PURPOSE: The purpose of this study was to compare the clinical and radiological results between patients who underwent total knee arthroplasty using the conventional method and the navigation-assisted method. MATERIALS AND METHODS: A retrospective review of was performed on 32 patients (40 knees) who underwent total knee arthroplasty between February 2004 and December 2006 and were followed-up for 8 to 10 years. Mechanical axis deviation, range of motion, radiologic position of the implants, and subjective clinical scores were measured and compared between 20 navigation-assisted total knee arthroplasties and 20 conventional total knee arthoplasties. Change in the values (α, β, γ, and δ angles) from the immediate postoperative period to the last follow-up were also calculated and compared between the two groups. RESULTS: The mean range of motion in the navigation group was improved to 121.8°±16.3° (92°–140°) at the last follow-up, and the Western Ontario McMaster Universities osteoarthritis Index (WOMAC) score was 89.8±5.4 and the Knee Society score (KSS) was 91.5±7.5. The mean range of motion in the conventional group was 112.6°±25.6° (60°–140°) at the last follow-up. The WOMAC score was 84.2±10.6, and the KSS was 81.1±14.3. The α, β, γ, and δ angles of the implants were not significantly changed until the last follow-up. In the comparison between the two groups, only the mean range of motion (p=0.018) and the KSS (p=0.038) showed statistically better results in the navigation group than the conventional group. CONCLUSION: Navigation-assisted total knee arthroplasty showed better KSS and range of motion compared with the conventional group in a cross-sectional study with 8 to 10 years of follow-up results. However, only the KSS showed a significant difference between the two groups by the amount of changes in the clinical and radiological results.
Arthroplasty ; Arthroplasty, Replacement, Knee* ; Cross-Sectional Studies ; Follow-Up Studies* ; Humans ; Knee ; Magnets* ; Methods ; Ontario ; Osteoarthritis ; Postoperative Period ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: The rotational alignment of the femoral and tibial components is closely related to the results after total knee arthroplasty (TKA). In this study, we measured the combined rotational alignment change (ΔCR) after TKA and compared the different influence of symmetric and asymmetric tibial component designs on the combined rotational alignment. MATERIALS AND METHODS: Eighty-four patients (mean age, 67.9 years) were included. A symmetric tibial component was used in 51 knees (group I), whereas an asymmetric tibial component was used in 50 knees (group II). We measured the angles of four anatomical landmarks by using preoperative and postoperative computed tomography images. The combined rotational alignment and the amount of change were calculated. The correlation between the isolated tibial component rotation (ITR) and ΔCR was analyzed by using the Spearman correlation coefficient. RESULTS: The mean ΔCR was −0.1°±6.3° in group I and −4.8°±5.7° in group II after TKA. Excluding the intercomponent rotation, the change was −1.0°±7.3° and −6.7°±6.7° in group I and group II, respectively. A correlation analysis between the ITR and tibial component rotation relative to the tibial tuberosity showed a statistically significant correlation. CONCLUSIONS: The combined lower limb rotational alignment was internally rotated in both symmetric and asymmetric tibial component designs after TKA. The asymmetric tibial component was better than the symmetric tibial component in achieving internally rotated combined lower limb rotational alignment. The internal rotation of the symmetric tibial component relative to the tibial tuberosity tip should fall within 20° to correct the externally deformed lower limb.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Humans ; Knee ; Lower Extremity ; Tibia

PURPOSE: As the number of total knee arthroplasties (TKAs) increases, the incidence of femoral periprosthetic fractures after TKA is also increasing. This review aimed to suggest a new surgically oriented classification system for femoral periprosthetic fractures. METHODS: We investigated the classifications, and current treatment trends for femoral periprosthetic fractures after TKA by means of a thorough review of the relevant literature. RESULTS: Numerous studies reported good results of surgical treatment with modern fixatives including locking compression plates and retrograde intramedullary nails. However, few classifications of femoral periprosthetic fractures reflect the recent developments in surgical treatment. CONCLUSIONS: We recommend that surgical management be considered the first-line treatment for femoral periprosthetic fractures after TKA. Our new classification will help in deciding the surgical treatment option for femoral periprosthetic fractures after TKA.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Classification ; Femur ; Fixatives ; Incidence ; Knee ; Periprosthetic Fractures

No abstract available.

PURPOSE: To evaluate clinical and radiological results of arthroscopically assisted reduction and internal fixation of intra-articular fractures of the tibial plateau. MATERIALS AND METHODS: Between July 2003 and June 2009, we performed arthroscopy and fluoroscopy-assisted reduction and internal fixation for tibia plateau fracture. Our study included 21 patients who had been followed-up for more than 18 months. We used the Knee Society Knee Score (KSS) and Knee Society Functional Score (KSFS) for the clinical evaluation. We used the Rasmussen Radiological Score for the radiological evaluation. RESULTS: At the last follow-up, all 21 cases showed bone union, and the mean range of movement was 115.5+/-8.5degrees. According to the KSS and KSFS, we obtained excellent or good results in 18 cases (85%). We obtained excellent or good results in 19 cases (90%) each by the Rasmussen Clinical Score and Rasmussen Radiological Score, respectively. CONCLUSION: The 2 year follow-up of arthroscopy assisted surgery showed relatively satisfactory results.
Arthroscopy ; Follow-Up Studies ; Humans ; Intra-Articular Fractures ; Knee ; Tibia

STUDY DESIGN: This is a prospective study. PURPOSE: We compared the outcomes of segmental decompression and wide decompression in patients who had multilevel lumbar foraminal stenosis with back pain. OVERVIEW OF LITERATURE: Wide decompression and fusion in patients with multilevel lumbar foraminal stenosis may increase the risk of perioperative complications. METHODS: From March 2005 to December 2007, this study prospectively examined 87 patients with multilevel lumbar foraminal stenosis and who were treated by segmental or wide decompression along with posterior fusion using pedicle screw fixation, and these patients could be followed-up for a minimum of 2 years. Of the 87 patients, 45 and 42 patients were assigned to the segmental decompression group (group 1) and the wide decompression group (group 2), respectively. We compared the clinical and radiological outcomes of the patients in these two groups. RESULTS: There were no significant differences between groups 1 and 2 in terms of the levels of postoperative pain based on the visual analogue scale, the Oswestry Disability Score, the clinical results based on the Kirkaldy-Willis Criteria, the complication rate or the posterior fusion rate. On the other hand, the mean operating times in groups 1 and 2 were 153 +/- 32 minutes and 187 +/- 36 minutes, respectively (p < 0.05). The amount of blood loss during surgery and on the first postoperative day was 840 +/- 236 ml and 1,040 +/- 301 ml in groups 1 and 2, respectively (p < 0.05). CONCLUSIONS: These results suggest that segmental decompression offers promising and reproducible clinical and radiological results for patients suffering from multilevel lumbar foraminal stenosis.
Constriction, Pathologic ; Decompression ; Hand ; Humans ; Pain, Postoperative ; Prospective Studies ; Stress, Psychological

PURPOSE: To evaluate the radiologic, clinical results between who had intertrochanteric fracture, treated with Compression Hip Screw (CHS) and Proximal Femoral Nail Antirotation (PFNA). MATERIALS AND METHODS: We retrospectively reviewed each 36 and 48 patients of intertrochanteric fracture which were treated with CHS or PFNA by one surgeon from January 2005 to June 2009. We evaluated mean operation time, amount of bleeding, radiologic results, and the clinical outcomes with the mobility score of Parker and Palmer, social function scoring system. RESULTS: The mean operation time, amount of bleeding were less in the PFNA group, there were 116.7 min, 486.1 ml for the CHS group versus 87.7 min, 289.6 ml for the PFNA group. The radiologic results were not significantly different. Decrease of mobility score of Parker and Palmer, social function score were similar. Proximal migration of leg screw and perforation of femoral head was 2 case and deep infection was 1 cases in CHS group. CONCLUSION: There were no significant differences that are clinical and radiological results in treatment of intertrochanteric fracture using the CHS and PFNA. But PFNA is less invasive device than CHS, therefore it may be useful device in elderly patients.
Aged ; Femoral Fractures ; Femur ; Head ; Hemorrhage ; Hip ; Humans ; Leg ; Nails ; Retrospective Studies

PURPOSE: To investigate the care patterns for radiation therapy and to determine inter-hospital differences for patients with laryngeal carcinoma in Korea. MATERIALS AND METHODS: A total of 237 cases of laryngeal carcinoma (glottis, 144; supraglottis, 93) assembled from 23 hospitals, who underwent irradiation in the year of 1998 and 1999, were retrospectively analyzed to investigate inter-hospital differences with respect to radiotherapy treatment. We grouped the 23 hospitals based on the number of new patients annually irradiated in 1998; and designated them as group A (> or =900 patients), group B (> or =400 patients and <900 patients), and group C (<400 patients). RESULTS: The median age of the 237 patients was 62 years (range, 25 to 88 years), of which 216 were male and 21 were female. The clinical stages were distributed as follows: for glottis cancer, I; 61.8%, II; 21.5%, III; 4.2%, IVa; 11.1%, IVb; 1.4%, and in supraglottic cancer, I; 4.3%, II; 19.4%, III; 28.0%, IVa; 43.0%, IVb; 5.4%, respectively. Some differences were observed among the 3 groups with respect to the dose calculation method, radiation energy, field arrangement, and use of an immobilization device. No significant difference among 3 hospital groups was observed with respect to treatment modality, irradiation volume, and median total dose delivered to the primary site. CONCLUSION: This study revealed that radiotherapy process and patterns of care are relatively uniform in laryngeal cancer patients in Korean hospitals, and we hope this nationwide data can be used as a basis for the standardization of radiotherapy for the treatment of laryngeal cancer.
Female ; Glottis ; Humans ; Immobilization ; Korea ; Laryngeal Neoplasms ; Male ; Retrospective Studies

PURPOSE: Bilateral traumatic locked posterior dislocations of the shoulder are very rare and there has been no report on the operative treatment for this injury in the Korean medical literature. MATERIALS AND METHODS: We present here a case of bilateral locked posterior dislocations of the shoulders after trauma and this was successfully treated with open reduction and lesser tuberosity transfer on the right shoulder and subscapularis tendon transfer on the left shoulder. RESULTS AND CONCLUSION: Twenty-four months later, the clinical and radiologic results were excellent.
Dislocations ; Shoulder ; Shoulder Dislocation ; Tendon Transfer

PURPOSE: We compared the results of electromagnetic navigation assisted total knee arthroplasty (TKA) with that of conventional TKA from the viewpoint of the postoperative limb alignment and the implant position. MATERIALS AND METHODS: We retrospectively analyzed 115 consecutive total knee arthroplasties that were done between September 2006 and June 2007. There were 65 navigation assissted cases and 50 conventionally implanted cases. We analyzed the postoperative radiologic results, the clinical results over one year follow up after surgery and the range of motion (ROM). RESULTS: The postoperative mechanical axis deviation showed no significant difference between the two groups. However, the tibial zone, as assessed by Kennedy and White's method were at zone C for 60 cases (92%) in the navigation group and for 40 cases (80%) in the conventional group (p=0.01). On the coronal plane, the implant position of the femoral component was 89.4+/-4.1degrees in the navigation group and 87.6+/-4.3degrees in the conventional group (p<0.01), and the implant position of the tibial component was 89.7+/-1.1degrees and 91.9+/-1.8degrees in each group, respectively (p<0.01), and this shows the better result in the navigation group. CONCLUSION: Electromagnetic navigation assisted TKA had similar clinical results on the short-term follow up as compared with conventional TKA. However, it radiologically showed a more satisfactory position of the implant and it displayed superiority in locating the precise position of the femoral and tibial components, and especially on the coronal plane.
Arthroplasty ; Axis, Cervical Vertebra ; Extremities ; Follow-Up Studies ; Knee ; Magnets ; Range of Motion, Articular ; Retrospective Studies