The angle of the femoral anteverison has been recognized as an important consideration in the orthopedic Geld. The angle of the femoral anteversion can be measured roentgenographically by 3 methods, such as fluoroscopic, biplanar and axial methods. It is the purpose of this study to investigate the comparative accuracy of the roentgenographic methods determining the angle of the femoral anteversion. The measurements by the fluoroscopic(Rogers), biplanar (Magilligan) and axial (Dunn) methods were compared with the direct measurement of 42 adult dried femora and the measured values were statistically analyzed. The results were as follows: l. Among fluoroscopic, biplanar and axial methods, the biplanar method using Magilligan technique was the statistically reliable method to determine the angle of the femoral anteversion. 2. The axial method showed tendency to underestimate the angle of the femoral anteversion. 3. Though the fluoroscopic method was not so accurate as the biplanar method statistically, the 2 methods showed no difference in the ratio of measurement error within ±5°and ±10° range.
Adult ; Humans ; Methods ; Orthopedics

Congenital kyphoscoliosis is an abnormal curvature of spine that is due to presence of vertebral anomalies which cause an imbalance in the longitudinal growth of the spine. Congenital kyphoscoliosis is often rigid and its correction can be difficult. It is often resistant to conservative treatment and more patients require surgical treatment than those with idiopathic curvature. The indication for the conservative treatment with Milwaukee brace is much limited. Largely Milwaukee brace is a delaying tactic to correct the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 49 patients with congenital scoliosis, kyphosis and kyphoscoliosis who were treated surgically with various methods of preoperative correction, from Jan. 1968 to Dec. 1983, in special reference to new classification, proposed for common application to both kyphosis and scoliosis, and following results were obtained. 1.The average age when scoliosis was observed was 6.9 years, but the average age of surgery was deferred until 15.2 years. 2. The distribution of curve pattems were 1 cervicothoracic, 24 thoracic, 12 thoracolumbar, 7 lumbar and 1 lumbosacral curve in 45 scoliotic curves and 13 thoracic, 13 thoracolumbar and 4 lumbar curves in 30 kyphotic curves. The average degrees of deformity were most severe in thoracolumbar curves both in kyphosis and scoliosis. 3. The new morphological classification, which could be applicable to both kyphosis and scoliosis, was proposed. The type of unsegmented bar with contralateral hemivertebra was most common both in kyphosis and scoliosis. 4. Preoperative average degrees of scoliosis was 58.7 degrees and final correction was 20.6 degrees (35.1%) with loss of comection of 3.7 degrees (6.3%). Preoperative average degrees of kyphosis was 63.7 degrees and final correction was 20.1 degrees (42.5%) with loss of correction of 7.0 degrees (11.0%). 5. The surgical method with anterior and posterior fusion was the best treatment of severe kyphoscoliossis, in the aspect of final correction and loss of correction. 6. The lumbar curve was most amenable to treatment with the best final correction and the least loss of correction.
Braces ; Classification ; Congenital Abnormalities ; Humans ; Kyphosis ; Methods ; Scoliosis ; Spinal Curvatures ; Spine

Congenital scoliosis is a disease characterized by its rigid and progressive curve. It is usually resistant to conservative treatment and early surgical fusion has been reommended. The indication for conservative treatment with brace is much limited but present mainly as a delaying tactic to maintain the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 17 patients (18 curves) with congenital scoliosis who were treated with brace with average follow-up of 4.3years (at least 2 years) from Jan. 1968 to Dec. 1983 and the following results were obtained. 1. The interval from the time when scoliosis was observed to the time of brace application was less than 1 year in 10 patients (58.8%). 2. The average age was 6.6 years ranging from 0.2 years to 14.1 years. The average initial curve was 40.5 degrees. 3. The average final amount of correction was 3.6 degrees (8.7%). 4. The lumbosacral curve gave the best correction. The correction effect of brace treatment was less effective in the thoracic curves. 5. The correction was more effective in the patients younger than 10 years. 6. The shorter the curve, the more correction was obtained. 7. The type of failure of formation gave much more correction than the type of failure of segmentation. 8. The brace treatment was more effective in the patients whose curves were less than 50 degrees in younger age and with the anomaly of failure of formation. Bracing would delay spine fusion until more ideal time even in severe curves or anomalies of failure of segmentation. 9. Spine fusion should be done early regardless of age for progressive curves even with brace treament.
Braces ; Follow-Up Studies ; Humans ; Scoliosis ; Spinal Curvatures ; Spine

Spinal stenosis is a localized narrowing of spinal canal due to strurctural abnormalities. Its symptoms are obscure, and characterized by chronic, poorly localized, bilateral nerve root compression signs. Computerized tomography(CT) has been accepted as almost an absolute diagnostic method for spinal stenosis after its application in the orthopedic field. During the period of 2 years, from March 1982 to March 1984, 26 cases of spinal stenosis were treated surgically after botlt CT scanning and myelography. We obtained following results about advantage of CT scanning in spinal stenosis. 1. Myelography showed following findings: Hourglass defect 9, Complete block 8, Unilateral focal defect 4, Uniform narrowing 1, Mixed 2, Negative finding 2. Myelographic finding was not specific for spinal stenosis and diagnostic accuracy was inferior to CT. 2. The type of spinal stenosis was identified by CT scan finding. Of 26 cases, 21 cases were degenerative spinal stenosis, of which central stenosis was present in 7 cases, and lateral stenosis was present in all cases. The remaining 5 cases were combined type, and both central and lateral stenosis were present in all cases. 3. The diagnostic accuracy,in localizing the level of stenosis was 61.5% by myelography, and 96.2% by CT scan. CT was especially superior to myelography in the localization of the multi-segmental stenosis. 4. CT gives valuable information about extent and degree of stenosis, especially lateral recess stenosis, thus helping the surgeon to decide on the extent of decompressive lamininectomy preoperatively.
Clothing ; Constriction, Pathologic ; Methods ; Myelography ; Orthopedics ; Radiculopathy ; Spinal Canal ; Spinal Stenosis ; Tomography, X-Ray Computed

We reviewed the post-reconstructive results and complications of arthroscopic anterior cruciate ligament reconsbuction using the patellar bone-tendon-bone autograft in 91 patients who underwent the index surgery at least one year ago. The changes of Lysholm knee score, limitation of motion, instability of the reconstructed ACL, musc)e strength, presence of anterior knee pain and other complications were evaluated at final fol- low-up(mean, 2.6 year). The results were as follows. 1. The mean Lysholm knee score was 65.5+-15.5 preoperatively and improved to 88.5+-7.4 postoperatively(p<0.05), 2. Of all, nine(9.9%) complained anterior knee pain. 3. Three patients(3.3%) showed limited range of motion. 4. Five(3.5%) showed instability of reconstructed ACL during the followup. Two were caused by trauma. Ln other three, no definite causes were found. 5. In 23 patients, cybex isokinetic thigh muscle strength test was perfornied preoperatively and at post-up. One year. The strength of quadriceps of the operated side at the angular velocity of 60 degrees per second showed mean 41.7% deficit of the normal side at postoperative one year. 6. Other complications were one case of chronic click sound in motion, and one case of the fracture which occurred at the autograft donor site of the proximal tibia.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Muscle Strength ; Postoperative Complications ; Range of Motion, Articular ; Thigh ; Tibia ; Tissue Donors

Scedosporium prolificans is a fungus that can be found in soil or polluted water. It is mandatory to evaluate Scedosporium prolificans infection in case of injury by soil- contaminated materials. Musculoskeletal infections by Scedosporium prolificans are extremely rare and the clinical manifestations are similar to other bacterial infections. So it is difficult to detect Scedosporium prolificans infection. We report a neglected case with bone and joint infection by Scedosporium prolificans after joint laceration with a broken piece of flowerpot in a 10-year-old boy.
Bacterial Infections ; Child ; Fungi ; Humans ; Joints ; Lacerations* ; Male ; Scedosporium* ; Soil

No abstract available.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Methods

PURPOSE: To analyze and report the analyzed clinical results of meniscal repair. MATERIALS AND METHODS: Thirty-two cases were reviewed after arthroscopic meniscal repair. The meniscal repair was indicated by unstable tears in red-red or red-white zone with the tear size longer than 10mm. The location, pattern of the tear and associated injury were examined respectively, and the clinical results were evaluated with preoperative, postoperative Lysholm score and findings of physical examination. Physical examination was focused on tenderness, click, effusion and McMurray test. Also, a second look arthroscopy was performed in the case of bucket-handle tears and other types with recurring symptoms and positive physical findings. RESULTS: The number of medial meniscus tear was higher than lateral meniscus tear and the were no considerable differences in the number between the right and the left knees. The most common location of tear was the red-red zone tear in 30 cases, and the most common tear pattern was longitudinal tear in 22 cases. The number of bucket-handle tear was nine. The most common associated injury was ACL injury. Acording to clinical assessment, 29 out of 32 cases showed satisfactory results, and the results of 7 out of 9 bucket-handle tears were good. CONCLUSION: An analysis of the clinical results of meniscal repair has been carried out, showing that meniscal repair is regarded as a reliable treatment modality in meniscal tear with proper patient selection.
Arthroscopy ; Knee ; Menisci, Tibial ; Patient Selection ; Physical Examination

The first human meniscal allograft transplantations (MATs) were performed 30 years ago. In the early era, candidates were limited to patients who have favorable joint conditions. MAT is currently indicated for patients with post-meniscectomy symptoms, such as compartmental pain or effusion after a subtotal or total meniscectomy. The current indication for MAT is being expanded to other patients who were not indicated previously. The present article reviews how the indications of MAT have changed over the years.

PURPOSE: This study was performed to evaluate the usefulness of 99mTc-HMPAO-labelled leucocyte scintigraphy for diagnosing prosthetic infection after total knee replacement arthroplasty without the aid of following bone marrow scintigraphy. MATERIALS AND METHODS: The study subjects were 25 prostheses of 17 patients (one man and 16 women, mean age: 65 years) who had total knee replacement arthroplasty. After injection of 99mTc-HMPAO-labelled leucocyte, the whole body planar and knee SPECT images were obtained in all patients. The subjects were classified into three groups according to clinical suspicion of prosthetic infection: Group A (n=11) with high suspicion of infection; Group B (n=6) with equivocal suspicion of infection, and Group C (n=8) with asymptomatic contralateral prostheses. Final diagnosis of infection was based on surgical, histological and bacteriological data and clinical follow-up. RESULTS: Infection was confirmed in 13 prostheses (11 in Group A and 2 in Group B). All prostheses in Group A were true positive. There were two true positives, one false positive and three true negatives in Group B, and six true negatives and two false positives in Group C. Overall sensitivity, specificity, and accuracy for diagnosis of the infected knee prosthesis were 100%, 75% and 88%, respectively. CONCLUSION: 99mTc-HMPAO-labelled leucocyte scintigraphy is a sensitive method for the diagnosis of infected knee prosthesis. However, false positive uptakes even in asymptomatic prosthesis suggest that bone marrow scintigraphy may be needed to achieve improved specificity.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Bone Marrow ; Diagnosis* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Knee ; Knee Prosthesis ; Prostheses and Implants ; Radionuclide Imaging* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon