PURPOSE: The purpose of this article is to show the efficacy of a bioabsorbable polylactide (PLA) screw for treating syndesmotic injuries of ankle fractures. MATERIALS AND METHODS: Ten patients who underwent an open reduction and internal fixation operation for ankle fractures that had syndesmotic injuries from Dec. 1992 to Feb. 1997 were enrolled into the study. There were 6 men and 4 women. The average age of the patients was 42.6 years and the average follow-up period was 2 years 7 months. The cases were analyzed by clinical and radiological findings at the time of their last follow-up evaluation. RESULTS: According to the clinical results, there was statistically no significant difference between finding an average of 15.8 degrees of dorsiflexion and 45.8 degrees of plantar flexion of the ankle on the affected side of the individuals and that of 17.8 degrees of dorsiflexion and 48.5 degrees of plantar flexion on their normal contralateral side. Upon radiological analysis, the medial clear space was decreased from 7.3+/-1.8 mm to 3.1+/-1.0 mm, the tibio-fibular clear space was decreased from 7.8+/-0.9 mm to 4.9+/-0.5 mm and the tibio-fibular overlap increased from 4.6+/-1.8 mm to 10.5+/-1.4 mm. Also there was no pain and instability in the affected side in any of the patients at the time of the last follow-up. CONCLUSION: A bioabsorbable PLA screw is a good implant for stabilizing syndesmotic injuries of the ankle fractures because there is no evidence of a significant osteolysis resulting around the implant, there is a gradual transfer of stress to the surrounding bone, and there is no requirement for a subsequent removal.
Ankle Fractures* ; Ankle Injuries* ; Ankle* ; Female ; Follow-Up Studies ; Humans ; Male ; Osteolysis

PURPOSE: The purpose of this study is to analyse clinical and radiologic results of total knee arthroplasty in complete or partial ankylosed knee. MATERIALS AND METHODS: From July 1986 to August 1996, total knee arthroplasties were performed in 37 ankylosed knees. Of these, five patients were lost to follow-up. Thirty two patients were evaluated. The average follow up period was 5 years 2 months (2 years-11 years 10month). Average age of patients at the time of total knee arthroplasty was 40.4 years (20~63 years). There were seven men and twenty five women. Twenty patients had complete ankylosis and twelve patients had partial ankylosis. Quadriceps tendon was lengthened with the method of modified V-Y advancement technique in 10 cases. Tibial tubercle was proximally transferred in 3 cases. RESULTS: The postoperative average range of motion was 75.3 degrees (30 degrees - 115 degrees) in complete ankylosis, 98.7 degrees (60 degrees -130 degrees) in partial ankylosis. The average HSS knee score improved from 56.8 points preoperatively to 85.6 points postoperatively. Radiolucent line was observed in two knees with less than 2mm width in 3 years and 4 years postoperatively, but the patient had no pain. CONCLUSION: In patient selection, healthy extensor mechanism and adequate soft tissue condition are most important. With meticulous surgical technique and aggressive rehabilitation, patients can obtain reasonable restoration of function in ankylosed knee after total knee arthroplasty.
Ankylosis ; Arthroplasty* ; Female ; Follow-Up Studies ; Humans ; Knee* ; Lost to Follow-Up ; Male ; Patient Selection ; Range of Motion, Articular ; Rehabilitation ; Tendons

BACKGROUND: This study evaluated the outcomes of debridement arthroplasty for stiff elbows, as well as the factors affecting clinical outcomes after surgical treatment. METHODS: Eighteen patients with post-traumatic stiff elbows were treated with debridement arthroplasty using a posterior approach. The mean patient age was 33 years (range, 16 to 59 years), and the average follow-up period was 59 months (range, 24 to 141 months). The patient's ability to perform activities of daily living, including combing their hair, feeding themselves, performing hygiene, and putting on shirt and shoes, were evaluated using the Mayo Elbow Performance Score. RESULTS: At the last follow-up, 16 elbows had painless motion. Two patients continued to complain of mild intermittent pain. The flexion and extension improved to 121degrees and 10degrees after surgery, respectively, indicating an average 34degrees increase in elbow flexion range and an average 25degrees increase in elbow extension range (p < 0.001, p < 0.001). The Mayo Elbow Performance Score at the last follow-up was excellent in nine elbows (50%) and good in nine elbows (50%). CONCLUSIONS: Debridement arthroplasty is a predictable procedure for the treatment of intractable stiff elbow, provided that the elbow is stable and congruous.
Activities of Daily Living ; Adolescent ; Adult ; Arthroplasty/*methods ; Debridement/methods ; Elbow Joint/*injuries/physiopathology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Pain ; Range of Motion, Articular ; Recovery of Function ; Statistics, Nonparametric ; Treatment Outcome ; Young Adult

PURPOSE: To compare the clinical outcomes and complications of hemiarthroplasty (HHR) and total shoulder arthroplasty (TSR) in non-traumatic arthritis patients. MATERIALS AND METHODS: Thirty-two patients (34 shoulders) underwent shoulder arthroplasty for nontraumatic shoulder arthropathy. There were sixteen patients with rheumatoid arthritis, nine with osteoarthritis, four with avascular necrosis and etc. HHR was performed in eleven shoulders and TSR in twentythree shoulders. RESULTS: In HHR, the pain score decreased from preoperatively 7.09 to 0.91 postoperatively. The mean forward elevation was 137degrees and the mean external rotation at the side and abduction were 55degrees and 131degrees, respectively. The mean ASES score was 82.4. In TSR, the pain score decreased from 7.04 preoperatively to 1.17 postoperatively. The mean forward elevation, external rotation at the side and abduction were 132degrees, 44degrees, and 132degrees, respectively. The mean ASES score was 81.2. In rheumatoid arthritis, the mean ASES score of the HHR and TSR were 77.8 and 78.1, respectively. In osteoarthritis, the mean ASES score was 84.7 and 90.8, respectively. During the follow up, glenoid erosion was observed in three HHR cases, and glenoid loosening in two TSR case. CONCLUSION: HHR and TSR produced similar results in terms of the functional improvement. The clinical results were much better in patients with osteoarthritis than in those with rheumatoid arthritis, and TSR was performed on most cases of rheumatoid arthritis.
Arthritis* ; Arthritis, Rheumatoid ; Arthroplasty* ; Follow-Up Studies ; Hemiarthroplasty* ; Humans ; Necrosis ; Osteoarthritis ; Shoulder*

PURPOSE: To analyze the general characteristics of isolated SLAP (superior labrum anterior to posterior) lesions of shoulder and to evaluate efficacy of arthroscopic treatment. MATERIALS AND METHODS: We retrospectively reviewed 43 athletic patients with 46 isolated SLAP lesions. The mean follow-up period was 21 months, and mean patient age was 25 years. Twenty seven patients presented with injury to the dominant shoulder, and 3 had bilateral involvement. RESULTS: Pain and clicking were the most common symptoms. The mechanism of injury was assumed to be chafing in 27 cases, compression in 9 cases. Type 2 lesion was commonest (30 cases). The single most sensitive test was the compression-rotation test, which was positive in 92% of patients. The average UCLA score at the last follow-up was 31.6 points; 18 cases ranked as excellent and 21 as good.Postoperative performance data was obtained for in 27 athletes, 19 were able to return to their sports. CONCLUSION: Arthroscopic surgery for an isolated SLAP lesion resulted in 85% of patients being rated good or above, and 70% of athletic patients were able to resume sporting activity.
Arthroscopy ; Athletes ; Follow-Up Studies ; Humans ; Retrospective Studies ; Shoulder* ; Sports

OBJECTIVE: The aim of this study was to report a case series of in vitro matured (IVM) oocyte freezing in gynecologic cancer patients undergoing radical surgery under time constraints as an option for fertility preservation (FP). METHODS: Case series report. University-based in vitro fertilization center. Six gynecologic cancer patients who were scheduled to undergo radical surgery the next day were referred for FP. The patients had endometrial (n=2), ovarian (n=3), and double primary endometrial and ovarian (n=1) cancer. Ex vivo retrieval of immature oocytes from macroscopically normal ovarian tissue was followed by mature oocyte freezing after IVM or embryo freezing with intracytoplasmic sperm injection. RESULTS: A total of 53 oocytes were retrieved from five patients, with a mean of 10.6 oocytes per patient. After IVM, a total of 36 mature oocytes were obtained, demonstrating a 67.9% maturation rate. With regard to the ovarian cancer patients, seven IVM oocytes were frozen from patient 3, who had stage IC cancer, whereas one IVM oocyte was frozen from patient 4, who had stage IV cancer despite being of a similar age. With regard to the endometrial cancer patients, 15 IVM oocytes from patient 1 were frozen. Five embryos were frozen after the fertilization of IVM oocytes from patient 6. CONCLUSION: Immature oocytes can be successfully retrieved ex vivo from macroscopically normal ovarian tissue before radical surgery. IVM oocyte freezing provides a possible FP option in patients with advanced-stage endometrial or ovarian cancer without the risk of cancer cell spillage or time delays.
Cryopreservation* ; Embryonic Structures ; Endometrial Neoplasms ; Female ; Fertility Preservation ; Fertilization ; Fertilization in Vitro ; Freezing ; Humans ; In Vitro Oocyte Maturation Techniques ; In Vitro Techniques* ; Oocyte Retrieval* ; Oocytes* ; Ovarian Neoplasms ; Sperm Injections, Intracytoplasmic ; Uterine Neoplasms

BACKGROUND AND OBJECTIVES: We performed this study to evaluate the common carotid artery intima-media thickness (CCA IMT), and its correlation with several clinical variables, including the 10 year coronary heart disease (10 Yr CHD) risk in both healthy and hyperlipidemic hypertensive (HH) Koreans. SUBJECTS AND METHODS: This was a multi-centered prospective epidemiological study. The study population consisted of 227 healthy subjects without risk factors, with the exception of age (mean 49 years old, 114 males), and 243 HH subjects (mean 51 years old, 120 males). The carotid IMT and presence of plaques were semi automatically measured in both carotid arteries at a central reading facility. RESULTS: Linear regression analysis of all the subjects revealed that the independent factors of both CCA IMT were age, pulse pressure (PP) and HDL-cholesterol, and that of the right CCA IMT were sex and 10 Yr CHD risk. In healthy subjects, the independent factor of both CCA IMTs was age, and that of the right CCA IMT was body weight. In the HH subjects, age, sex, total cholesterol, HDL-cholesterol and PP were independent factors of both CCA IMTs, but 10 Yr CHD risk was an independent factor of only the right CCA IMT. Carotid plaques were seen in 17% of the healthy subjects and 35% of the HH subjects. An ROC curve analysis showed a right CCA IMT of 0.646 mm and left CCA IMT of 0.656 mm demonstrated 60% sensitivity and specificity in differentiating healthy from HH subjects. CONCLUSION: This result reliably demonstrates the Korean CCA IMT, as well as several other significant pieces of information.
Blood Pressure ; Body Weight ; Carotid Arteries ; Carotid Artery, Common ; Carotid Intima-Media Thickness* ; Cholesterol ; Coronary Disease ; Epidemiologic Studies* ; Humans ; Korea* ; Linear Models ; Middle Aged ; Prospective Studies ; Risk Factors* ; ROC Curve ; Sensitivity and Specificity

PURPOSE: To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. MATERIALS AND METHODS: Our study was open labelled prospective phase IV multi-center study. the study population included patients with more 4 numeric rating scale(NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups; patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief; second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. RESULTS: Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, p=0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. CONCLUSION: Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There was no major side effect.
Academies and Institutes ; Acute Pain ; Analgesics ; Female ; Fentanyl* ; Humans ; Male ; Nausea ; Prospective Studies ; Quality of Life ; Radiotherapy* ; Sleep Initiation and Maintenance Disorders ; Transdermal Patch*