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

OBJECTIVE: This study was done to evaluate the frequency and to examine the difference of radiographic findings between patellofemoral joint (PFJ) and tibiofemoral joint (TFJ) in radiographic change of knee osteoarthritis (OA). METHODS: 347 Korean women (694 knees) who visited our clinic with knee joint pain took anteroposterior (AP) weight bearing view of TFJ, lateral and skyline view of PFJ of the knees from Jan. to Dec. in 1999. Radiographs were read for features of OA using Kellgren-Lawrence. The difference of frequency in two joint's radiographic changes of OA was examined using chi-square and Wilcoxon signed rank test. RESULTS: Radiographic knee OA was correlated with patient's age (r=0.482, P<0.001) and with body mass index (r=0.123, p<0.001). Frequency of radiographic OA using lateral view of PFJ was 38.8%, using AP view of TFJ was 28% and skyline view of PFJ was 23.1% (p<0.05). CONCLUSION: These results show that lateral view of PFJ with AP view of TFJ increase the frequency of radiographic knee OA, but skyline view of PFJ doesn't contribute to increase the frequency of radiographic knee OA.
Body Mass Index ; Female ; Humans ; Joints ; Knee Joint* ; Knee* ; Osteoarthritis ; Osteoarthritis, Knee* ; Patellofemoral Joint ; Radiography ; Weight-Bearing

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

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*

Isometric positioning of the ACL graft is an important consideration in successful reconstruction of the ACL-deficient knee. The purpose of this study is to get a certain guideline in the endoscopic one-tunnel technique of anterior cruciate ligament reconstruction by measuring the skin angle and determine the degree of minimum flexion of the knee joint during femoral tunneling and interference screw fixations. To get the guide lines, first we get the tibial tunnel angle parallel to the Blumensaat's line from fully extended lateral knee joint radiography. Secondly measure the differences between angles of the femur-tibia shaft and anterior thigh-leg skin. Then measure the minimum femur-tibia flexion angle does not perforated the posterior cortex of the distal femur during femoral tunneling. Intraoperative measuring the angle between interference screw guide pin and tibial tunnel to get the parallelism of the femoral tunnel and interference screw. The results were as follows; The average femur-tibia shaft angle with 30degrees anterior thigh-leg skin angle was 30.2+/-1.75degrees, with 45degrees was 45.2+/-1.23degrees, with 60degrees was 61.9+/-4.23degrees, with 75degrees was 78.6+/-2.62degrees, with 90degrees was 97.8+/-3.96degrees. Predetermined sagittal tibial tunnel vector on the 0degrees extension knee joint lateral radiographs were applied to the several knee joint dynamograms. The mean minimum flexion angle of the femur-tibia shaft that doesn't perforate the posterior cortex of the femur was 45+/-1.58degrees (male), 44.5+/-4.97degrees (female). The average angle between interference screw guide pin and tibial tunnel was 23.0+/-2.23degrees. The findings of the present study suggest that anterior thigh-leg skin angle can be used instead of the true femur-tibia shaft angle. Less knee flexion angle makes good arthroscopic view during the tibio-femoral tunneling and interference screw fixation.
Anterior Cruciate Ligament Reconstruction ; Femur ; Knee Joint* ; Knee* ; Radiography ; Skin ; Transplants

PURPOSE: This study was performed to determined by follow-up observation, the result of the arthroscopic treatment for advanced degenerative arthritis of the knee joint. MATERIALS AND METHODS: During the period from January 1991 to December 1995, 270 cases had been followed for more than one year after arthroscopic treatment for degenerative arthritis of the knee joint. There were 66 males and 204 females of average age 61 years. On the Kellgren and Lawrence radiological grading system, follow-up radiography was conducted after the treatment in those cases Grade III before the treatment. A clinical assessment was performed pain, range of motion and the Hospital for Special Surgery (HSS) knee score before and after operation, and the Baumgaertner scale was used for the 2 and 48 month follow-up after operation. Recurrence was considered to have occurred when conditions were the same as before treatment. RESULTS: According to the Baumgaertner scale, clinical assessment showed overall rates of excellent and good in 191 cases (70.8%) at 2 month post-operatively, and 157 cases (58.1%) at 48 month post-operatively. Comparing the radiologic results before and after treatment using Baumgaertner's scale. the radiologically lower grade was the better result And a degenerative symptom was aggravated an average of 3.8 years. CONCLUSION: This study shows that the arthroscopic treatment is an effective option if used during the early stage of degenerative arthritis of the knee joint.
Female ; Follow-Up Studies ; Humans ; Joints* ; Knee Joint ; Knee* ; Male ; Osteoarthritis ; Radiography ; Range of Motion, Articular ; Recurrence

Arthroplasty, Replacement, Knee ; adverse effects ; Female ; Humans ; Knee Joint ; diagnostic imaging ; surgery ; Middle Aged ; Radiography

PURPOSE: The fixed flexion view (FFV) of the knee is considered useful for evaluating the joint space when assessing the severity of osteoarthritis (OA) of the knee. To clarify the usefulness of FFV for evaluation of the joint space and severity of knee OA, this study evaluated changes in the joint space on the FFV and standing extended view (SEV) in patients with knee OA. MATERIALS AND METHODS: The SEV and FFV images were acquired in 567 patients (1,102 knees) who visited the hospital with a chief complaint of knee joint pain. Medial joint space width (MJSW) and Kellgren-Lawrence (K-L) classification assessed using the SEV and FFV images were compared. RESULTS: Mean MJSW was significantly smaller when assessed on the FFV than on the SEV (3.02±1.55 mm vs. 4.31±1.30 mm; p<0.001). The K-L grade was the same or higher on the FFV than on the SEV. CONCLUSIONS: The FFV is more useful than the SEV for evaluating the joint space in OA knees. Treatment strategies in patients with knee OA should be determined based on routinely acquired FFV images.
Asian Continental Ancestry Group ; Classification ; Humans ; Joints ; Knee Joint ; Knee ; Osteoarthritis ; Radiography