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.

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 ; Femur ; Knee Joint ; Knee* ; Lower Extremity ; Osteoarthritis ; Osteotomy* ; Patient Selection

Acute compartment syndrome of the thigh, which usually occurs in the anterior compartment, is a rare condition. It can have various causes including femur fractures, vessel injury, pseudoaneurysm of the femoral or popliteal artery, and use of anticoagulant. However, there have been few reports of acute compartment syndrome of the thigh without fracture caused by blunt trauma. We report 4 cases of acute compartment syndrome of the thigh without fracture caused by blunt trauma, in which three patients were treated with fasciotomy and a Vacuum-Assisted wound Closure system and the other one had a delayed diagnosis, and eventually underwent above-knee amputation.
Amputation ; Aneurysm, False ; Compartment Syndromes ; Delayed Diagnosis ; Femur ; Glycosaminoglycans ; Humans ; Popliteal Artery ; Thigh

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 ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Open ; Iowa ; Methods ; Soft Tissue Injuries ; Tibia* ; Tibial Fractures

No abstract available.

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 ; Clavicle ; Humans

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 ; Aneurysm, False* ; Clavicle ; Fascia ; Female ; Humans ; Middle Aged ; Muscles ; Rupture* ; Subclavian Artery*

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 ; Femur* ; Follow-Up Studies ; Humans ; Intra-Articular Fractures* ; Knee ; Lower Extremity ; Osteoarthritis ; Prognosis ; Range of Motion, Articular ; Reference Values

PURPOSE: To compare results of minimally invasive plate osteosynthesis using a locking compression plate and a periarticular locking plate in distal femur fractures. MATERIALS AND METHODS: We retrospectively reviewed 31 consecutive femoral fractures who treated by minimally invasive plate osteosynthesis from April 2006 to May 2009. Sixteen patients were treated using a locking compression plate (group A) and 15 patients were treated using a periarticular locking plate (group B). RESULTS: The mean operation time was 78 minutes and 76 minutes (p=0.273), and the mean radiation exposure time was 1.9 minutes and 2.3 minutes (p=0.001) in the group A and B, respectively. The plate bending during operation was performed in 4 cases of group A. The knee range of motion was 117.5degrees and 118.2degrees (p=0.825), and the Lysholm score was 81.3 and 81.8 (p=0.723) in the group A and B, respectively. Schazker criteria showed more than good grade in 93.8% of group A and in 93.3% of group B (p=1.0). CONCLUSION: No significant differences in clinical results were observed between the two groups. However, a lower anatomical compliance was showed in the locking compression plate, and a higher risk of radiation exposure was showed in the periarticular locking plate.
Compliance ; Femoral Fractures ; Femur ; Humans ; Knee ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: To assess the evaluation of prognostic factors according to union time after unreamed femoral nailing. MATERIALS AND METHODS: From Mar. 1998 to Mar. 2002, 53 cases of bone healing were analyzed among the fifty-nine femoral shaft fractures were treated with unreamed femoral nail (AO, UFN) and had been followed for more than 12 months. Clinical bone healing time was analyzed by Kempf's method and were evaluated prognostic factors according to union time. RESULTS: Mean duration of the bone healing time was 18.7 weeks. According to Denker's classification, functional results were seen over satisfactory at all cases. Bone healing time was more faster at the low communition group than high communition group at 18.1 weeks. At the middle portion, bone healing time was fastest. Closed reduction cases were more faster than open reduction cases at 17.9 weeks. Bone healing time was faster that fracture was more close distance from isthmic portion. Bone healing time was not influenced age, isthmic ratio, operation time, associated injury. CONCLUSION: All cases were unioned within 5 months without severe complication. That was seen faster bone healing time, in that low communition, more close distance of fracture from the isthmic portion, closed reduction method.
Classification ; Femur