The results of unicompartmental knee arthroplasty are still controversial. The purpose of this study is to evaluate the clinical results of three different component systems of unicompartmental knee arthroplasties. From December 1982 to January 1996, 106 unicompartmental knee arthroplasties were performed. There were 13 Modular II(group I), 47 Microloc(group II) and 46 Allegretto(group III) unicompartmental knee arthroplasties. Average follow-up period was 7 years 1 month. At the last follow-up, average knee score of Hospital for Special Surgery(HSS) was 92 points and average tibiofemoral angle was valgus 3.5 degrees. Among three groups, there was no significant difference in knee score of HSS and tibiofemoral angle. Twelve knees(11%) in all three groups have required revision. The causes of revision were six implant wears(all in group II), five implant loosenings(one in group I and four in group III) and one deep infection(in group II). In conclusion, the results of unicompartmental knee arthroplasty at average 7.1 years follow-up period were satisfactory. High incidence of insert wear in Microloc unicompartmental knee arthroplasty(group II) might be due to thin polyethylene insert supported by metal backed tibial tray.
Arthroplasty* ; Follow-Up Studies ; Incidence ; Knee Joint ; Knee* ; Polyethylene

The suprapatellar plica is a remnant of the embryonic septum separating the suprapatellar pouch from the knee joint. Complete type of suprapatellar plica is rarely reported and its clinlical significance is controversial. The purpose of this study is to verify the complete type of suprapatellar plica as an important cause of anterior knee pain and to evaluate the clinical results after arthroscopic excisien of it. From September 1991 to April 1997, we studied prospectively 54 patients, 90 knees which were diagnosed as cornplete type of suprapatellar plica preoperatively. The mean age was 32 years (15-57 years) and sex distribution was 14 males and 40 females. For the preoperative diagnosis, we checked clinical symptom, past history, physical finding and plain X-ray routinely and performed bone scan, double contrast arthrogram and MRI, if necessary. All patients complained vague anterior knee pain at standing, sitting, stair climbing and exercise for long times. All 90 knees were examined arthroscopically. Among them, 80 knees had complete type of suprapatellar plica and remaining 10 knees had other findings. After all, positive predictive value of preoperative diagnosis for complete type of suprapatellar plica was 89%. Among 36 patients diagnosed as bilateral preoperatively, 33 patients(92%) were confirmed as bilateral in arthroscopic examination. After arthroscopic excision of plica, clinical results were total relief of pain in 19 knees(24%), improvement in 55 knees(69%), no change in 6 knees(7%) and none of worsening. In conclusion, complete type of suprapatellar plica should be considered as an important cause of anterior knee pain especially which is vague, intermittent and bilateral.
Diagnosis ; Female ; Humans ; Knee ; Knee Joint ; Magnetic Resonance Imaging ; Male ; Prospective Studies ; Sex Distribution

Ligament injuries of the knee joint are very common among competitive athletes. Acrurate assessment ot the nature of these injuries is a prerequisite for appropriate therapy. The purpose of this study is to evaluate the significance of MRI findings in assesing the status of ACL tear and associated injuries. 31 cases of ACL injuries were examined and reconstructed arthroscopically from Jan. 1997 to Sep. 1997 at Kyung Hee University Hospital. 1n all cases, we reviewed preoperative physical and MRI findings and performed postoperative radiologic assessments. Results were as follows; 1. Lachman test and Pivot shift test were positive in all 31 cases but anterior drawer test was positive in 29 case,s. 2. In MRI findings, 24 cases were interpretated as complete ACL tear and / cases as inccomplete ACL tear. But these 7 cases were confirmed as complete tear in mthroscopic exanunation with careful probing of ACL fiher. 3. MRI showed associated meniscal injuries in 19 cases(61%)-14 cases(74%) at medial meniscus, 5 cases(26%) at lateral meniscus. All cases were confirmed arthroscopically. In conc1usion, physical findings are more reliable than MRI findings in diagnosing the complete ACL tear and deciding the ACL reconstruction. But MRI findings are very helpful to assess the associated injuries and plan the treatments.
Anterior Cruciate Ligament ; Athletes ; Equidae ; Humans ; Knee Injuries ; Knee Joint ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial

No abstract available.
Posterior Cruciate Ligament*

The PFC (Press Fit Condylar) knee was first implanted clinically in 1984 with retention of posterior cruciate ligament. Thereafter PFC modular version had been developed at 1988 with option of posterior cruciate ligament substitution and minor design changes. We classified the 170 patients, 252 knees which underwent the PFC total knee arthroplasty in the period from January 1988 to May 1995 into three groups. In group I, 62 patient. Had 93 total knee arthroplasties with insertion of the original PFC total knee prosthesis with retention of posterior cruciate ligament from January 1988 to October 1991. In group Iia, 51 patients had 74 total knee arthroplasties with insertion of the modular PFC total knee prosthesis with retention of posterior cruciate ligawient from November 1991 to May 1995. In group III, 57 patients had 85 total knee arthroplasties with insert.ion of the modular PFC total knee prosthesis with substitution of posterior cruciate ligament from November 1991 to May l995. Average follow-up periods were 7 years 5 months in group I and 3 years 2 months in group Iia and Ilb. Clinical and radiographic results were similar among the group I, Iia and llb except slight better scores in group Iia and Iib than group I, even though group IlI and IlI had short follow-up periods, Postoperative implant wear was developed at 5 knees in group I, 1 knee in group Iia and not developed in group Ilb. Implant loosening was developed at 1 knee only in group 1. Revisional arthroplasty was performed to 7 knees in group I, 1 knee in group Iia and not in group 1Ib. In conclusion, posterior cruciate ligament substitution group had no difference in functional results with the retention group. In the problem of implant wear, posterior cruciate ligament substitution group was superior to the retention group but similar in loosening.
Arthroplasty* ; Follow-Up Studies ; Humans ; Knee Prosthesis ; Knee* ; Posterior Cruciate Ligament ; Postoperative Period

PURPOSE: To compare the results of posterior cruciate ligament reconstruction by open and arthroscopic method. MATERIALS AND METHODS: From 1995 to 1997, 18 reconstructions of posterior cruciate ligament were performed. Group 1 (open method) was composed of 9 cases and group 2 (arthroscopic method) was consisted of 9 cases. After 21-month follow-up, The two groups were compared by clinical and radiologic methods. RESULTS: Clinically, Lysholm knee score was 80 points in group 1 and 83 points in group 2 after operation. Post operative results by Hughston's criteria were good in 5, fair in 2 and poor in 2 cases (group 1) and good in 6, fair in 2 and poor in 1 cases (group 2). Radiologically, post operative average of posterior drawer stress view was 5.2 mm (group 1) and 5.0 mm (group 2). Almost double the operation time was taken to reconstruct posterior cruciate ligament by arthroscopic method than open method. There were technical errors in 2 cases performed by arthroscopic method. CONCLUSIONS: The results of both methods had no significant difference. We think that the reconstruction of PCL using patellar tendon by open method is a recommendable treatment method together with arthroscopic method, if the merits or demerits of both methods are considered carefully. But more long-term follow-up is necessary to compare the results of PCL reconstruction by open and arthroscopic methods.
Follow-Up Studies ; Knee ; Patellar Ligament ; Posterior Cruciate Ligament

Screw fixation of the tibial component offers advantages in initial fixation in cementless total knee replacement. But the high incidence of screw related osteolysis was reported. The purpose of this study is to evaluate clinical results of cementless total knee replacement and to look for radiographic changes at the screw-bone interface. From January 1988 to December 1991, primary cementless total knee replacements with Miller Galante I (Zimmer, Warsaw. IN) were performed to 53 knees at Kyung Hee university hospital. Among them, 21 cases which could be followed-up for more than 4 years were studied retrospectively about the clinical and radiographic results. The mean follow-up period was 5.5 years(ranged from 4.2 years to 8 years). At the last follow-up period, knee scores of Hospital for Special Surgery were improved from mean 56 points to 90 points and the range of motion from 72 degrees to 110 degrees. In the last follow-up radiographs, osteolysis around screw was classified as linear(type I ), cystic(type II ) and cavitary(type III ) according to the width of the lucency around screws. Among 21 cases, radiographic findings of osteolysis around screw were detected in 10 cases but not in 11 cases. But clinical results were similar between these two groups. Among the total 84 screws(4 screws in each case), 21 screws(25%) showed screw related osteolysis typed as I in 13 screws(15.4%), II in 4 screws(4.8%) and III in 4 screws(4.8%). Among the 13 cases that followed-up more than 6 years, 20 screws(38%) showed screw related osteolysis typed as in 11 screws(21.2%), I in 5 screws(9.6%) and II in 4 screws(7.8%). The most frequently involved site of screw was anteromedial(33.3%). In conclusion, after mean 5.5 year follow-up, the clinical results were satisfactory but the development of osteolysis around screw might be an indicator of the implant failure.
Arthroplasty, Replacement, Knee* ; Follow-Up Studies ; Incidence ; Knee ; Osteolysis* ; Range of Motion, Articular ; Retrospective Studies

STUDY DESIGN: A prospective study OBJECTIVES: To analyze the serial results of selective nerve root blocks in herniated lumbar disc patients. LITERATURE REVIEW SUMMARY: To our knowledge there has been no study demonstrating the serial efficacy of root blocks for patients with a herniated lumbar disc only. MATERIALS AND METHODS: Selective nerve root blocks were performed in 36 patients who had a lumbar disc herniation only, with radiculopathy, between November 2002 and April 2003. The diagnoses were made by CT or MRI, which agreed with the symptoms and physical examinations. There were 31 men and 5 women, with a mean age of 28.2 years. The mean interval between the onset and procedure was 7.6 weeks, ranging from 1 to 26 weeks. Mono- and double-segment injections were used in 18 cases, respectwely. The straight leg raising angle, visual analogue pain scale, and motor and sensory functions were investigated before, immediately, 2 days, and 1 and 3 months after the procedure. RESULTS: The mean straight leg raising angle improved significantly, from 28+/-9 degrees to 53+/-18 degrees, immediately, and was maintained until 3 months after the procedure (P<0.001). The visual analogue pain scale was also improved, from 4.6+/-0.9 to 2.0+/-1.5, immediately, and was maintained until 3 months after the procedure (P<0.001). Two of ten patients with motor weakness, and six of eighteen with sensory deficit were improved. There was no procedure related complication; however, surgical treatment was performed in two patients who showed no improvement until 3 months. CONCLUSIONS: Selective nerve root block is a safe and effective treatment method to obtain a rapid and remarkable improvement of radiculopathy in herniated lumbar disc patients.
Diagnosis ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Pain Measurement ; Physical Examination ; Prospective Studies ; Radiculopathy ; Sensation

STUDY DESIGN: A prospective study OBJECTIVES: To analyze the serial results of selective nerve root blocks in herniated lumbar disc patients. LITERATURE REVIEW SUMMARY: To our knowledge there has been no study demonstrating the serial efficacy of root blocks for patients with a herniated lumbar disc only. MATERIALS AND METHODS: Selective nerve root blocks were performed in 36 patients who had a lumbar disc herniation only, with radiculopathy, between November 2002 and April 2003. The diagnoses were made by CT or MRI, which agreed with the symptoms and physical examinations. There were 31 men and 5 women, with a mean age of 28.2 years. The mean interval between the onset and procedure was 7.6 weeks, ranging from 1 to 26 weeks. Mono- and double-segment injections were used in 18 cases, respectwely. The straight leg raising angle, visual analogue pain scale, and motor and sensory functions were investigated before, immediately, 2 days, and 1 and 3 months after the procedure. RESULTS: The mean straight leg raising angle improved significantly, from 28+/-9 degrees to 53+/-18 degrees, immediately, and was maintained until 3 months after the procedure (P<0.001). The visual analogue pain scale was also improved, from 4.6+/-0.9 to 2.0+/-1.5, immediately, and was maintained until 3 months after the procedure (P<0.001). Two of ten patients with motor weakness, and six of eighteen with sensory deficit were improved. There was no procedure related complication; however, surgical treatment was performed in two patients who showed no improvement until 3 months. CONCLUSIONS: Selective nerve root block is a safe and effective treatment method to obtain a rapid and remarkable improvement of radiculopathy in herniated lumbar disc patients.
Diagnosis ; Female ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Pain Measurement ; Physical Examination ; Prospective Studies ; Radiculopathy ; Sensation

PURPOSE: The purpose of this study was to provide the basic data for the anatomy of distal femur by real measurement, to determine the morphologic fit between the distal femur of Koreans and the femoral prostheses in total knee arthroplasty. MATERIALS AND METHODS: For 173 knees of 117 patients who underwent total knee arthroplasty, we measured the mediolateral width and the anteroposterior height of the distal femur during operation. RESULTS: The average mediolateral width of the distal femur was 68.4+/-4.3 mm, and the average anteroposterior height of the medial and lateral condyle were 59.0+/-4.7 mm and 60.8+/-4.0 mm respectively. the distal femurs of Koreans are smaller on average than the femoral prostheses used in Korea. The average ratio of height to width of the distal femur is 0.86+/-0.07, but the ratios of the five different kinds of femoral prostheses were not constant. So discrepancy between the ratio of the distal femur and the femoral prosthesis results in poor bony coverage. CONCLUSION: A more adequate femoral prosthesis is required to improve the compatibility to the distal femur. These results should contribute to the development of new model of femoral prosthesis for Koreans.
Arthroplasty* ; Femur* ; Humans ; Knee* ; Korea ; Prostheses and Implants*