1.Current perspectives in stem cell therapies for osteoarthritis of the knee
Yeungnam University Journal of Medicine 2020;37(3):149-158
Mesenchymal stem cells (MSCs) are emerging as an attractive option for osteoarthritis (OA) of the knee joint, due to their marked disease-modifying ability and chondrogenic potential. MSCs can be isolated from various organ tissues, such as bone marrow, adipose tissue, synovium, umbilical cord blood, and articular cartilage with similar phenotypic characteristics but different proliferation and differentiation potentials. They can be differentiated into a variety of connective tissues such as bone, adipose tissue, cartilage, intervertebral discs, ligaments, and muscles. Although several studies have reported on the clinical efficacy of MSCs in knee OA, the results lack consistency. Furthermore, there is no consensus regarding the proper cell dosage and application method to achieve the optimal effect of stem cells. Therefore, the purpose of this study is to review the characteristics of various type of stem cells in knee OA, especially MSCs. Moreover, we summarize the clinical issues faced during the application of MSCs.
2.Osteotomy around the Knee: Indication and Preoperative Planning.
Seung Wan LIM ; Seung Min RYU ; Oog Jin SHON
The Journal of the Korean Orthopaedic Association 2018;53(4):283-292
Osteotomy around the knee is a widely considered surgical procedure for osteoarthritis with lower extremity malalignment. High tibial osteotomy (HTO) is performed for varus deformity, while distal femur osteotomy (DFO) is performed for valgus deformity. However, if the correction is insufficient, double osteotomy can also be considered. This report included the basic principles and current concepts of patient selection and preoperative planning in osteotomy around the knee.
Congenital Abnormalities
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Femur
;
Knee Joint
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Knee*
;
Lower Extremity
;
Osteoarthritis
;
Osteotomy*
;
Patient Selection
3.Acute Rupture of Subclavian Artery Pseudoaneurysm after Delayed Osteosynthesis of Clavicular Fracture: A Case Report.
Oog Jin SHON ; Jee Hoon KIM ; Kang Hyun PARK
Journal of the Korean Fracture Society 2014;27(1):82-87
Subclavian vessels are well protected by muscles, fascia and sheaths, so vascular complications associated with clavicular fractures are rare. Pseudoaneurysms after clavicular fractures have been reported, and the occurrence or rupture of pseudoaneurysm has been reported rarely as a late complication. However, cases of pseudoaneurysm after rupture of the clavicular fracture following delayed osteosynthesis of the clavicular fracture have not been reported. A 58-year-old female that presented with a right clavicular shaft fracture obtained conservative treatment. Surgery was performed after 4 months because of non-union in the local medical center. After operation, rupture of the subclavian pseudoaneurysm occurred following osteosynthesis of the clavicular shaft fracture. We report this case here with a review of the literature.
Aneurysm
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Aneurysm, False*
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Clavicle
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Fascia
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Female
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Humans
;
Middle Aged
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Muscles
;
Rupture*
;
Subclavian Artery*
4.Comparison of Results of Tension Band Wire and Hook Plate in the Treatment of Unstable Fractures of the Distal Clavicle.
Chul Hyun PARK ; Oog Jin SHON ; Jae Sung SEO
Journal of the Korean Fracture Society 2011;24(1):55-59
PURPOSE: To compare the clinical and radiological outcomes of two surgical methods with tension band wire and Hook plate for unstable distal clavicle fractures. MATERIALS AND METHODS: Thirty patients with type II distal clavicle fractures were evaluated, who were operated with tension band wire (Group I) and Hook plate (Group II) fixation, from June 2005 to June 2009, and could be followed-up for more than 1 year after operation. The reduction and union were evaluated by the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and Constant-Murley scoring system. RESULTS: All 30 cases showed bony union. By Kona's functional evaluation, there were 16 cases with excellent and good results in Group I and 14 cases in Group II. The average Constant score was 88.3 (71~100) in Group I and 89.6 (72~100) in Group II, but there was no significant difference in both groups. As complications, there were 2 case with subacromial impingement, and 1 case showed subacromial erosion. There was no K-wire migration, deep infection and acromioclavicular joint arthritis. CONCLUSION: Tension band and Hook plate fixation technique gave satisfactory clinical and radiological results in patients with type II distal clavicle fractures. These results suggest that tension band wire and Hook plate fixation technique seems to be an effective method for type II distal clavicle fracture. But we think thal early removal of plate is necessary due to risks for subacromial impingement and erosion in Hook plate fixation.
Acromioclavicular Joint
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Clavicle
;
Humans
5.Surgical Treatment for Displaced Intra-Articular Calcaneal Fractures.
Journal of the Korean Fracture Society 2016;29(3):221-231
Calcaneal fractures are the most common type of tarsal fracture, and comminuted and bursting fractures are common due to the anatomic characteristics of the calcaneus. Assessment and treatment of calcaneal fractures has improved significantly over time. Despite advancements in surgical techniques and equipment, these fractures remain difficult to treat. In this review article, the physiopathology, classification, and surgical treatments of displaced intra-articular calcaneal fractures are updated.
Calcaneus
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Classification
6.The Mid-Term Result after Osteosynthesis of Intra-Articular Fractures of Distal Femur.
Sam Guk PARK ; Jeong Jae MOON ; Oog Jin SHON
Journal of the Korean Fracture Society 2016;29(4):242-249
PURPOSE: This study was to evaluate the radiological and clinical mid-term results and the presence of post-traumatic osteoarthritis after osteosynthesis in patients under the age of 50 years undergoing osteosynthesis for distal femur intra-articular fractures (AO/OTA 33-B & C) from high-energy trauma. MATERIALS AND METHODS: Between January 2008 and January 2013, a total of twenty-one patients with more than three years of follow-up were enrolled. Recovery of the alignment of the lower extremity, union period, and the presence of post-traumatic osteoarthritis were confirmed by follow-up radiographs. Clinically, the range of motion, pain on fracture lesion, and Knee Society score (KSS) were evaluated. RESULTS: The average duration of union was 18.2 weeks (10-28 weeks), and the alignment of the lower extremity was within normal range in all patients. Seven patients showed post-traumatic osteoarthritis at the final follow-up after more than three years. The presence of post-traumatic osteoarthritis was associated with the classification of fractures, coronal plane fracture, and age. The average range of motion, knee score among KSS, and function score at the last follow-up were 128.7°, 86.1, and 85.1, all showing a greater improvement when compared with the one-year follow-up scores. CONCLUSION: The mid-term result was radiologically and clinically satisfactory. Furthermore, only 33.3% of patients showed a slight progress of post-traumatic osteoarthritis, which critically effects the prognosis.
Classification
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Femur*
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Follow-Up Studies
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Humans
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Intra-Articular Fractures*
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Knee
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Lower Extremity
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Osteoarthritis
;
Prognosis
;
Range of Motion, Articular
;
Reference Values
7.Comparative Study of Proximal Femoral Nail Antirotation and Zimmer Natural Nail for the Treatment of Stable Intertrochanteric Fractures.
Journal of the Korean Fracture Society 2013;26(4):305-313
PURPOSE: To compare the results between Proximal femoral nail antirotation II (PFNA II) and Zimmer natural nail Asia type (ZNN) for the treatment of stable intertrochanteric fractures. MATERIALS AND METHODS: Between September 2011 and September 2012, 40 consecutive patients with stable intertrochanteric femoral fractures were treated with PFNA II or ZNN. We reviewed 20 cases of PFNA II and 20 cases of ZNN prospectively. We evaluated the operation time, amount of bleeding, mean hospital day, and capability of mobility and function using 'mobility score of Parker and Palmer' and 'social score of Jensen'. We also evaluated the reduction state by the Fogagnolo, Cleveland index, change of tip and apex distance (TAD), sliding distance of cervical screw, change of neck shaft angle and bone union time. RESULTS: There were no significant differences between the groups treated with PFNA and ZNN. Both groups showed good clinical results. PFNA showed less TAD change and ZNN showed a shorter sliding distance of cervical screw, but they were not statistically different. The bone union time was approximately 13 weeks in both groups. CONCLUSION: PFNA and ZNN produced good clinical and radiologic results in the treatment of stable intertrochanteric fractures. There were no significant differences between the groups. Both implants provide good stability and union, so we can conclude that they are both suitable for the treatment of stable intertrochanteric fractures.
Femoral Fractures
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Femur
;
Hemorrhage
;
Hip Fractures*
;
Humans
;
Prospective Studies
8.Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture.
Journal of the Korean Fracture Society 2010;23(1):42-49
PURPOSE: To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a lateral plate (Zimmer, Periarticular Lateral Distal Tibial Plates, USA) in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage. MATERIALS AND METHODS: From January 2005 to December 2007, 15 patients with distal tibial fracture treated by MIPPO technique using a lateral plate were analyzed. The duration of follow-up was more than 1 year. We evaluated union time by simple X-ray, clinical results by IOWA ankle rating system, and complication. RESULTS: The bone union was achieved in all cases at average 16.7 weeks. Evaluation of the ankle function test showed an average of 90.3 points, resulting in satisfactory. At the last follow-up, there was no non-union, angular deformity more than 5 degrees or infection. CONCLUSION: We concluded that MIPPO technique using a lateral plate is a efficient method for high functional recovery with good bone healing and low complication in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage.
Animals
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Ankle
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Congenital Abnormalities
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Follow-Up Studies
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Humans
;
Iowa
;
Tibial Fractures
9.Unstable Intertrochanteric Femoral Fracture Treated with Mini-incision Reduction Technique and Intramedullary Nail.
Journal of the Korean Fracture Society 2010;23(1):13-19
PURPOSE: To evaluate the efficacy of mini-incision reduction technique in unstable intertrochanteric femoral fracture treated with intramedullary nail. MATERIALS AND METHODS: From January, 2005 to December, 2007, we selected 26 patients of unstable intertrochanteric femoral fracture which underwent anatomic reduction by mini-incision reduction technique using various instruments, and treated with intramedullary nail. We evaluated the radiological results with the union time, change of femoral neck-shaft angle and distance of lag screw sliding by follow-up radiography, and the clinical results with the mobility score of Parker and Palmer, Salvati and Wilson hip function scoring system and Jensen index. RESULTS: The mean union time was 18.9 weeks. The mean changes of femoral neck-shaft angle was 4.1 degree. The mean distance of lag screw sliding was 4.4 mm. Decrease of mobility score of Parker and Palmer, Salvati and Wilson hip function score was showed, and social function score of Jensen maintained 54% compared with preoperative score. CONCLUSION: Mini-incision reduction technique using various instruments showed satisfactory clinical and radiological results, and we believe that it is a recommendable method in unstable intertrochanteric femoral fracture which manual reduction is difficult.
Femoral Fractures
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Follow-Up Studies
;
Hip
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Humans
;
Nails
10.Interlocking Intramedullary Nail in Distal Tibia Fracture.
Journal of the Korean Fracture Society 2007;20(1):13-18
PURPOSE: To evaluate the effectivity of interlocking intramedullary nailing for distal tibia fracture and prognostic factor to bone healing. MATERIALS AND METHODS: From April 2000 to June 2005, 21 cases who had distal tibia fracture were treated by interlocking intramedullary nail were analyzed. The duration of follow-up was more than 1 year. We evaluated clinical results by IOWA ANKLE rating system and union time by simple X-ray. Furthermore, we estimated prognostic factor to union time. RESULTS: The bone union was achieved at average 18.5 weeks. At the last follow-up, there was no non-union and infection. Average IOWA ANKLE rating score was 91.3 point. The union time was delayed in open and segmental fracture at initial fracture. And severe soft tissue injury in open fracture revealed bad result. CONCLUSION: We concluded that interlocking intramedullary nail is effective method for treatment of the distal tibial fractures. And, adequate soft tissue management is important to bone healing and clinical outcome.
Ankle
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Follow-Up Studies
;
Fracture Fixation, Intramedullary
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Fractures, Open
;
Iowa
;
Methods
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Soft Tissue Injuries
;
Tibia*
;
Tibial Fractures