PURPOSE: To analyze the results of cementless total hip arthroplasty with a F2L Multineck femoral stem. MATERIALS AND METHODS: A total of 64 patients (73 hips), who underwent cementless total hip arthroplasty with a F2L Multineck femoral stem, SPH acetabular cup and a ceramic liner from December of 1998 to October of 2001 were followed up for at least 4 years, were selected for the clinical and radiological evaluations. RESULTS: At the final evaluation, 63 patients had an improved average Harris hip score ranging from 51.4 preoperatively to 95.1. None of the patients had any significant leg length inequality. Thigh or inguinal pain was observed in 3 hips (1 hip of femoral stem subsidence and 2 hips of damaged ceramic parts), for which revision total hip arthroplasty was performed. Hip dislocation occurred in 2 hips within 2 weeks after surgery and conservative management was performed after a closed reduction. CONCLUSION: Total hip arthroplasty with a F2L Multineck femoral stem produced satisfactory results. Postoperative complications such as hip dislocation and leg length inequality could be minimized by modulating the anteversion angle, femoral offset and leg length with multineck femoral stem.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Ceramics ; Hip ; Hip Dislocation ; Humans ; Leg ; Leg Length Inequality ; Postoperative Complications ; Thigh

PURPOSE: To compare the clinical results of High intensity laser therapy (HILT) versus Extracorporeal shock wave therapy (ESWT) in the lateral epicondylitis. MATERIALS AND METHODS: Fifty patients who suffer from lateral epicondylitis for more than six month duration were randomly assigned two treatment groups. Group 1 (n=25) was treated with HILT using a HIRO 3.0 laser(ASA srl, Arcugnano, Italy) and total energy was administered approximately 1200J following a standard protocol for each session; Group 2 (n=25) recieved with ESWT treatment using an EvoTron(Switech Medical AG, Kreuzlingen, Switzerland) for a total of 1000 shocks for each session. The patients were evaluated by assessment of pain using visual analog scale (VAS) and simple elbow test (SET). Comparision of overall clinical outcomes were evaluated by Roles and Maudsley score at 9 months. RESULTS: Average VAS and SET scores were significantly improved in two groups, also achieved significant improvement of symptoms at 9 months follow up according to Roles and Maudesley scores(P<0.05). The success rate in the HILT group was 76 % and in the ESWT group was 72 %. CONCLUSIONS: This study suggests that HILT could be considered as effective and noninvasive treatment modality for lateral epicondylitis.
Elbow ; Follow-Up Studies ; Humans ; Laser Therapy ; Shock

PURPOSE: To evaluate the therapeutic results of communited intercondylar fractures of the distal humerus that were treated by surgical treatment. MATERIALS AND METHODS: From January, 1998 to December, 2004, we reviewed fifteen cases of intercondylar fracture of the distal humerus, which were treated by surgical treatment. The follow up period ranged from six month to 5 years. The functional results were evaluated using Broberg and Morrey's functional scale according to surgical approach, type of plate and location of plating. RESULTS: The functional results were as follows; seven excellent, six good, one fair and one poor. The mean range of motion in elbow joint was 7~106 degrees. The mean functional score was 86.6 points through olecranon osteotomy, 90.5 points through Campbell's posterior approach. The mean functional score was 91.6 points in cases using 2 reconstruction plate, 78 points in cases using 1 reconstruction plate and 1/3 semitubular plate, and 86 points in case using 1 reconstruction plate and lag screws. The mean functional score was 88.9 points in cases by posterior and lateral fixation, 86 points in cases by both posterior fixation and 97 points in case by both lateral fixation. CONCLUSION: There are no significant differences in treatment outcome according to surgical approach, different plate and location of plating.
Adult* ; Elbow Joint ; Follow-Up Studies ; Humans ; Humerus* ; Olecranon Process ; Osteotomy ; Range of Motion, Articular ; Treatment Outcome

PURPOSE: To compare the clinical and radiological results between patellar resurfacing, group and patellar retention group in total knee arthroplasty. MATERIALS AND METHODS: Of the 74 patients who underwent total knee arthroplasty on due to knee osteoarthritis since March 1996, and followed-up for at least for 5 years, there were 42 and 32 cases in the patellar retention and patellar resurfacing groups respectively. These subjects were evaluated preoperatively and at 1 and 5 years postoperatively using the pain score, Hospital for Special Surgery (HSS) knee score, walking and stair-climbing in knee function score and radiological analysis. The radiological evaluation was achieved by measuring the patellar tilt angle and displacement with a 45degreesmerchant view. The results were analyzed using the student's t-test. RESULTS: There were no significantly differences between the patellar resurfacing and patellar retention groups in the pain score, HSS knee score, walking in knee function score and radiological analysis (p>0.05), but the patellar retention group achieved superior results in stair-climbing (p<0.05). CONCLUSION: The clinical and radiological results were similar in the patellar retention and patellar resurfacing groups. The use of selective indications of patellar resurfacing is required in order to achieve better results for total knee arthroplasty.
Arthroplasty* ; Follow-Up Studies* ; Humans ; Knee* ; Osteoarthritis ; Osteoarthritis, Knee ; Patella ; Walking

BACKGROUND AND OBJECTIVES: Making the noninvasive diagnosis of coronary artery disease in patients with a permanent pacemaker is difficult because of the inability to interpret electrocardiograms and the low specificity of perfusion scintigraphy. We evaluated the diagnostic accuracy of noninvasive pacemaker stress echocardiography (PASE) as a screening test for coronary artery disease in patients with atypical angina and a permanent pacemaker. SUBJECTS AND METHODS: This a prospective study, and transthoracic stress-pacing echocardiography was performed on 15 patients (9 men and 6 women; age, mean age: 71.1+/-11.0 years) with atypical angina and a permanent pacemaker. All the patients underwent noninvasive pacemaker-stress echocardiography by external programming (pacing the heart rate up to 150 beats per minute). Coronary angiography was performed on the 8 patients with positive PASE results. Significant coronary artery disease was defined as > or =70% stenosis in at least one major coronary artery. RESULTS: The echocardiographic images were interpretable for all the patients. No significant side effects were observed. The left ventricular systolic function was preserved in all the patients (left ventricular ejection fraction; 63.5+/-8%). Only 5 (62.5%) of 8 patients showed significant coronary artery disease, as documented by coronary angiography. CONCLUSION: Noninvasive PASE is a simple, rapid, safe and diagnostically efficient test for detecting coronary artery disease in patients with atypical angina and a permanent pacemaker. Larger studies are necessary to validate our findings.
Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Echocardiography ; Echocardiography, Stress ; Electrocardiography ; Heart Rate ; Humans ; Male ; Mass Screening ; Pacemaker, Artificial ; Perfusion Imaging ; Prospective Studies ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: Currently, the drug-eluting stent (DES) has been widely used because of its excellent clinical outcome. We compared the utilization patterns and clinical outcomes between the DES and the bare metal stent (BMS) in the real world. SUBJECTS AND METHODS: We retrospectively reviewed the stent registry at the Catholic Medical Center between January 2002 and October 2004. There were 1120 patients treated with DES (n=1837) who were compared to 910 patients who received BMS implantation (n=1238). RESULTS: Patients with de novo lesions in the DES group more frequently had multivessel disease and received a greater number of stents than those in BMS group (p<0.001). The mean diameter of inserted stents was smaller in the DES group (p<0.001). The follow-up rate for clinical and angiographic evaluations at 6 months after stenting was 91% and 65% (n=592) in the BMS group and 90% and 74% (n=829) in the DES group, respectively. The rate of major adverse cardiac events (death, nonfatal myocardial infarction, or target vessel revascularization) at 6 months was 7.3% in the DES group and 17.5% in the BMS group (p<0.001). The rates of target vessel revascularization in the DES group and in the BMS group were 4.2% and 12.9%, respectively (p<0.001). CONCLUSION: The patients in the DES group had longer length, smaller diameter and higher number of placed stents, compared to the BMS group. The rates of revascularization and major adverse cardiac events in the DES group were lower than those in the BMS group.
Angioplasty ; Drug-Eluting Stents* ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Prognosis* ; Retrospective Studies ; Stents*

BACKGROUND: Cardiovascular risk remains increased despite optimal low density lipoprotein cholesterol (LDL-C) level induced by intensive statin therapy. Therefore, recent guidelines recommend non-high density lipoprotein cholesterol (non-HDL-C) as a secondary target for preventing cardiovascular events. The aim of this study was to assess the efficacy and tolerability of omega-3 fatty acids (OM3-FAs) in combination with atorvastatin compared to atorvastatin alone in patients with mixed dyslipidemia. METHODS: This randomized, double-blind, placebo-controlled, parallel-group, and phase III multicenter study included adults with fasting triglyceride (TG) levels ≥200 and <500 mg/dL and LDL-C levels <110 mg/dL. Eligible subjects were randomized to ATOMEGA (OM3-FAs 4,000 mg plus atorvastatin calcium 20 mg) or atorvastatin 20 mg plus placebo groups. The primary efficacy endpoints were the percent changes in TG and non-HDL-C levels from baseline at the end of treatment. RESULTS: After 8 weeks of treatment, the percent changes from baseline in TG (−29.8% vs. 3.6%, P<0.001) and non-HDL-C (−10.1% vs. 4.9%, P<0.001) levels were significantly greater in the ATOMEGA group (n=97) than in the atorvastatin group (n=103). Moreover, the proportion of total subjects reaching TG target of <200 mg/dL in the ATOMEGA group was significantly higher than that in the atorvastatin group (62.9% vs. 22.3%, P<0.001). The incidence of adverse events did not differ between the two groups. CONCLUSION The addition of OM3-FAs to atorvastatin improved TG and non-HDL-C levels to a significant extent compared to atorvastatin alone in subjects with residual hypertriglyceridemia.