Rupture of the anterior cruciate ligament is a serious injury that can cause severe degenerative change if untreated, and there are many controversies in its treatment. The authors experienced 126 patients of the anterior cruciate ligament rupture in the Department of Orthpaedic Surgery, Chung-Ang university from May 1985 to December 1992. Among them, we performed 36 anterior cruciate ligament reconstructions using bone-patellar tendon-bone autograft reinforced with Trevira ligament, an assumption that the artificial ligament acts as an internal splint during the vulnerable period of healing. Bone-patellar tendon-bone autograft was passed through the transosseous hole in the tibia, then across the knee and through the isometric path of lateral femoral condyle through a bone tunnel. Thereafter, the Trevira ligament was passed through the same tibial tunnel, but over the top route to the lateral femoral condyle. Of the 36 cases, 28patients (Group I: 15 cases of Mini-arthrotomy,Group II: 13 cases of Arthroscopic technique) with average follow up of 23.5 months (minimum 12 months, maximum 40 months) were analyzed. According to the Mullers criteria, the result were excellent in 12 cases (Group I: 5 cases; Group II: 7 cases), good in 14 cases(Group I: 9 cases ; Group II: 5 cases and fair in 2 cases (Group I: 1 case; Group II: 1 case). On stress roentgenograms by Telos arthrometer, the average difference of anterior displacement between the injured and normal sides were decreased to 2.3mm from average 9.1mm preoperatively (Group I: from 9.3mm to 2.6mm; Group II: from 8.8mm to 2.1mm). And subjectively, there was no difference between the injured and normal sides in 8 cases (Group I: 4 cases, Gruop II: 4 cases).
Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Patellar Ligament ; Rupture ; Splints ; Tibia

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Tears

No abstract available.
Humans

The hamate fracture is very rare condition. The mechanism of fracture may be attributed to direct trauma by rolling down. We have experienced a case of fracture of the body of the hamate bone. It was treated by conservative method. The result was satisfactory with conservative treatment without traumatic arthritis, nonunion, ulnar nerve palsy, flexor digitorum profundus tendinitis & limitation of motion. A case of fracture of the body of the hamate bone is reported with brief review of literature.
Arthritis ; Hamate Bone ; Methods ; Tendinopathy ; Ulnar Neuropathies

No abstract available.

No abstract available.
Carpal Tunnel Syndrome* ; Humans

We investigated the comparative effects of electroacupuncture (EA) with different frequency on the spinal c-fos and inotropic glutamate receptor expression in carrageenan-injected rats. Bilateral EA stimulation with 2, 15 and 120 Hz were delivered at those acupoints corresponding to Zusanli and Sanyinjiao in man via the needles. The inhibitory effects of the EA on the inflammatory process were investigated in the central nociceptive sites by immunohistochemical analysis. Three hours after carrageenan injection, the number of c-fos-like immunoreactive (LI) neurons was significantly increased in all layers of the ipsilateral spinal cord at L4-5 segment. But these immunoreactive neurons were markedly reduced in the spinal gray matter, especially in the superficial laminae, by all kinds of EA stimulation. The number of NMDA (NR-1 and NR-2A) and AMPA receptors (GluR-1, GluR-2/3) -LI neurons was also increased by carrageenan injection. But NR-2A-LI neuron was significantly reduced in superficial laminae of dorsal horn by 2 Hz EA stimulation. While GluR-1-LI neuron of 15 Hz and 120 Hz EA was increased in the nucleus proprius compared with carrageenan-injected group, GluR-2/3-LI neuron of these EA stimulated groups significantly reduced in superficial laminae of dorsal horn. In conclusion, EA treatment can attenuate spinal c-fos expression in carrageenan injected rats and regulates spinal inotropic glutamate receptor expression.
Acupuncture Points ; alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; Carrageenan ; Electroacupuncture* ; Glutamic Acid* ; Horns ; N-Methylaspartate ; Needles ; Neurons ; Rats* ; Receptors, AMPA ; Receptors, Glutamate* ; Spinal Cord

We investigated the comparative effects of electroacupuncture (EA) with different frequency on the spinal c-fos and inotropic glutamate receptor expression in carrageenan-injected rats. Bilateral EA stimulation with 2, 15 and 120 Hz were delivered at those acupoints corresponding to Zusanli and Sanyinjiao in man via the needles. The inhibitory effects of the EA on the inflammatory process were investigated in the central nociceptive sites by immunohistochemical analysis. Three hours after carrageenan injection, the number of c-fos-like immunoreactive (LI) neurons was significantly increased in all layers of the ipsilateral spinal cord at L4-5 segment. But these immunoreactive neurons were markedly reduced in the spinal gray matter, especially in the superficial laminae, by all kinds of EA stimulation. The number of NMDA (NR-1 and NR-2A) and AMPA receptors (GluR-1, GluR-2/3) -LI neurons was also increased by carrageenan injection. But NR-2A-LI neuron was significantly reduced in superficial laminae of dorsal horn by 2 Hz EA stimulation. While GluR-1-LI neuron of 15 Hz and 120 Hz EA was increased in the nucleus proprius compared with carrageenan-injected group, GluR-2/3-LI neuron of these EA stimulated groups significantly reduced in superficial laminae of dorsal horn. In conclusion, EA treatment can attenuate spinal c-fos expression in carrageenan injected rats and regulates spinal inotropic glutamate receptor expression.
Acupuncture Points ; alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid ; Animals ; Carrageenan ; Electroacupuncture* ; Glutamic Acid* ; Horns ; N-Methylaspartate ; Needles ; Neurons ; Rats* ; Receptors, AMPA ; Receptors, Glutamate* ; Spinal Cord

PURPOSE: To evaluate the early clinical results of lumbar microdiscectomy using minimally invasive tubular retractor (METRx-MD system, Medtronic Sofamor Danek, Memphis, TN), and to validate the merits of minimally invasive spinal surgery. MATERIALS AND METHODS: From April, 2003 to April 2004 we retrospectively studied a consecutive series of 45 patients who underwent lumbar microdiscectomy using minimally invasive tubular retractor. In all cases, minimally invasive approach using the tubular retractor were performed with a 2 cm sized paramedian incision. The following data were collected: clinical outcomes, operative time, intraoperative blood loss, need for blood replacement, time needed before ambulation, length of hospital stay, and complications. The clinical outcomes were assessed by the modified MacNab criteria. RESULTS: Minimally invasive tubular microdiscectomy was performed in 45 patients over a 12-month period with an average follow-up of approximately 8 months. The clinical outcomes assessed by MacNab criteria were excellent in 33 patients (73%), good in 10 patients (22%). The average operative time was 63 minutes (range, 35 to 95 minutes). The average blood loss was 62 mL (range, 50 to 110 mL). None of the patients needed blood replacement. With the exception of 2 patients, all patients could walk at the day of surgery. The average hospital stay was 2.3 days. None of the patients had dural tear, wound problem, or other complications. CONCLUSION: Lumbar microdiscectomy using tubular retractor can offer a useful modality for the treatment of lumbar herniated disc with the merits of minimally invasive spinal surgery. Further long-term, randomized, prospective investigations are needed to fully evaluate the impact of this technique.
Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; Length of Stay ; Operative Time ; Wounds and Injuries

In order to provide the basic data about the hip joint arthroplasty, we measured the femoral head diameter, offset and position in normal 150 males and 150 females using a standardized roentgenographic technique that provided views perpendicular to the plane of the femoral neck in which the focus centered on the lesser trochanter of the femur. We obtained 11.4% of magnification rate by comparing the real size of femoral marker with radiologic size. The result of this study are as following: The mean femoral head diameter was 46.4 ±4.1mm in male and 45.1±3.8mm in female. The mean femoral head offset was 39.2±4.8mm in male and 37.8±4.6mm in female. The mean femoral head position was 48.9±3.2mm in male and 47.6±3.6mm in female.
Adult ; Arthroplasty ; Female ; Femur ; Femur Neck ; Head ; Hip Joint ; Humans ; Male