurs elsewhere. Early diagnosis and proper treatment of all hand tumors have been emphasized since the growth of tumors and pain can cause disturbance of intrinsic function of the hand. For the period of 10 years from 1977 to 1986, 105 cases of hand tumor were treated surgically and the results of clinical observation were as follows ; l. Among 105 cases, benign tumor was 101 cases(96.2%) Bone origin tumor was 20 cases, in which enchondroma and enchondromatosis were 17 cases(70%). Soft tissue origin tumor was 85 cases, in which ganglion was 54 cases(63.5%). 2. Among 105 cases, 42 cases were male and 63 cases were female. In age distribution, it showed even distribution. 3. In the duration of wymptom, 51 cases were below 1 year(48.6%). 4. The tumor occured 85 cases in soft tissue, 14 in phalanx, 7 in metacarpal and 1 in carpal bone. 5. The tumors were treated by excision or curettage and bone graft with good improvement, but postoperatively recurred in 2 cases of Hemangioma. Ampuation was performed in 3 cases of malignant tumors without recurrence.
Age Distribution ; Carpal Bones ; Chondroma ; Clinical Study ; Curettage ; Early Diagnosis ; Enchondromatosis ; Female ; Ganglion Cysts ; Hand ; Hemangioma ; Humans ; Male ; Pathology ; Recurrence ; Transplants

Proliferating cell nuclear antigen (PCNA, PC10), an auxillary protein of DNA polymerase, plays a main role in the early stage of DNA Synthesis and is synthesized from Gl phase to s phase of the cell cycle. Nucleolar organizer region (NORs) are DNA loops encoding RNA proteins(AgNORs). To evaluate correlation with PCNA labelling index (LI)and AgNORs according to histological grades and clinical stages of transitional cell carcinoma of the urinary bladder, the authors analysed 54 transitional cell carcinoma using immunohistochemical stain for PCNA and silver stain for AgNORs in paraffin sections. The comparison of PCNA (PC10) LI and clinical stage showed a significant correlation (p<0.05), where as PCNA (PC10) LI according to histologic grade showed no significant correlation. High grade tumors showed increase PCNA LI. Superficial tumors (Ta-Tl) showed significantly lower PCNA LI than muscle invasive tumors (T2-T4)(p<0.05). There was no significant correlation between AgNORs and clinical stage, bur higher stage and higher grade tumors showed increased noubers of AgNORs. These results suggest that PCNA LI has a significant correlation with clinical stages of transitional cell carcinoma of the urinary bladder.