PURPOSE: This study was performed to find out whether tibial bone defect preceeding the surgery has an effect on the outcome of patients who have undergone total knee replacement therapy with an evaluation period of more than five years. MATERIAL AND METHOD: Osteoarthritis patients who were treated with total knee replacement and evaluated for more than 5 years were selected, of which 42 patients were with tibial bone defects, and 21 without. Clinical evaluation were made on the basis of pre- and post-operative Knee Society Knee Score and Functional Score, radiological evaluation using the American Knee Society Score. and range of motion, tibio-femoral angle, subjective satisfaction, complication were evaluated. RESULTS: Knee fuction score and subjective satisfaction of the two groups showed significant improvement after the surgery, but comparison between the two was statistically insignificant. Radiological evaluation showed radiolucency in zone 1 and 2 of tibia in the majority of both groups, but dissociation of the inserted device was not shown. CONCLUSION: In the cases of tibial bone defect, bone cement, screw fixation enforced with autograft, and wedge metal insertions can be considered to be effective in treating patients by total knee replacement surgery.
Arthroplasty, Replacement, Knee* ; Autografts ; Humans ; Knee ; Osteoarthritis ; Range of Motion, Articular ; Tibia

Background: Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). Methods: From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. Results: In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9± 14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, –1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy. Conclusion This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).