The PCL is one of the most important structure, providing 95% of the total retraint to posterior displacement of the tibia. Insufficieny of the PCL has received increased attension in recent literature, perhaps because of the apparent increase in its incidence due to the increased in motor-vehicle accident and to more accurate evaluation of knee injuries. But there is still so much controvercy cercerning the treatment for individuals with insufficiency of the PCL because the results of operative treatment have been inconsistent. The purpose of this study were to analyze the the results of arthroscopic PCL reconstruction using autogenous bone-patellar tendon-bone and then, we suggest the ideal method of treatment for patients with insufficiency of the PCL. We studied the functional and static results of 14 patients who were followed up more than 1 year out of 16 cases after reconstruction of the PCL using autogenous patellar tendon under arthroscopy from l993 to l995 at the department of orthopedic surgery of Inchon Christian Hospital and Inha university Hospital. The results were as follows: 1. The causes of injury were slip and fall (50%) and traffic accident (50%), and there were 6 acute and 8 chronic knee injuries. 2. Average Lysholm knee evaiuation score were preoperative 61.3, postoperative 93, average posterior tibial displacement of injuried side as compared with normal side in posterior stress x-ray, preoperative 18.2mm(range 10-24mm), postoperative 5.0mm(range 2-11 mm) and average postoperative range of motion was 2.1-127.9 degree. lll conclusion, the reconstruction of PCL with autogenous patellar tendon under arthroscopy is a recommendable treatment method in patients who have insufficiency of PCL, because of small incision, rninimum loss of knee function, rnimimum postoperative pain, and eary motion and rehabilitation. But we think that more cases, long-term follow-up, study of the comparion with patients who treated conservatively are needed.
Accidents, Traffic ; Arthroscopy* ; Follow-Up Studies ; Humans ; Incheon ; Incidence ; Knee ; Knee Injuries ; Orthopedics ; Pain, Postoperative ; Patellar Ligament* ; Posterior Cruciate Ligament* ; Range of Motion, Articular ; Rehabilitation ; Tibia

The discovery of oncogenes and tumor suppressor genes have made it possible to partly understand the mechanism of cancer development. It is generally accepted that the cancer development is caused by specific gene alterations and now more than 100 oncogenes and suppressor genes are known to be involved in human carcinogenesis. However, there are only a few reports about oncogene expression on bone tumors. The author carried out an immunohistochemical study to reveal the oncogene and suppressor genes on carcinogenesis of bone tumors using antibodies against c-myc, c-H-ras, p53 and EGF. In 32 cases of osteochondrorma, EGF, p53 and c-myc antisera revealed positive reaction in 4 (12.5%), 2 (6.3%) and 7 (21.9%) cases, and, in 4 cases of chondrosarcoma, c-myc antisera revealed positive reaction in 2 (50%) cases. In 21 cases of osteosarcoma, the positive reaction of p53 was noted in 10 (47.6%) cases and that of c-myc in 3 (14.3%) cases. In 14 cases of fibrous bone tumors, there are only 2 (14.3%) cases of positive reaction with p53. These results suggest some roles of the p53 and c-myc genes in osteosarcoma development and c-myc gene in osteochondroma and chondrosarcoma development.
Antibodies ; Carcinogenesis ; Chondrosarcoma ; Epidermal Growth Factor ; Genes, myc ; Genes, Suppressor ; Genes, Tumor Suppressor* ; Humans ; Immune Sera ; Oncogene Proteins ; Oncogenes* ; Osteochondroma ; Osteosarcoma

Osteochondroma is the most common of the benign bone tumors. They are probably developmental malformations rather than true neoplasms. But rarely they develope in a joint, especially in the ankle joint. We reported a case of intraarticular osteochondromatosis of ankle joint.
Ankle Joint ; Ankle ; Joints ; Osteochondroma ; Osteochondromatosis

Many modalities of the treatment of fractures of distal 1/3 of tibia were introduced. But, May anatomical bone plate is considered to be a valuable method in treating distal 1/3 tibial fractures because of reduction potentiality by their contour, ability of firm fixation, decreased complications. Twenty two patients having distal 1/3 tibial fractures, were treated by May anatomical bone plate, at the Department of Orthopedic Surgery, Inchon Chirstian Hospital from January 1988 to December 1993. The results were follows; 1. Ninteen cases(86%) out of 22 were closed fractures and the remaining 3 cases(14%) were open fracrues, the comminuted fractures were 6 cases(22%) and the segmental fractures were 2 cases(9%). 2. Average interval from injuy to operation was 16.8 days and 21 cases had associated injuries. 3. The mean duration of bone union was 16.9 weeks. 4. Seven cases(31.8%) of delayed union and two cases(9.1%) of superficial infection were noted.
Bone Plates ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Incheon ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

The giant intra-articular osteochondroma of the knee is very rare and is probably result of synovial metaplasia of the fibrous capsule or of the adjacent connencive tissue of a joint, and of the fragment of articular cartilage. The gross findings and histology are consistent with the osteochondroma. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 19 years old man who had history of knee injury when he was 16 years old. The mass was excised and the symptome was relieved.
Cartilage, Articular ; Joints ; Knee Injuries ; Knee ; Metaplasia ; Osteochondroma

PURPOSE: We tried to outline the incidence and characteristics of meniscal tears in recent lesions and chronic insufficiency of the ACL. MATERIALS AND METHODS: Through this retrospective study of 103 reconstructions of the anterior cruciate ligament (ACL) performed between Jun 1996 to Sep 1998, according to a more accurate evaluation, ACL-deficient knees can be classified into two different stages (recent, chronic injuries). RESULTS: Overall, there was a significantly increasing incidence of meniscal tears in chronic injuries (P<0.05). A predominance of lateral meniscal tears were demonstrated with recent injuries, whereas the incidence of medial meniscal tears increased significantly with chronic injuries (P<0.05). CONCLUSIONS: This study highlights the increase of lateral meniscal lesion in recent ACL rupture and increase of severe meniscal lesion, especially medial meniscus, with progressive worsening of knee instability after an ACL injury. Although not significant, meniscal tears in the recent injuries were more amenable to repair. The results suggest that maximal meniscal preservation is best achieved with ACL reconstruction shortly after injury.
Anterior Cruciate Ligament* ; Incidence ; Knee* ; Menisci, Tibial ; Retrospective Studies ; Rupture*

The elbow injury is frequent among the children. The cubitus varus and cubitus valgus deformities are the common late complications of the elbow fracture. Although, these deformities rarely limit elbow function, the correction is frequently requested due to cosmetic problem and/or tardy ulnar nerve palsy. We performed 33 supracondylar closed wedge osteotomies from Jan. 1976 to Jan. 1986, of which 27 cases were cubitus varus, and 6 cases were cubitus valgus at Yonsei University College of Medicine. The results were as follows; 1. Cubitus varus deformity was more common than cubitus valgus; the ratio was 4.5 : 1. 2. The most common initial injury resulted in such angular deformity of elbow was supracondylar fracture of humerus. 3. The duration of plaster-cast immobilization after operation was much longer in cases who operated over 15 years old than under 15 years old. 4. There is no relationship between the duration after initial injury and the result of operation. 5. The result of supracondylar osteotomy was excellent in 11 cases(33.3%), good in 17 cases(51.5 %), and poor in 5 cases(15.2%). 6. Three fourths of cases resulted in excellent and good result were under 15 years old. 7. It is recommeneed that the angular deformity of elbow is corrected early rather than at the conclusion of growth.
Child ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Immobilization ; Osteotomy ; Ulnar Neuropathies

Tuberculosis of the bones and joints is not an uncommon condition in Korea, but extraosseous tuberculosis of the soft tissue is relatively rare. A few reports of extraosseous tuberculosis, tuberculous tenosynovitis and bursitis, hsve been published in the literature, but there have been no reports concerning soft tissue tuberculosis in other than the tendon, synovium and bursa. We reviewed 7 cases of soft tissue tuberculosis of the lower back at the Department of Orthopedic Surgery, Yonsei University College of Medicine from Jan. 1984 to Sept. 1986. Five cases had received steroid injection to the lumbosscral region, and two had undergone acupuncture, thus all seven cases had experienced injections to the lumbosacral region. We think that a possible route of infection is the hematogenous one, at an area of decreased local resistance after steroid injection, And that direct inoculation of the tuberculous bacilli was result of artificial injection and acupuncture. But, further studies are needed to support the proposal that the hematogenous route following steroid injection and direct inoculation by artifical puncture is the source of soft tissue tuberculosis. These results indicate that steroid injections into the soft tissue should be performed limitedly under sterile conditions.
Abscess ; Acupuncture ; Bursitis ; Joints ; Korea ; Lumbosacral Region ; Orthopedics ; Punctures ; Synovial Membrane ; Tendons ; Tenosynovitis ; Tuberculosis

No abstract available.

Transforming growth factor-beta1 (TGF-beta1) and bone morphogenetic protein-2 (BMP-2) are abundant proteins in the bone matrix. However, their interaction in controlling osteoblast differentiation is not clearly understood. In this study, HBMSCs were cultured in collagen gel matrix with different condition of exogenous rhBMP-2 and TGF-beta1 in order to determine the interaction of BMP-2 and TGF-beta1 on human bone marrow stromal cells (HBMSCs) differentiation. The cultured cells were analyzed for cell proliferation, alkaline phophatase (ALP) activity and mineralization stainning with Von-Kossa. The cells treated with TGF-beta1 exhibited a higher rate of cell growth than those without. However, the cells cultured in collagen gel matrix showed a lower rate of cell growth than the cells cultured in a monolayer. To investigate the effects of both cytokines on osteoblast differentiation, the cells were treated with 0, 1, 5, 10 ng/ml of TGF-beta1 for 2 days. This was followed by culturing with 0, 1, 5, and 10 ng/ml of TGF-beta1 and 100 ng/ml of rhBMP-2 together for 3 days with the alkaline phosphatase (ALP) activity measured. The cells treated with 1 ng/ml of TGF-beta1 responded efficiently to rhBMP-2 and expressed ALP activity with a level equivalent to that exhibited by cells that were not treated with TGF-beta1. The cells treated with 5 and 10 ng/ml of TGF-beta1 showed a dramatic decrease in ALP activity. The cells treated with 10ng/ml of TGF-beta1 followed by rhBMP-2 alone exhibited an intermediate ALP activity. The cells treated with 100 ng/ml of rhBMP-2 demonstrated Von-Kossa positive solid deposits after 3 weeks, while there were few Von-Kossa positive solid deposits when the cells treated with 10 ng/ml of TGF-beta1. These results show that TGF-beta1 inhibits the effects of rhBMP-2 on the osteoblast differentiation of HBMSCs in a dose dependant manner. Furthermore, the effects of TGF-beta1 on HBMSCs are reversible. This suggest that TGF-beta1 and rhBMP-2 are coordinately controlled during the osteoblast differentiation of HMBSCs.
Alkaline Phosphatase/metabolism ; Bone Marrow Cells/*drug effects ; Bone Morphogenetic Proteins/*pharmacology ; Cell Differentiation/drug effects ; Cell Division/drug effects ; Cells, Cultured ; Collagen/*pharmacology ; Human ; Recombinant Proteins/pharmacology ; Stromal Cells/*drug effects ; Transforming Growth Factor beta/*pharmacology