To evaluate the effects on the restoration of proprioception, we compared joint position sense (JPS) after meniscal allograft transplantation. Nine patients who underwent meniscal allograft transplantation between March 2008 and January 2010 were evaluated at preoperation and 6 months post-operation. International Knee Documentation Committee (IKDC) subjective score and Lysholm score were evaluated. The peak torque of the isokinetic flexor and extensor strength test was performed using Biodex system III. Passive JPS was assessed to evaluate proprioceptive function. In the results, IKDC subjective score and Lysholm score were improved (p=0.05). The flexor and extensor power decreased, however there was no statistically significant difference. In the assessment of JPS, there was improvement from 6.56degrees and 4.11degrees to 4.89degrees and 1.89degrees, however, this was not statistically significant. Although, proprioception was improved in JPS at 6 months after meniscus transplantation, it did not show statistic significance. Therefore, future studies using combined methods will be needed to evaluate proprioceptive function after meniscal allograft transplantation.
Humans ; Joints ; Knee ; Proprioception ; Torque ; Transplantation, Homologous ; Transplants

transplantation surgery and pathology, so that maxillofacial reconstructive surgeons may occasionally be faced with the challenge of diagnosing skin refection of a composite tissue allograft. Facial allotransplantation (FAT) is a new surgical technique that could be considered as a new paradigm in facial reconstruction. Since the first human FAT had been achieved in 2005, 17 cases have been reported in the world up to date. However, many problems such as life-long immunosuppression, immune rejection, ethical problems and psychological problems are remained, so facial CTA is new reconstructive option with no general acceptance. The authors reviewed the indications, the results of 17 cases and their complications, and additional consideration factors in this article, and intended to raise the awareness of oral and maxillofacial surgeons in this type of facial transplantation.]]>
Animals ; Extremities ; Facial Transplantation ; Hand ; Humans ; Immunosuppression ; Joints ; Larynx ; Rats ; Rejection (Psychology) ; Skin ; Trachea ; Transplantation, Homologous ; Transplants

The atlantoaxial joint is a complex structure which facilitates rotation of the head on the neck. The transverse atlantal ligament is essential to retain the odontoid process of C2 in the anterior part of the C1 ring. Disruption or laxity of the transverse ligament, some odontoid process fracture result in atlantoaxial instability. In case of instability, stabilization is desirable to relieve pain and reduce the risk of neural damage. The isolated atlantoaxial instability with normal occipitoatlantal joint is generally treated by a monosegmental fusion. The standard fixation for C1-2 instability is posterior wiring using the Gallie, Brooks technique or their modifications. The most recent and innovative development in the evolution of upper cervical spine fixation is the use of C1-2 transarticular screw fixation. The transarticular screw fixation technique can be employed in situation where the posterior arch of C1 is absent or fractured and standard wiring technique risk posterior subluxation of C1, on C2, or for congenital odontoid anomalies and multiple failures of standard wiring techniques. The transarticular screw fixation of the atlantoaxial joints, with posterior bone grafting, provides good fixation and is biomechanically superior to wring methods. This paper presents the comparison of posterior fixation methods and the detailed introduction of posterior C1-2 transarticular screw fixation technique.
Atlanto-Axial Joint ; Bone Transplantation ; Head ; Joints ; Ligaments ; Neck ; Odontoid Process ; Spine

PURPOSE: Finger immobilization by Kirschner-wire (K-wire) insertion may be used for postoperative stability after release of scar contracture. K-wire insertion through the phalangeal bone requires drilling and can result in joint and/or tendon injury or pain during wire removal. To prevent these problems, we inserted the K-wire through the soft tissue. METHODS: Seventy-five fingers of 45 patients who underwent reconstruction of scar contracture of the fingers were immobilized by K-wire. After contracture release, just before skin grafting and/or local flap surgery, in full extension of the finger, a K-wire was inserted manually from the fingertip to the proximal phalanx or metacarpal bone through the soft tissue under the phalangeal bone, along the longitudinal axis on the volar side. If the graft site did not have enough soft tissue or the K-wire was felt on the recipient bed, the K-wire was inserted on the dorsal side of the finger. K-wires were manually removed two weeks after surgery. RESULTS: In most cases, the time to insert the K-wire was 2-3 minutes per finger, and immobilization and stability was maintained for two weeks. In two fingers, the K-wire came out prematurely during wound care; this did not affect the overall outcome. There were no complications due to K-wire insertion or pain during removal. CONCLUSION: Finger immobilization by K-wire insertion through soft tissue is simple to perform, leads to stable immobilization, has no adding procedure. This method is useful for temporary finger immobilization in full extension.
Axis, Cervical Vertebra ; Cicatrix* ; Contracture* ; Fingers* ; Humans ; Immobilization* ; Joints ; Skin Transplantation ; Tendon Injuries ; Transplants ; Wounds and Injuries

Radial longitudinal deficiency, also known as radial club hand, is a congenital deformity of the upper extremity which can present with a spectrum of upper limb deficiencies. The typical hand and forearm deformity in such cases consists of significant forearm shortening, radial deviation of the wrist and hypoplasia or absence of a thumb. Treatment goals focus on the creation of stable centralized and functionally hand, maintenance of a mobile and stable wrist and preservation of longitudinal forearm growth. Historically centralization procedures have been the most common treatment method for this condition; unfortunately centralization procedures are associated with a high recurrence rate and have the potential for injury to the distal ulnar physis resulting in a further decrease in forearm growth. Here we advocate for the use of a vascularized second metatarsophalangeal joint transfer for stabilization of the carpus and prevention of recurrent radial deformity and subluxation of the wrist. This technique was originally described by the senior author in 1992 and he has subsequently been performed in 24 cases with an average of 11-year follow-up. In this paper we present an overview of the technique and review the expected outcomes for this method of treatment of radial longitudinal deficiency.
Forearm/abnormalities/*surgery ; Hand Deformities, Congenital/*surgery ; Humans ; Joints/*transplantation ; Metatarsophalangeal Joint/surgery ; Radius/abnormalities/*surgery

Radial longitudinal deficiency, also known as radial club hand, is a congenital deformity of the upper extremity which can present with a spectrum of upper limb deficiencies. The typical hand and forearm deformity in such cases consists of significant forearm shortening, radial deviation of the wrist and hypoplasia or absence of a thumb. Treatment goals focus on the creation of stable centralized and functionally hand, maintenance of a mobile and stable wrist and preservation of longitudinal forearm growth. Historically centralization procedures have been the most common treatment method for this condition; unfortunately centralization procedures are associated with a high recurrence rate and have the potential for injury to the distal ulnar physis resulting in a further decrease in forearm growth. Here we advocate for the use of a vascularized second metatarsophalangeal joint transfer for stabilization of the carpus and prevention of recurrent radial deformity and subluxation of the wrist. This technique was originally described by the senior author in 1992 and he has subsequently been performed in 24 cases with an average of 11-year follow-up. In this paper we present an overview of the technique and review the expected outcomes for this method of treatment of radial longitudinal deficiency.
Forearm/abnormalities/*surgery ; Hand Deformities, Congenital/*surgery ; Humans ; Joints/*transplantation ; Metatarsophalangeal Joint/surgery ; Radius/abnormalities/*surgery

Chondrocytes isolated from the articular cartilage of rabbit knee joint were cultured in vitro within fibrin glue carrier for 2 weeks. Histochemical and electromicroscopical approaches were used to study chondrocytes behavior and phenotypic expression. In vitro study, chondrocyte assumed a rounded morphology, accumulated metachromatic matrix and took on the cytological characteristics of in vivo cartilage cells. Allogenic cultured chondrocyte in fibrin glue was transplanted into osteochondral defect in rabbit joint. The contralateral knee joint served as a control in which the defect was left empty. This in vivo study was performed for the investigation of the chondrogenic potential of cultured chondrocytes embedded in fibrin glue. Grafted defects was filled with cartilage in gross finding, repaired tissue consisted of differentiated chondrocytes and matrix resumed that of hyaline cartilage. At sixteen week after transplantation, subchondral region was partially transformed into bone without loss of overlying articular cartilage, but in control group, defect did not heal successfully. Repaired articular cartilage was thicker than host cartilage and tide mark was not shown up to 24 weeks. Some of repaired tissue was degraded partially. These results suggest that fibrin glue provides suitable environment for differentiation of chondrocyte and allograft of cultured chondrocyte in fibrin glue transplanted into large osteochondral defect improves cartilage repair.
Allografts ; Cartilage ; Cartilage, Articular ; Chondrocytes* ; Fibrin Tissue Adhesive ; Hyaline Cartilage ; Joints ; Knee Joint ; Rabbits* ; Transplantation ; Transplants*

PURPOSE: We wanted to analyze the causes of revision and the clinical and radiographic results after revision total knee arthroplasty. MATERIALS AND METHODS: Thirty-eight knees in 34 patients underwent revision total knee arthroplasty using the PFC(R) Sigma revision system between March 1999 and May 2005. The average patient age was 71.2 years, and the average follow-up period was 6 years 7 months (range: 4 years~10 years 2 months). We evaluated the time interval between the primary and revision arthroplasty and the causes of revision. The clinical outcomes were assessed using the knee score and the functional score of the Knee Society Scoring system (KSS system), and the radiographic measurements were assessed using the roentgenographic method of the American Knee Society. RESULTS: The mean interval between primary and revision arthroplasty was 6 years 3 months. The causes of revision included 25 cases of aseptic loosening and osteolysis, 7 cases of infection, 3 cases of joint stiffness and 3 cases of polyethylene problems. At the follow up, the mean preoperative knee and functional scores improved from 45.1 points to 84.5 and 37.2 to 78.2, respectively. Radiographycally, the average femorotibial angle was corrected from 2.2degrees in valgus to 6.5degrees. The radiolucency score was below 4 in all the cases. The complications after revision arthroplasty were 2 cases of superficial infection and 1 case of wound dehiscence with a skin defect. CONCLUSION: The main causes of revision arthroplasty were aseptic loosening and osteolysis. Satisfactory results were obtained using the posterior cruciate ligament and substituting the PFC(R) Sigma knee system with appropriately selected metal augmentation and an allograft. This study showed favorable results on long term follow-up.
Arthroplasty ; Follow-Up Studies ; Humans ; Joints ; Knee ; Osteolysis ; Polyethylene ; Posterior Cruciate Ligament ; Skin ; Transplantation, Homologous

Pigmented villonodular synovitis (PVNS) is a rare benign condition that is locally aggressive and may destructively invade the surrounding soft tissues and bone causing functional loss of the joint and the limb. The knee is the most affected joint (range, 28% to 70%) but involvement of the bone is not a common feature seen at this site. We present a rare case of diffuse PVNS of the knee associated with subchondral cyst of the lateral femoral condyle. This posed a diagnostic dilemma because of bone invasion. The radiological image of synovitis was pathognomonic of PVNS but etiology of the osteolytic lesion was confirmed only on histopathology. The large osteochondral defect was eventually managed in a staged manner with bone grafting and osteochondral autograft transfer.
Autografts ; Bone Cysts ; Bone Transplantation ; Cartilage ; Extremities ; Joints ; Knee ; Synovitis ; Synovitis, Pigmented Villonodular

Idiopathic osteonecrosis of the femoral head is an important and unresolved problem in orthopaedic surgery. Generally the progressive collapse of the femoral head and ultimate osteoarthritis of the hip will ensue requiring joint replacement. But longterm results of total hip joint replacement surgery are unfavorable especially in young patients. Therefore, if alternatives to the toal joint replacement are to be effective, they must be applied especially in young patients with osteonecrosis of the femoral head. Recently we attempted the vascular-pedicled iliac bone graft (VPIBG), using the deep circumflex iliac vessel as a vascular pedicle, in 13 hips of 10 patients with idiopathic osteonecrosis of the femoral head and followed up 9–19 months after operation. Aims of this procedure are to decompress the femoral head hence allowing better circulation, to revitalize the dead head by insertion of live bleeding bone and to give a mechanical support preventing further collapse of the femoral head. Though more follow up studies are required, the preliminary results seen during 9–19 months after surgery are encouraging enough to be reported.
Bone Transplantation ; Follow-Up Studies ; Head ; Hemorrhage ; Hip ; Hip Joint ; Humans ; Joints ; Osteoarthritis ; Osteonecrosis ; Transplants