PURPOSE: To analyse clinical result of total knee arthroplasty without patellar resurfacing who had moderate to severe patellofemoral arthritis. MATERIALS AND METHODS: Unilateral knee joints of 54 cases, diagnosed to be moderate to severe patellofemoral arthritis on the basis of Ahlback's radiographic evaluation score of patella on preoperative plain radiography among the patients undergone the total knee arthroplasty due to primary degenerative osteoarthritis at this hospital between January 2000 and March 2004, were subject to this study. Patellar resurfacing was not performed in any cases. Likewise, the knee score of Hospital for Special Surgery and Feller's patellar score were used in clinical assessment preoperatively, and was used two years after the operation. RESULTS: The knee score of Hospital for Special Surgery was increased from 55.1 (35~78) to 82.8 (67~95), and also Feller's patellar score was increased from 19.1 (11~24) to 28.3 (18~30) after operation. Mild anterior knee pain was observed in 5 cases (9.3%) after the operation, but medication was needed in just 2 cases. The 42 cases (77.8%) could normally go up and down stairs without holding the rail. CONCLUSION: The total knee arthroplasty without patellar resurfacing, performed for the patients diagnosed with moderate to severe patellofemoral arthritis related with the indication for patellar resurfacing, derived satisfactory outcomes.
Arthritis* ; Arthroplasty* ; Humans ; Knee Joint ; Knee* ; Osteoarthritis ; Patella ; Radiography

Degenerative arthritis of the knee joint is one of the main causes of disability in middle-aged persons. This paper is planned by the necessity of objective information upon changes of tibio-femoral angle according to weight bearing in patients with degenerative arthritis of the knee joint. The authors studied the tibio-femoral angle in 29 cases of degenerative arthritis of the knee ranging fmm 5th to 6th decades of age, and compared with 27 cases of the control group, in the Dept. of Orthopedic Surgery, S.N.U.H. fmm Mar. 1983 to May 1984. The following observations were obtained: 1. In patients with degenerative arthritis of the knee, changes of the tibio-femoral angle according to weight bearing were +2.2±1.94 in 5th decade, +2.3±2.02 in 6th decade. 2. Compared to control group, the degenerative arthritis group showed a significant varization with weight bearing. 3. It was seemed that the weight bearing radiography is essential in diagnosis and treatment of degenerative arthritis of the knee joint.
Diagnosis ; Humans ; Knee ; Knee Joint ; Orthopedics ; Osteoarthritis ; Radiography ; Weight-Bearing

BACKGROUND: Despite the wide use of knee radiography in children and adolescent patients visiting the outpatient clinic, there has been no analysis about the prevalence and type of incidental findings yet. This study was performed to investigate the incidental findings on knee radiographs in children and adolescents according to age. METHODS: A total of 1,562 consecutive patients younger than 18 years of age were included. They who visited Seoul National University Bundang Hospital's outpatient clinic with a chief complaint of knee pain or malalignment between 2010 and 2011. We reviewed the knee radiographs and analyzed the prevalence and type of incidental findings, such as metaphyseal lucent area, epiphyseal cortical irregularity, osteochondroma and Harris growth arrest line. RESULTS: The mean age of the patients was 10.2 years (range, 1 month to 18 years). We identified 355 incidental findings in 335 patients (21.4%) and 98 abnormal findings (6.3%). The most common incidental finding was metaphyseal lucent area (131, 8.4%), followed by epiphyseal cortical irregularity (105, 6.7%), Harris growth arrest line (75, 4.8%), and osteochondroma (44, 2.8%). An epiphyseal cortical irregularity tended to have a higher prevalence at younger age (p < 0.001) and the prevalences of metaphyseal lucent area and Harris growth arrest line were also higher at a younger age (p = 0.001 and p < 0.001, respectively). However, the osteochondroma tended to have a higher prevalence at an older age (p = 0.004). CONCLUSIONS: This study describes the incidental findings on knee radiographs in children and adolescents and provides effective information from a viewpoint of an orthopedic doctor. The authors recommend considering those incidental findings if unfamiliar findings appear on a knee radiograph in the pediatric outpatient clinic.
Adolescent ; Child ; Child, Preschool ; Humans ; *Incidental Findings ; Infant ; Knee/*radiography ; Knee Joint/*radiography ; Retrospective Studies

We report the case of a polyethylene tibial post fracture in a 72-year-old woman 14 months after a Scorpio posterior-stabilized (PS) total knee arthroplasty. The polyethylene wear was found around the fracture site of the post, especially over the anterior aspect of the post base. The failure mechanism of the post fracture in the present case was anterior impingement with excessive wear over the base of the anterior aspect of the tibial post, which became a stress-riser of post and cam articulation. This is the first report of a polyethylene tibial post fracture of a Scorpio PS prosthesis.
Aged ; *Arthroplasty, Replacement, Knee ; Female ; Humans ; Knee Joint/radiography ; Knee Prosthesis/*adverse effects ; Osteoarthritis, Knee/surgery ; *Polyethylenes ; *Prosthesis Failure ; Reoperation

BACKGROUND: Clinical and radiologic evaluation and analyses of the surgeries using Buechel and Pappas (B-P) knee implants. METHODS: The study was conducted on 60 patients who underwent 94 total knee replacement arthroplasty with B-P knee implants from May 2009 to December 2010. The results were compared to the results of 41 patients who underwent 60 knee joint surgeries using NexGen-LPS implants from January 2008 to August 2009. RESULTS: The American Knee Society score of the B-P knee group increased from an average of 66.9 (clinical score) and 65.5 (functional score) to 93.4 and 90.3, respectively; while those for the NexGen-LPS group increased from an average of 68.8 (clinical score) and 62.4 (functional score) to 86.3 and 76, respectively. The average ranges of motion of the B-P knee group and the NexGen-LPS group were 119.1degrees and 114.8degrees, respectively, before surgery and improved to 121.0degrees and 123.0degrees at final follow-up after the surgery. The visual analogue scale scores for the B-P knee group and the NexGen-LPS group improved from 4.7 and 4.6 to 1.4 and 1.8, respectively. The flexion contracture also improved from 5.1degrees and 6.3degrees to 0.64degrees and 1.72degrees. The tibio-femoral angle for the B-P knee group and the NexGen-LPS group also improved greatly after the surgery, from varus 0.34degrees and 0.73degrees each to valgus 6.7degrees and 6.9degrees, respectively. CONCLUSIONS: The evaluation of more than 2 years of total knee replacement arthroplasty using B-P knee implants showed good results. B-P knee implants showed a relatively higher degree of satisfaction in clinical knee score and less intraoperative bone mass removal than NexGen-LPS implants.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*instrumentation ; Female ; Follow-Up Studies ; Humans ; Knee Joint/radiography/*surgery ; *Knee Prosthesis ; Male ; Middle Aged ; Osteoarthritis, Knee/radiography/*surgery

BACKGROUND: This study evaluated the preoperative distractive stress radiographs in order to quantify and predict the extent of medial release according to the degree of varus deformity in primary total knee arthroplasty. METHODS: We evaluated 120 varus, osteoarthritic knee joints (75 patients). The association of the angle on the distractive stress radiograph with extent of medial release was analyzed. The extent of medial release was classified into the following 4 groups according to the stage: release of the deep medial collateral ligament (group 1), release of the posterior oblique ligament and/or semimembranous tendon (group 2), release of the posterior capsule (group 3) and release of the superficial medial collateral ligament (group 4). RESULTS: The mean femorotibial angle on the preoperative distractive stress radiograph was valgus 2.4degrees (group 1), valgus 0.8degrees (group 2), varus 2.1degrees (group 3) and varus 2.7degrees (group 4). The extent of medial release increased with increasing degree of varus deformity seen on the preoperative distractive stress radiograph. CONCLUSIONS: The preoperative distractive stress radiograph was useful for predicting the extent of medial release when performing primary total knee arthroplaty.
Aged ; *Arthroplasty, Replacement, Knee/methods ; Female ; Humans ; Joint Deformities, Acquired/etiology/radiography ; Knee Joint/*radiography ; Ligaments, Articular/radiography ; Male ; Medial Collateral Ligament, Knee/*surgery ; Middle Aged ; Osteoarthritis, Knee/complications/radiography/*surgery

PURPOSE: To compare the results of posterior cruciate ligament reconstructions by tibial inlay and tibial tunnel techniques. MATERIALS AND METHODS: Despite of conservative treatment, all patients (31 cases) had pain and grade 2 or more posterior instability. Posterior drawer test and posterior drawer stress radiography were performed. Clinically, Lysholm knee score and Tegner activity score were evaluated. RESULTS: In the tibial tunnel group, posterior drawer test demonstrated grade 1 instability in 7 cases, grade 2 in 4 cases, and grade 3 in 1 case at the last follow-up. In the tibial inlay group, there was grade 1 instability in 14 cases and grade 2 in 5 cases. On posterior drawer stress radiography, the mean side-to-side difference in measurement of the tibial tunnel group improved from 12.4 mm preoperatively to 4.0 mm at follow-up, and that of the tibial inlay group improved from 11.8 mm to 2.9 mm. Lysholm knee score and Tegner activity score improved to 86.8 points and 5.83 points, respectively, in the tibial tunnel group, and to 88.2 points and 5.84 points, in the tibial inlay group. CONCLUSION: PCL reconstruction with the tibial inlay technique tends to maintain better posterior stability, but there is no statistically significant difference between the two techniques. Further study may be required.
Follow-Up Studies ; Humans ; Inlays* ; Knee ; Posterior Cruciate Ligament* ; Radiography

Purpose: To evaluate the value of an open wedge high tibial osteotomy (HTO) using a Locking Compression Plate(R) (LCP(R)) as a surgical technique. Materials and Methods: From May, 2003 to January, 2005, eleven open wedge HTO using LCP(R) were performed and the average follow-up period was 17.8 months. The knee score and function score for the clinical results, and the degree of varus deformity, the size of the joint space, the posterior tibial slope and the medial instability for radiography results were evaluated. Results: The knee score improved from 54.8 points to 95.9 points, and the function score improved from 57.3 points to 88.2 points. The femorotibial angle was corrected from 4.1degrees varus to 9.9degrees valgus. The posterior tibial slope did not show any significant change. The size of the joint space increased from 3.3 mm to 4.3 mm. No medial instability was observed. Conclusion: An open wedge HTO using LCP(R) achieved a corrected angle, reduced loss of the corrected angle, and an improved knee function. The surgical technique prevented the posterior tibial slope from increasing.
Congenital Abnormalities ; Follow-Up Studies* ; Joints ; Knee ; Osteotomy ; Radiography

PURPOSE: To evaluate the tibia osteotome angle and whole leg alignment in total knee replacement arthroplasty using intramedullary tibia guide. MATERIALS AND METHODS: Amongst 343 cases of TKA using an intramedullary tibial cutting guide from November 1998 to August 2001, 160 cases who took a standing whole leg AP simple roentgenography within 1 year were selected. Post-operatively, the angle formed by the tibial anatomical axis and tibial component, along with the angle formed between the femoral anatomical axis and tibial anatomical axis were measured. RESULTS: The average angle between the tibial anatomical axis and tibial component was 89.5 degrees (84 degrees~94 degrees), 133 cases(83.1%) were within the range of 90 degrees +/- 2 degrees and amongst these 66 cases(41.3%) were 90 degrees. The average angle formed between the femoral anatomical axis and tibial anatomical axis was 5.6 degrees(0 degrees~11 degrees). CONCLUSION: When used properly, an intramedullary tibial cutting guide in TKA result in satisfactory tibial osteotome angle and whole leg alignment in TKA.
Arthroplasty* ; Arthroplasty, Replacement, Knee ; Axis, Cervical Vertebra ; Knee* ; Leg ; Radiography ; Tibia

PURPOSE: The purpose was trying to clarify utility of allogenous bone graft on open type high tibial osteotomy, among the method of treatment of osteoarthritis with genu varum deformity. MATERIALS AND METHODS: Working with eight patients who have osteoarthritis with genu varum deformity, performed the open type high tibial osteotomy. and after transplanting allogenous bone graft, fixed using L-shaped plate. Before and after the operation, measured the degree of correction of genu varum through radiography of anterior and posterior of weigh load, understudied degree of union by testing bone histology during removal of implant, and evaluated functional factor as well as improvement of patients using Lysholm's knee score and HSS knee score. RESULTS: According to radiography of anterior and posterior of weigh load, the average of varus angle was 5.3 +/- 3.2 degrees before operation, the average of correction angle was 16.1 +/- 4.1 degrees after operation and the average of valgus angle was 10.7 +/- 4.3 degrees. By radiography of anterior and posterior of weigh load and lateral taken during the continual observation, complete bone union was seen. It got result that bone histology of transplanted part was composed of osteologic tissue and ratio of live bone and dead bone was 3.3:1, which live bone was 76.7 +/- 8% by image analyzer (Pro Plus(R) system) during the implant removal. The average of correction loss angle was 1.5 +/- 1.0 degrees After 15.3 months, average period of observation, average of Lysholm's score and HSS knee score were increased from 66.2 +/- 8.3 to 75.7 +/- 9.1 and from 55.2 +/- 9.0 to 79.0 +/- 7.5 respectively. CONCLUSION: The method that using a transplantation of allogenous bone graft on open type high tibial osteotomy, can be a fine surgical technique because it gains a perfect union, has an inconsiderable loss of correction angle and precision of correction angle, and can be contributed to the improvement of functional knee joint.
Congenital Abnormalities ; Genu Varum ; Humans ; Knee ; Knee Joint ; Osteoarthritis ; Osteotomy* ; Radiography ; Transplants*