, Jong Oh Kim, Sang Hoon Ko The purpose of this study is the evaluate the diagnostic accuracy of MRI, frequent location of injury site and injury type in meniscal injury, retrospective review of false positive cases.
From September 193 to January 1997 in our hospital, we analyzed a hundred cases of meniscal injury suggested by MRI. And we tried to correct operatively in meniscal injury by arthroscopic or open method of operation.
1)Diagnostic accuracy of MRI was 90%
2)Most common site of meniscal injury was medial meniscus posterior horn(54.4%).
3)Most common injury type was Bucket handle tearing(34.4%).
4)Cause of pitfall in false positive case was most common popliteal tendon sheath(30%).
MRI was effective method on diagnosis of meniscus injury and most common injury was medial meniscus posterior horn, And diagnostic fault was caused by popliteal tendon sheath, lateral inferior genicular artery, truncation artifect, meniscofemoral ligament, transverse geniculate ligament.
, Jong In Han, Jong Hak Kim, Chi Hyo Kim, Guei Yong Lee, Choon Hi Lee, Yeon Jin Cho There are controversies about the analgesic effects of intraaarticular morphine and local anethetics bupivacaine. This study sought to compare the effects of saline with mor-phine, bupivacaine with or without epinephrine, administrated intraarticularly upon pos-toperative pan following arthroscopic knee surgery under general anesthesia.
In a double-blined, randommized manner, 40 patients received one of saline(20ml, n=10), morphine(1mg in 20ml NaCl, n=10), bupivacaine(0.25%, 20ml, n=10), bu-pivacaine with epinephrine(0.25%, 20ml, 200ug of epinephrine, n=10) intaarticularly at the completion of surgery. The pain scores by VAS were determined after 1,2,3,4 and 24 hours after intraarticular administration.
There were no significant statistical differences between four groups in the pain score. The maximal pain scores were 37.5 in control group, 48.0 in morphine group, 33.6 in bupivacaine group postoperative 1 hour and 32.9 in bupivacaine with epinephrine group pos-toperative 2 hours. The pain scores were decreased as the time went by and were minimin as 21.4 in control group, 17.6 in morphine group, 11.2 in bupivacaine group and 12.3 in bu-pivacaine with epinephrine group 24 hour postoperatively.
Though there were no significant statistical significances with those doses, there were tendencies that the bupivacaine group with or without epinephrine had the postoperative analgesic effect rather than control group, and morphine group had a slow onset of analgesic ef-fect. So, we should study to decide the dose or volume of the drugs and appropriate time to evaluate for the anagesic effects after knee arthroscopy further.
Arthroscopy of the knee joint is an essential diagnostic procedure of the knee joint lesions because of its high diagnostic accuracy, simple procedure, high safty and low morbidity. We applied arthroscopy in the diagnosis of 62 patients with pain, swelling, limitation of motion and giving way of the knee joint from Jan. 1987 to Dec. 1991 at Ewha Womans University Hospital. Only 49 patients of these were followed over 6 months and we analysed and compared with clinical diagnosis and rthroscopic findings.
The results were follows :
1) Patients with knee joint lesions were most common in 3rd and 4th decades.
2) Patients with traumatic history were 57.1% (28 patients).
3) Most common lesions were meniscal lesion and most commonly used method of treatment after arthroscopy was meniscectomy.
4) Three patients with internal derangement of knee were diagnosed meniscal injury after arthroscopy.
Many patients disabled the knees by severe rheumatiod and degenerative arthritis have been treated with total knee replacement arthroplasty since 1970. Total knee arthroplasty(TKA) afforded much improvement in pain relief and function. We analyzed the result in 32 knees who were performed TKA at Department of Orthopaedic Surgery. Ewha Womans University Hospital from May 1987 to July 1992.
The results were as follows.
1) There were 25 females and 3 males, their mean age was 53 years old.
2) Preoperative etiology was degenerative arthritis in 20 cases, rheumatoid arthritis in 8 cases and osteonecrosis in 4 cases.
3) Knee joint function by Hospital for Special Surgery(HSS) knee rating score was increased from 55.3 points preoperatively to 87.0 points postoperatively.
4) The tibiofemoral angle was changed from 7.4 degree varus to 5.5 degree valgus.
5) The prosthesis type used were Press Fit Condylar(PFC) in 18 knees. Anatomic Modular Knee(AMK) in 6 knees, Miller-Galante(MG) in 4 knees and Porous Coated Anatomic(PCA) in 4 knees.
6) Complication was only one case of knee due to concomitant postoperative deep infection and skin necrosis.
It has been well known that the knee joint is burdened on motion and weight bearing and structurally, it is more frequently injured than other joints. And ligamentous injuries of the knee joint are frequent, because of the increasing traffics and popularity of sports.
In seems to be important to understand on the mechanism of injury, method of physical examination and treatment of the ligamentous injuries of the knee.
The purpose of this paper is to get accurate diagnosis and proper treatment. Sixty-four cases of ligamentous injuries in patients who were admitted and treated at the Department of Orthopedic Surgery of Ewha Womans University Hospital from March 1989 to February 1992 have been reviewed.
The results of this study were as follows :
1) The ligamentous injuries of the knee were more prevalent in male 2.2 times than female. and frequently occured in second to third decades(65.6%).
2) Traffic accident was the most common causes, and the most frequent associated injuries were fractures.
3) The most frequently ruptured ligment was medial collateral ligament and its most common site of rupture was femolar attachment.
4) Frequently, lateral collateral ligament was detached from the femoral attachment, anterior and posterior cruciate ligaments were ruptured through their substances.
5) There were twelve cases of isolated cruciate ligament injury, four cases were posterior and others were anterior.
6) Excellent or good result was obtained in most cases by both operative and nonoperative treatment.
, Jin Man Wang, Chung Nam Kang, Ki Hong Choi Management of bed-ridden patients with polyarticular rheumatoid arthritis poses a considerable challenge to the orthopaedic surgeon. Current techniques of total joint replacement provide for the potential restoration of joint function in patients previously considered inoperable due to far-advanced joint destruction. Because many patients with far advanced polyarticular rheumatoid arthritis will predictably require more than one total joint replacement before an improved functional status will occur, the question of multiple joint replacement arises. We have had a bilateral total kneereplacement in the chronic polyarticular rheumatoid patient. Three years after the operation, the patient has slight pain and motion of full extension to 90'flexion. Bilateral total knee replacement improved mobility and reduced pain in this patient.
First
Prev
