No abstract available.
Ankle*

Degenerative arthritis of the knee joint is one of the main causes of disability in middle-aged persons. This paper is planned by the necessity of objective information upon changes of tibio-femoral angle according to weight bearing in patients with degenerative arthritis of the knee joint. The authors studied the tibio-femoral angle in 29 cases of degenerative arthritis of the knee ranging fmm 5th to 6th decades of age, and compared with 27 cases of the control group, in the Dept. of Orthopedic Surgery, S.N.U.H. fmm Mar. 1983 to May 1984. The following observations were obtained: 1. In patients with degenerative arthritis of the knee, changes of the tibio-femoral angle according to weight bearing were +2.2±1.94 in 5th decade, +2.3±2.02 in 6th decade. 2. Compared to control group, the degenerative arthritis group showed a significant varization with weight bearing. 3. It was seemed that the weight bearing radiography is essential in diagnosis and treatment of degenerative arthritis of the knee joint.
Diagnosis ; Humans ; Knee ; Knee Joint ; Orthopedics ; Osteoarthritis ; Radiography ; Weight-Bearing

Nineteen patients (twenty knees) with degenerative arthritis of knee treated by arthroscopic curettage were reviewed. Of the nineteen patients, there were eighteen females and one male ranging in age from 49 to 68 years (mean, 57 years). The mean follow up period was 18.2 months (range, 12 months to 21 months). Simple standing roentgenorgram and 99m-Tc bone scintigraphy were used to select the patients with medial compartment involvement only, less than 5 degree of varus deformity and sparing of patello-femoral joint. Knee scoring by Hospital for Special Surgery Formula showed improvement from the preoperative average 68 points to postoperative average 89.6 points (21.6 points increase) and 84.1 points (16.1 points increase) at 6 months and one year respectively. Arthroscopic curettage of knee, if done early in degenerative arthritis, not only can shorten hospital days and immobilization period but also can defer other major surgical treatments by promoting natural healing process and symptomatic relief.
Congenital Abnormalities ; Curettage ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Joints ; Knee ; Male ; Osteoarthritis ; Radionuclide Imaging

There have been several reports that total knee arthroplasty(TKA) was most likely to survive successfully if the coronal tibiofemoral angle was close to 7 degree of valgus, the accepted normal. In order to know whether the postoperative coronal tibiofemoral angle influences the result of total knee arthroplasty, we examined the 152 TKA cases in 106 patients which had been performed at Department of Orthopaedic Surgery, Seoul National University Hospital from Jan. 1987 to Dec. 1991. In our series the average follow-up period was 31 months(range, 13 months to 75 months). Coronal tibiofemoral angles of all cases were checked on weight bearing anteroposterior plain X-rays and were divided into three groups(less than valgus 2° ; valgus 3° to 7° ; greater than valgus 8°). All cases were analyzed on the knee score of Hospital for Special Surgery and the American Knee Society total knee arthroplasty roentgenographic evaluation and scoring system and the cases with radiolucent lines wider than 2mm were checked. Three groups were analyzed comparatively with statistical means(Wilcoxon signed rank test, X² test). There were no significant differences in the clinical results of total knee arthroplasty according to the postoperative coronal tibiofemoral angle. Lateral subluxation of the patella occurred more frequently when the postoperative coronal tibiofemoral angle was above valgus 8°. In the tibial components of group lesser than valgus 2°, the frequency of radiolucent lines wider than 2mm was higher than those of other groups, but its significance should be examined through long term follow-up.
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Patella ; Seoul ; Weight-Bearing

Although long-term studies of total knee arthroplasty(TKA) have confirmed reliable relief of pain and maintenance of function, survivorship at nine to ten years has been inconsistent with late component loosening being the most frequent mode of failure. Tibial component failure has been more frequent than failure of the femoral or patellar component in most TKA series. Encouraged by the early results of porous-ingrowh femoral and patellar components, and aware of retrieval studies showing poor bone ingrowth into tibial components, the “hybrid” method of fixation with an uncemented femoral component and a cemented tibial component, has been introduced and incorporated the potential advantages of both traditional fixation techniques. Between January 1987 and December 1991, forty-five “hybrid” TKAs(group I) were performed in degenerative arthritis and evaluated retrospectively in comparison with the results of nineteen noncemented porous-coated TKAs(group II) in degenerative arthritis. The average follow-up period was 31 months(range, 14 to 60 months) in group I and 26 months(range, 13 to 63 months) in group II. Using the knee rating scale of the Hospital for Special Surgery and the American Knee Society Roentgenographic Evaluation and Scoring System, clinical and radiological comparative study between two groups was performed. Pain scores, range of motion and HSS knee scores improved in both groups, but there was no significant difference between group I and group II(p>0.05). In both groups, the scores of radiolucent lines were significantly higher in zone 1 and 4 of A-P roentgenograph of the tibial component than in other zones(p < 0.05). The tibiofemoral angle was corrected from varus 2.7° to valgus 5.8° in group I and from varus 3.4° to valgus 4.6° in group II. There was no significant differences in component position and scores of radiolucnet lines between group I and group II. In conclusion, there were no significant differences in clinical and radiological results between the “hybrid” and the cementless groups. Results of this study suggest that both the hybrid fixation and the comentless techniques can reliably provide satisfactory clinical and radiological results in properly selected degenerative arthritis patients. But the final outcomes of this study need further evaluation through long term follow-up.
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Methods ; Osteoarthritis ; Range of Motion, Articular ; Retrospective Studies ; Survival Rate

The authors reviewed 85 knees in 59 patients(9 males, 50 females) who had preoperative flexion contracture(FC) greater than 20° and taken total knee arthroplasty(TKA) at the Seoul National University Hospital from Jan.1987 to Dec.1992. We reviewed the surgical methods according to preoperative FC, changes of postoperative FC and range of motion, and clinical and radiologic findings. In our series, 48 knees were degenerative arthritis(average FC: 26°), 34 knees, rheumatoid arthritis(average FC: 40°)and 3 knees, others(average FC:28°). The average follow-up period was 2 years(range, 1 to 4(+8) years). Seventy three knees with FC less than 45 (Group I)had been treated with TKA accompanied with adequete soft tissue release, removal of osteophyte and appropriate bone resection. Eleven knees with FC greater than 50° (Group II) had been treated with skin traction followed by TKA. One knee with 65° of FC(Group III)was treated with posterolateral and posteromedial release including tendon lengthening at first, and then TKA in second stage. Preoperative FC was significantly greater in RA group than in DA group. Flexion contracture improved until postoperative 3 years in DA group and improved until postoperative 2 years and slightly deteriorated after then in RA group, but statistically insignificant(p>0.05). There was no difference of FC at postoperative 2 weeks and final follow-up between Group I and II. Range of motion improved until postoperative 2 years in DA group significantly(p < 0.05). In RA group, range of motion improved until postoperative 2 years(p>0.05) and deteriorated after then(p < 0.05). With TKA, range of motion increased significantly in both Group I and II and there was no difference of range of motion between Group I and II at final follow-up. Postoperative HSS score and pain score improved in DA and RA groups significantly, and final HSS score with greater in DA group than RA group(p < 0.05). Preoperative HSS score and pain score of Group I were significantly higher than those of Group II, but final follow-up, there was no difference between two groups. There was no correlation between final FC and HSS score. There was no difference in score of radiolucency between two groups in which final FC was greater and lesser than 10°. We thought that in knees with fixed flexion contracture, successful correction of moderate to severe flexion contracture and satisfactory result of total knee arthroplasty can be achieved by adequate soft tissue release, appropriate bone resection, and/or preoperative management.
Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteophyte ; Range of Motion, Articular ; Seoul ; Skin ; Tenotomy ; Traction

The purpose of this study is to compare the biologic properties of tendon to hone healing and hone to hone healing in knee ligament reconstruction. The lateral 4mm of patellar tendon which was detached from its tihial insertion site either subperiostcally(group I) or with a bone block(group II) was implanted and fixed using pullout method to the proximal tihia. Ten rabbits were killed at each of four time periods (two, four, eight and twelve weeks after the implantation), and the histological and biomechanical characteristics of thc graft healing sites were evaluated. Serial histological analysis of tendon to hone healing group revealed organization of the healing site similar to normal tendon to hone attachment by twelve weeks, while hone to bone healing group demonstrated direct hony union by eight weeks. The tension failure test for the patellapatellar tendon graft - tihia complex revealed that group II had significantly higher values than group I at four and eight weeks. The findings ot this study demonstrated that bone to hone healing has more rapid process than tendon to hone healing, although no significant difference was noted once the healing has matured. We can suggest lhat the duration and extent of postoperative protection of the knee for pntients who had a reconstruction of a ligament using hone - lendon autograft should be longer and higher than lor patients who had a reconstruction using hone - tendon hone autogralf.
Autografts* ; Dronabinol ; Humans ; Knee ; Ligaments ; Patellar Ligament* ; Rabbits* ; Tendons* ; Transplants

No abstract available.
Synovitis, Pigmented Villonodular*

No abstract available.
Arthroplasty* ; Knee*

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Knee*