BACKGROUND: Anatomic anterior cruciate ligament (ACL) reconstruction has been presented as a means to more accurately restore the native anatomy of this ligament. This article describes a new method that uses a double bundle to perform ACL reconstruction and to evaluate the clinical outcome. METHODS: Grafts are tibialis anterior tendon allograft for anteromedial bundle (AMB) and hamstring tendon autograft without detachment of the tibial insertion for posterolateral bundle (PLB). This technique creates 2 tunnels in both the femur and tibia. Femoral fixation was done by hybrid fixation using Endobutton and Rigidfix for AMB and by biointerference screw for PLB. Tibial fixations are done by Retroscrew for AMB and by native insertion of hamstring tendon for PLB. Both bundles are independently and differently tensioned. We performed ACL reconstruction in 63 patients using our new technique. Among them, 47 participated in this study. The patients were followed up with clinical examination, Lysholm scales and International Knee Documentation Committee (IKDC) scoring system and radiological examination with a minimum 12 month follow-up duration. RESULTS: Significant improvement was seen on Lachman test and pivot-shift test between preoperative and last follow-up. Only one of participants had flexion contracture about 5 degrees at last follow-up. In anterior drawer test by KT-1000, authors found improvement from average 8.3 mm (range, 4 to 18 mm) preoperatively to average 1.4 mm (range, 0 to 6 mm) at last follow-up. Average Lysholm score of all patients was 72.7 +/- 8.8 (range, 54 to 79) preoperatively and significant improvement was seen, score was 92.2 +/- 5.3 (range, 74 to 97; p < 0.05) at last follow-up. Also IKDC score was normal in 35 cases, near normal in 11 cases, abnormal in 1 case at last follow-up. CONCLUSIONS: Our new double bundle ACL reconstruction technique used hybrid fixation and Retroscrew had favorable outcomes.
Adult ; Anterior Cruciate Ligament/*surgery ; Bone Screws ; Female ; Femur ; Humans ; Male ; Orthopedic Procedures/*methods ; Prospective Studies ; Tendons/transplantation ; Treatment Outcome ; Young Adult

Chronic neutrophilic leukemia(CNL) is a rare disorder characterized by persistent neutrophilia of mature cell type without evidence of infection, hepatosplenomegaly, elevated neutrophil alkaline phosphatase score and the absence of Philadelphia chromosome We report a typical case of CNL with multiple myeloma(IgG-lambda type) in 68 years old female. Many neutrophils had toxic granule and vacuole. The peripheral blood smear showed neutrophlic leukocytosis(50,940/microliter, neutrophil 94%) with rare immature form. The cytogenetic study showed normal karyotype without Philadelphia chromosome. She was diagnosed as multiple myeloma with paraproteinemia, lytic bone lesion of skull, and immature plasma cells in bone marrow.
Aged ; Alkaline Phosphatase ; Bone Marrow ; Cytogenetics ; Female ; Humans ; Karyotype ; Leukemia, Neutrophilic, Chronic* ; Multiple Myeloma* ; Neutrophils ; Paraproteinemias ; Philadelphia Chromosome ; Plasma Cells ; Skull ; Vacuoles

We performed 15 cases of modified Bristow procedures for recurrent anterior instability of shoulder from january, 1987 to december, 1992 and the following results were obtained. 1. The patient's age at initial dislocation varied from 15 years to 29 years of age. 2. The most common cause of the recurrent anterior instability of shoulder was sport injury(6 cases) and next were traffic accident, hanging with one hand. 3. The average loss of external rotation of shoulder after operation were 10 degrees and internal rotation were 7 degrees. 4. The post-operative complication and recurrence were not observed. 5. End results were excellent in 7 and good in 5 by Rowe's grading system. 6. Strict attention to bone block placement was mandatory and decreased the risk of screw malpo-sition.
Accidents, Traffic ; Dislocations ; Hand ; Recurrence ; Shoulder ; Sports

Usually the condition of ipsilateral fracture of femur and tibia is called floating knee, it is termed applied to the flail knee joint segment. The key point of the treatment is focused to the early restoration of the knee function. We experienced 86 consecutive cases during the period from March 1978 to February 1991 in Yonsei University Wonju College of Medicine. Among them, 51 cases(above 16 years old) were analysed with the mean follow up period of 2.1 years(1.2-5.6 years). The results obtained were as follows: 1. Main cause of these fractures is traffic accident. Among them, the pedestrian accident is more than in-car accident. 2. The cases of open fracture were 13 cases (25.5%) in femur and 31 (60.8%) in tibia. The degree of open fracture was more severe in tibia. 3. There were 2 cases (3.9%) of fat embolism syndrome preoperatively. 4. At an average 25 months follow up after injury, the good and excellent result of the group 1 and 3 was 85.2%, and the group 2 and 4 was 71.4% by Karlström and Olerud criteria. 5. At the last follow up examination, the mean loss of range of motion of the knee was 5.6° in group 1 and 3, 10.9° in group 2 and 4(P < 0.05). 6. The operative treatment of the both side is better than case of one side operation and other side conservative treatment.
Accidents, Traffic ; Clinical Study ; Embolism, Fat ; Femur ; Follow-Up Studies ; Fractures, Open ; Gangwon-do ; Knee ; Knee Joint ; Range of Motion, Articular ; Tibia

The purpose of this study was to investigate the ability of cultured chondrocytes to prevent formation of bony bridge and possibly to repair of the damaged growth plate. Growth cartilage cells were obrained from the new born canine epiphyseal plates and was culture-expanded in high density. It took 14 days until formation of micro mass of cartilage cells which was easily removable from the culture flask. Twenty dogs were divided into two groups: group I (10), the medial side of growth plate of right proximal tibia was destroyed and cultured chondrocytes were homografted into the defect: and group II (10), the medial side of growth plate of right proximal tibia was destroyed and was left as it was. Left leg was served as a control. Serial radiological and histological observation were made until 16 weeks after homografting to determine the growth parrern. Following results were obtained. 1. In group I, 8 of 10 dogs had near normal growth with little angular deformity of the tibia, averaging 8° at post-op 16 weeks. Two dogs had 20° angulation at 16 weeks post-surgery. In contrast in group II, angular deformity was obvious at 4 weeks post-surgery, reaching 31° at 16 weeks post-surgery. 2. In group II, bony bridge was consistently formed on the medial side of the proximal tibia. In group I, the cultured chondrocytes initially appeared to be an amorphous cartiagenous mass, which, however, remained to contribute to matrix formation as time went on. 3. This study showed the ability of cultrued chondrocytes to prevent formation of bony bridge and possibly to repair the damaged growth plate. To prove the effectiveness of homografting of the growth cartilage cells for reconstruction of the growth plat, further studies should be followed.
Allografts ; Animals ; Cartilage ; Chondrocytes ; Congenital Abnormalities ; Dogs ; Growth Plate ; Leg ; Tibia ; Transplantation, Homologous

No abstract available.

No abstract available.
Animals ; Dogs* ; Patellar Ligament*

No abstract available.
Femoral Neck Fractures* ; Femur Neck*

The chondrogenic potential of free autogenous periosteal grafts for osteochondral defects was investigated at the Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine. Five millimeter diameter of circular full-thickness defects were made in patellar groove of both femur in 64 adolescent rabbits and the rectangular periostei, prepared from the proximal tibiae, were placed over the defects of patellar groove and sutured(cambium layer, facing joint surface) and the rabbits were allowed to move actively. A serial gross and histologic examinations of neochondrogenesis were done during 8 weeks. The results were as follows. l. At 2 weeks after operation, neochondrogenesis was hardly seen either in the graft group or in the control group. The defects were partially filled with some fibrous tissue. 2. After 6 weeks of operation, all defects in the graft group(postop 6 weeks and 8 weeks) were filled with hyaline cartilage cells but only 38% (postop 6 weeks) and 44% (postop 8 weeks) of the control group were filled with hyaline cartilage cells. 3. The cartilages, formed at 6 and 8 weeks, were more mature and better than those formed at 4 weeks. 4. The newly formed hyaline cartilage of the graft group filled the defect earlier and were better than those of the control group. 5. The chondrocytes in the newly formed tissue were originated from the cambium layer of periosteal grafts. 6. Free autogenous periosteal grafts can repair a full-thickness defect in a joint surface by producing tissue that resembles articular cartilage grossly and histologically.
Adolescent ; Cambium ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Femur ; Gangwon-do ; Humans ; Hyaline Cartilage ; Joints ; Rabbits ; Tibia ; Transplants

A Epiphyseal injury in children is common following trauma to result in significant and permanent loss of function and growth. We analyzed 24 cases of epiphyseal injuries about the knee inchildren, who were treated in the Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine from Jan. 1980 to Dec. 1987. The results were as follows :1. The sex ratio between male and female eas 2.5: 1, and mean age was 11 years old. 2. Large number of cases were by slip-down, traffic accidents or fall. 3. Epiphyseal injuries about the knee occurred in 12% among the 417 cases of childrens epiphyseal injuries. In point of injury patterns, large number of cases were Salter-Harris type 2 and type 3 injuries in the distal femur and the proximal tibia. 4. They were treated with closed reduction and plaster immobilization in 66%, with operative reduction and internal fixation in 34%. 5. Complications occurred in 6 cases : Knee pain and limitation of motion, angular deformity and limb shorteniing.
Accidents, Traffic ; Child ; Clinical Study ; Congenital Abnormalities ; Extremities ; Female ; Femur ; Gangwon-do ; Humans ; Immobilization ; Knee ; Male ; Sex Ratio ; Tibia