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Localized Pigmented Villonodular Synovitis in an Unusual Location in the Knee: A Case Report.

Sang Jun SHIM ; Ho Jong RA ; Young Joon CHOI ; Jae Kwang HWANG ; Dae Woon EOM ; Hui Dong KANG

Journal of Korean Orthopaedic Research Society.2015;18(1):38-42.

Localized pigmented villonodular synovitis (LPVNS) is a rare lesion that can affect any joint, although it is most frequently found in the knee. When LPVNS affects the knee, it is usually a single mass of pedunculated appearance. We present a LPVNS occurred from the junction of the anterior horn of the lateral meniscus and the joint capsule in the knee. It detached and then moved at an unusual location, which caused pain, limitation of knee flexion and locking.
Animals ; Horns ; Joint Capsule ; Joints ; Knee* ; Menisci, Tibial ; Synovitis, Pigmented Villonodular*

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Recurred Multiple Intraarticular Synovial Hemangioma of the Knee: Case Report.

Byung Ill LEE ; Byoung Min KIM ; Duk Hwan KHO

Journal of Korean Orthopaedic Research Society.2015;18(1):33-37.

Synovial hemangioma is a rare benign intraarticular tumor. Synovial hemangioma of the knee joint has unspecific symptoms, which are pain, limitation of motion and hemarthrosis, often seen as an internal derangement of the knee. A 24-year-old woman presented with intermittent joint effusion and pain of the left knee joint and physical examination revealed slight atrophy of the quadriceps and tenderness around lateral joint line of knee. The patient was performed arthroscopic surgery due to synovial hemangioma about 17-years ago. Magnetic resonance imaging (MRI) showed the synovial hemangioma from Hoffa fat pad to anterior aspect of lateral meniscus, and thus surgical treatment was planned. Arthroscopic excision was performed and additional lesion was observed in lateral gutter, suprapatellar pouch of the knee. The biopsy confirmed the diagnosis of synovial hemangiomas. After 3 year, the patient was completely asymptomatic and showed no signs of recurrence.
Adipose Tissue ; Arthroscopy ; Atrophy ; Biopsy ; Diagnosis ; Female ; Hemangioma* ; Hemarthrosis ; Humans ; Joints ; Knee Joint ; Knee* ; Magnetic Resonance Imaging ; Menisci, Tibial ; Physical Examination ; Recurrence ; Young Adult

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Mechanism of Ligamentum Flavum Hypertrophy.

Jae Ho YANG ; Young Mi KANG ; Chul Hyun KI ; Sa Hyun SUNG ; Hwan Mo LEE ; Seong Hwan MOON

Journal of Korean Orthopaedic Research Society.2015;18(1):25-32.

Ligamentum flavum (LF) is yellowish ligament tissue connecting the lamina of adjacent vertebra. Degenerative changes in the spine cause the hypertrophy of LF and facet joint and disc bulging and herniation. These changes results in a narrowing of the spinal canal. Neural decompression surgery by removing the hypertrophied lamina, LF and disc pathologies has been considered as successful treatment method in lumbar spinal stenosis. This surgery has showed relatively satisfactory clinical results and has increased life-expectancy in elderly patients. However, issues about post spinal surgery syndrome and re-stenosis after the surgery also have been reported. Because LF is one of the main mechanisms of spinal stenosis, accurate understanding about pathologic mechanism on the LF hypertrophy may suggest alternative treatment methods such as medical treatment or less invasive treatment than surgical decompression can be considered. Hypertrophy of the ligamentum flavum is generated from increase of collagen synthesis, fibroblast proliferation, and fibrosis caused by 1) the expression of growth factors (TGF-beta1 etc.) stimulated by the repeated mechanical tension, 2) inflammatory cytokines from spinal facet joint structure and LF 3) delayed cell death, and 4) inflammatory cytokine from hypertrophied and degenerated LF itself. After the middle ages, gradual and partial inhibition of LF hypertrophy can be expected by administration NSAIDs or selective cyclo-oxygenase-2 inhibitors because these drugs may cause reduction of the increased cytokines. Also, relaxin can be another new treatment material for spinal stenosis by the mechanism of melting hypertrophied LF and reducing synthesis of collagen.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Cell Death ; Collagen ; Cytokines ; Decompression ; Decompression, Surgical ; Fibroblasts ; Fibrosis ; Freezing ; Humans ; Hypertrophy* ; Intercellular Signaling Peptides and Proteins ; Ligaments ; Ligamentum Flavum* ; Pathology ; Relaxin ; Spinal Canal ; Spinal Stenosis ; Spine ; Zygapophyseal Joint

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Treatment of Articular Cartilage Injury Using Mesenchymal Stem Cells.

Sung Ryeoll PARK ; Seok Jung KIM

Journal of Korean Orthopaedic Research Society.2015;18(1):18-24.

Articular cartilage lesions can be a debilitating disease resulting in the development of osteoarthritis (OA). In recent years, mesenchymal stem cell (MSC) strategies combined with the microfracture technique are emerging as a powerful tool for cartilage repair. Even though there are some successful reports of MSCs treatments, many aspects have to be optimized such as best cell source and application method. The interest in this field is growing and randomized controlled trials are needed to show the potential of MSC treatment.
Cartilage ; Cartilage, Articular* ; Mesenchymal Stromal Cells* ; Osteoarthritis

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Surface Characteristics and Biocompatibility of Micro Arc Oxidized Titanium Alloy.

Young Wook LIM ; Eun Sang LEE ; Yong Sik KIM ; Kwang Yun SONG ; Soon Yong KWON

Journal of Korean Orthopaedic Research Society.2015;18(1):9-17.

PURPOSE: The aim of this research was to characterize micro arc oxidized titanium (MAO-Ti), accompanied by biocompatibility test in vivo as well as in vitro in comparison to the different types of surface modification; machined, blasted and plasma spray. MATERIALS AND METHODS: XRD and SEM investigations were performed in order to assess the structure and morphology. Biologic and morphologic responses to the osteoblast cell lines (Saos-2) were then examined, using Promeg(R) proliferation assay, alkalinephosphatase activity, alphavbeta3 integrin expression and cytoskeleton staining (Rhodamine-Phallodine). The analysis of gene expression for osteocalcin and collagen I was done through RT-PCR. RESULTS: MAO-Ti showed more activity on osteointegration and cell differentiation compared to other types of surface modification. CONCLUSION: In summary, MAO-Ti appears to exhibit more favorable biocompatibility than the compared groups in vitro and in vivo as well.
Alloys* ; Cell Differentiation ; Cell Line ; Collagen ; Cytoskeleton ; Gene Expression ; Osteoblasts ; Osteocalcin ; Plasma ; Titanium*

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Ultimate Determination of P.F.C Femoral Prosthetic size in TKR for the Elderly Patients.

Dong Heon KIM ; Sung Hak OH

Journal of Korean Orthopaedic Research Society.2015;18(1):1-8.

PURPOSE: To analyze the clinical and radiologic results after total knee arthroplasties using down-sizing femoral prosthesis for tight fitting in patients over 75 years old. SUBJECTS AND METHODS: The study tracked the histories of 99 elderly patients aged 75 and over who underwent total knee arthroplasties with at least five years of follow-up from January 1st, 2005 to December 31st, 2007. The average age of the 99 patients was 78.58 years, and 17 women an 82 men patients underwent 78 cases of total knee arthroplasties on the right and 77 cases of total knee arthroplasties on the left. The HSS score and VAS scoring systems were introduced for clinical analysis. We compared the results of the width of the radiolucent line in 7 sections around the femoral component, 7 sections around the tibia component and 5 sections in the patella component using the American Knee Society Radiographic Evaluation and Scoring system respectively. RESULT: The average period of postoperative follow-up study was 6.2 years. The average femoral prosthesis size in preoperative measurement was 2.41 while the size selected in surgery was 1.89. The average VAS score decreased from 8.15 in preoperative measurement to 2.85 in postoperative measurement. Clinical significant loosening or dislocation of femoral prosthesis was not observed. Although the radiolucent line was observed in 5 cases, the score was less than 4. CONCLUSION: Total knee arthroplasties using down-sizing femoral prosthesis does not increase osteolysis and dislocation of femoral prosthesis but does reduce pain and help patients return to normal activities. Therefore this study showed that total knee arthroplasties using down-sizing femoral prosthesis helped elderly patients aged 75 and over.
Aged* ; Arthroplasty ; Dislocations ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteolysis ; Patella ; Prostheses and Implants ; Tibia

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Transfer of Metallic Debris from the Metal Surface of an Acetabular Cup to Artificial Femoral Heads by Scraping: Comparison Between Alumina and Cobalt-chrome Heads.

Chong Bum CHANG ; Jeong Joon YOO ; Won Seok SONG ; Jong Won KIM ; Kyung Hoi KOO ; Hee Joong KIM

Journal of Korean Orthopaedic Research Society.2005;8(2):137-143.

PURPOSE: The purpose of the current in vitro study was to evaluate the transfer of metal to both alumina and cobalt-chrome (Co-Cr) heads that were scraped by a titanium alloy surface under different load conditions. MATERIALS AND METHODS: Alumina and Co-Cr heads were scraped by an acetabular metal shell under various loads using a creep tester. Microstructural changes in the scraped area were visualized with a scanning electron microscope and chemical element changes were assessed using an energy dispersive X-ray spectrometry. Changes in the roughness of the scraped surface were evaluated by a three-dimensional surface profiling system. RESULTS: Metal transfer to alumina and Co-Cr heads began to be detectable at a 10~15 kg load, which could be exerted by one-handed force. At loads of 30, 50 kg, fissures occurred on the head surfaces in addition to metal transfer. CONCLUSION: This study reveals that metallic debris was transferred from the titanium alloy acetabular shell to both alumina and Co-Cr heads by minor scraping. When the contact force increased, scratching of the head surface occurred in addition to the transfer of metal. The results of this study suggest that the greatest possible effort should be made to protect femoral heads, regardless of material, from contact with metallic surfaces during total hip arthroplasty.
Acetabulum* ; Alloys ; Aluminum Oxide* ; Arthroplasty, Replacement, Hip ; Head* ; Spectrometry, X-Ray Emission ; Titanium

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Integrin alphavbeta3, alpha5beta1 Effects on Cell Proliferation and Migration in Human Osteosarcoma.

Hyun Guy KANG ; Han Soo KIM ; Kap Joong KIM ; Jun Hyuk KIM ; So Mi SEOUL ; Joo Han OH ; Sang Hoon LEE ; Sun Jong CHOI

Journal of Korean Orthopaedic Research Society.2005;8(2):130-136.

BACKGROUND: We investigate the influence of cell surface adhesion receptor integrin alphavbeta3, alpha5beta1 contributes to proliferation and migration of tumor cell in osteosarcoma for carves out a new treatment model by regulation of integrin roles in human osteosarcoma. MATERIALS AND METHODS: We performed proliferation assay, total 11 cell lines including 7 osteosarcoma cell lines established from patients and 4 osteosarcoma standard cell lines. Murine monoclonal anti-alpha5beta1 and anti-alphavbeta3 (Chemicon International Inc. Temecula, CA) were used for growth inhibition assays. We also performed cell motility assay by using the Boyden chamber to evaluate the effect of integrin mediated cell migration. We used the HOS standard osteosarcoma cell lines and each separates contained serum free media with mouse IgG1 negative control antibody, anti-alpha5beta1 antibody and anti-alphavbeta3 antibody. RESULTS: Proliferation of cells decreased significantly in 10 out of 11 cell lines when blocking with alphavbeta3 or alpha5beta1 respectively. Blocking with anti-alphavbeta3 antibody decreased significantly tumor cell proliferation in 10 cell lines. Among the 10 cell lines, 7 cell lines showed significantly more decrease of proliferation with anti-alphavbeta3 antibody than with anti-alpha5beta1antibody. Blocking with anti-alpha5beta1 antibody decreased significantly tumor cell proliferation in 10 cell lines. Among the 10 cell lines, 3 cell lines showed significantly more decrease of proliferation with anti-alpha5beta1 antibody than with anti-alphavbeta3 antibody. Including statistically not significant 2 cell lines the growth inhibition of osteosarcoma cell lines was more obvious (10 out of 11) in blocking with anti-alphavbeta3 antibody. The migration of cells was significantly decreased when blocked with anti-alpha5beta1 antibody and anti-alphavbeta3 antibody. CONCLUSION: Under the based on the integrin alphavbeta3, alpha5 beta1 are central role on proliferation and migration of osteosarcoma cells, we could be more approach to new therapeutic endeavors with antibody to integrin alphavbeta3, alpha5beta1 molecular target of osteosarcoma.
Animals ; Cell Line ; Cell Migration Assays ; Cell Movement ; Cell Proliferation* ; Culture Media, Serum-Free ; Humans* ; Immunoglobulin G ; Integrin alphaVbeta3* ; Mice ; Osteosarcoma*

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Analysis of RECK (a novel MMP inhibitor) Expression and its Roles as a Biomarker and Evaluation of RECK as a Potential Therapeutic Agent for Osteosarcoma.

Kap Jung KIM ; Han Soo KIM ; Hyun Guy KANG ; Joo Han OH ; Sang Hoon LEE ; Sang Ki LEE ; Mi Ra LEE

Journal of Korean Orthopaedic Research Society.2005;8(2):121-129.

PURPOSE: The purpose of this study is to analyze the mechanism of RECK gene (a novel MMP inhibitor) in human osteosarcoma and evaluation of RECK as a prognostic factor and therapeutic target. MATERIALS AND METHODS: Osteosarcoma cell lines were established from tumor samples of 23 patients who had been treated from March 2003 to April 2004 and 4 standard cell lines (HOS, MG-63, SaOS-2, U-2OS). We isolated the RNA from 27 cell lines and evaluated the expression level of RECK gene using quantitative real time-PCR method. MMP-2 and MMP-9 expression were evaluated by gelatin zymography. Five cell lines were selected which had a statistical significance between RECK gene up-regulation and MMP expression (p=0.01). Then 5 cell lines and 3 standard cell lines were transfected by RECK gene. We compared RECK gene expression with MMP down-regulation between transfected cell lines and non-transfected cell lines. Invasion of transfected cell lines were evaluated by invasion assay using matrigel. RESULTS: RECK genes were expressed in all cell lines and 1 cell line showed especially high expression. In zymography, pro-MMP-2 was expressed in almost cell lines whereas pro-MMP-9 was rarely expressed. RECK gene expressions were increasingly high and MMP expressions were low in transfected cell lines via zymography. Transfected HOS cells decreased invasiveness in matrigel invasion assay and showed small number of migrated cells. It had a statistical significance (p<0.01). CONCLUSION: It is expected that down-regulation of MMP by RECK gene expression can be used as a biologic marker. It can be a new therapeutic strategies and valuable prognostic factors in treating osteosarcoma.
Biomarkers ; Cell Line ; Down-Regulation ; Gelatin ; Gene Expression ; Humans ; Osteosarcoma* ; RNA ; Transfection ; Up-Regulation

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Result of Transplantation of Chondrocytes and Periosteum-Derived Cells for Long-Bone Growth Plate Injuries of the Rabbits.

Hui Taek KIM ; Dong Joon KANG ; Wang Jun KIM ; Hee Kyung CHANG ; Chong Il YOO

Journal of Korean Orthopaedic Research Society.2005;8(2):111-120.

PURPOSE: To study the effectiveness of chondrocyte and periosteum-derived cell transplantation in preventing bar formation in growth plate injuries. MATERIALS AND METHODS: Thirty immature rabbits were grouped according to site of growth plate damaged (distal femur or proximal tibia on the medial side) and type of cell and material inserted (chondrocytes plus agar, periosteum-derived cells plus agar, periosteum-derived cells plus Gelfoam, agar alone, or Gelfoam alone). Radiograms were taken for 16 weeks to measure the changes in varus angle of the distal femur and proximal tibia. Transformation of inserted cells was observed histologically. RESULTS: Rabbits inserted with agar alone showed more severe genu varum compared to those inserted with chondrocytes plus agar. Rabbits inserted with periosteum-derived cells plus agar or Gelfoam showed similar deformities compared to those inserted with agar or Gelfoam alone. Some inserted periosteum-derived cells began transformation into chondrocytes. All rabbits showed gradual bar formation and ultimate fusion of the growth plate. CONCLUSION: Cell-based therapy of growth plate injury still has obstacles to overcome. Further study will be required on how to maintain the inserted chondrocytes, or chondrocytes differentiated from the inserted periosteum-derived cells, and to prevent them from changing into osteoid formation cells.
Agar ; Cell Transplantation ; Chondrocytes* ; Congenital Abnormalities ; Femur ; Gelatin Sponge, Absorbable ; Genu Varum ; Growth Plate* ; Rabbits* ; Tibia ; Transplants

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