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대한슬관절학회> Knee Surgery & Related Research(구 대한슬관절학회지)> Treatment of Osteochondritis Dissecans of the Knee with Autologous Iliac Bone Graft and Hyaluronic Acid Scaffold

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Treatment of Osteochondritis Dissecans of the Knee with Autologous Iliac Bone Graft and Hyaluronic Acid Scaffold

Jaime Hinzpeter , Alvaro Zamorano , Maximiliano Barahona , Pablo Campos
  • : 대한슬관절학회
  • : Knee Surgery & Related Research(구 대한슬관절학회지) 31권2호
  • : 연속간행물
  • : 2019년 06월
  • : 143-146(4pages)
Knee Surgery & Related Research(구 대한슬관절학회지)

DOI


목차

Case Report
Discussion
Conflict of Interest
References

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Osteochondritis dissecans (OCD) is a condition that corresponds to an idiopathic focal lesion affecting the subchondral bone with possible compromise of the stability of the adjacent cartilage. Treatment depends on the size of the lesion, cartilage stability, and the physeal status. The case reported is about an 18-year-old male patient who complained of suffering from knee pain for a period of ten months. Magnetic resonance imaging (MRI) revealed a lesion of 2 cm2 in the medial femoral condyle that compromised the subchondral bone, compatible with OCD. He underwent surgery that consisted of filling the subchonral defect with an iliac crest autograft and sealing the defect with a hyaluronic acid scaffold. At the 12-month follow-up, the MRI shows complete healing and the patient has resumed sports activities. Management with autologous iliac crest graft and hyaluronic acid scaffold represents an effective alternative treatment for OCD.

UCI(KEPA)

I410-ECN-0102-2019-500-001597146

간행물정보

  • : 의약학분야  > 정형외과학
  • : KCI등재
  • :
  • : 월간
  • : 2234-0726
  • : 2234-2451
  • : 학술지
  • : 연속간행물
  • : 1989-2021
  • : 1270


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1Tibial-graft fixation methods on anterior cruciate ligament reconstructions: a literature review

저자 : Vitor Luis Pereira , João Victor Medeiros , Gilvan Rodrigues Silva Nunes , Gabriel Taniguti De Oliveira , Alexandre Pedro Nicolini

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-8 (8 pages)

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Introduction: Anterior cruciate ligament (ACL) reconstruction is the most performed orthopedic surgical procedure.
The result of ACL reconstructions depends on multiple technical variables, including tension to be applied to the graft for fixation, knee-flexion angle during fixation and the type of fixation to the bone.
Objective: To carry out a survey of the literature with the best evidence on these themes.
Methods: Literature review about methods of tibial-graft fixation in ACL reconstructions - tension applied at the time of fixation, type of graft fixation, and knee-flexion degree during tibial fixation.
Results: Thirty studies on the selected topics were found. Most studies point to graft-tension levels close to 90 N to obtain the best results. Regarding the knee-flexion angle, multiple studies suggest that fixation at a 30° angle would bring superior biomechanical advantages. Regarding the type of implant for fixation, it is not possible to affirm the superiority of one method over another in clinical outcomes.
Conclusions: There is no consensus on the best method for tibial fixation of the grafts in ACL reconstructions regarding tension, type of implant and knee-flexion angle. However, the analysis of the studies pointed to certain trends and allowed the drawing of specific conclusions.

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2Radiologic results of additional single screw fixation with lateral locking plate after hybrid closed-wedge high tibial osteotomy

저자 : Nobuyuki Hiraoka , Shuji Nakagawa , Eigo Otakara , Hiroaki Inoue , Kenji Takahashi , Yuji Arai

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-8 (8 pages)

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Background: Hybrid closed-wedge high tibial osteotomy (hybrid CWHTO) is an effective surgical treatment for medial compartment osteoarthritis of the knee. Our study investigated whether the combination of a lateral locking plate and a single medial screw promoted bone union after hybrid CWHTO.
Methods: The study cohort consisted of 30 patients (15 men and 15 women) who underwent hybrid CWHTO for medial compartment osteoarthritis or spontaneous osteonecrosis of the knee. Sixteen knees were fixed with a lateral locking plate (LP group), and 17 were fixed with both a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia (LPS group). The times to bone union, radiolucency, and callus formation at the osteotomy site were evaluated radiographically.
Results: The mean postoperative time to radiographic confirmation of bone union was 5.5 ± 2.6 months in the LP group and 3.4 ± 1.5 months in the LPS group. Radiolucency at the osteotomy site and excess callus formation on the posterior side of the tibia were lower in the LPS group than in the LP group.
Conclusions: This modified hybrid CWHTO combining a lateral locking plate and a cannulated cancellous screw on the medial side of the tibia improves the stability of the osteotomy site and shortens the period of bone union.

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3Cost, safety, and rehabilitation of samestage, bilateral total knee replacements compared to two-stage total knee replacements

저자 : Raymond C. W. Wan , Jason C. H. Fan , Yuk-wah Hung , Ka-bon Kwok , Carmen K. M. Lo , Kwong-yin Chung

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-13 (13 pages)

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Background: Many patients experience bilateral knee osteoarthritis and require bilateral total knee replacement (TKR). Same-stage, bilateral TKR is proposed to be a cost-effective and safe solution compared to two-stage, but conflicting results in the literature are reported. We aim to compare the costs, safety, and rehabilitation performance of patients in same-stage versus two-stage, bilateral TKR with our centre's perioperative protocol.
Materials and methods: We retrospectively reviewed 175 patients (95 same-stage, 80 two-stage) who had undergone bilateral TKR in our centre. Patient selection for same-stage, bilateral TKR was strictly protocol-driven and required fulfilment of all criteria, including age < 75 years, American Society of Anesthesiologists (ASA) grade 1 or 2, body mass index (BMI) < 40, and having non-complex arthritis. All patients followed a standardised pre-operative, intra-operative, and post-operative Enhanced Recovery After Surgery (ERAS) protocol. The cost, safety profiles, and rehabilitation outcomes were compared between the same-stage and two-stage groups.
Results: The same-stage, bilateral TKR reduced the length of hospital stays by 5.71 days per patient, decreased the operation time by 27.4 min, saved 3.34 (18.6%) physiotherapy sessions, and 3.78 (51.5%) occupational therapy sessions. The same-stage group experienced a higher haemoglobin drop but no significant difference in transfusion percentage, transfusion volume, complication rate, and readmission rate. The two-stage subgroup with anaesthetic risk, age, and BMI similar to the same-stage group showed the same results. Same-stage, bilateral TKR patients experienced no significant difference in final post-operative pain levels and rehabilitation outcomes as two-stage TKR patients.
Conclusion: This study showed that same-stage, bilateral TKR can reduce costs, with similar safety profiles and rehabilitation outcomes compared to the two-stage, bilateral TKR.

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4Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 1. Diagnosis and risk factors

저자 : Srihatach Ngarmukos , Kang-il Kim , Siwadol Wongsak , Thanainit Chotanaphuti , Yutaka Inaba , Cheng-fong Chen , David Liu

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-13 (13 pages)

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5Immediate weight-bearing is safe following lateral locked plate fixation of periprosthetic distal femoral fractures

저자 : Oisin J. F. Keenan , Lauren A. Ross , Matthew Magill , Matthew Moran , Chloe E. H. Scott

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-10 (10 pages)

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Purpose: This study aimed to determine whether unrestricted weight-bearing as tolerated (WBAT) following lateral locking plate (LLP) fixation of periprosthetic distal femoral fractures (PDFFs) is associated with increased failure and reoperation, compared with restricted weight-bearing (RWB).
Materials and methods: In a retrospective cohort study of consecutive patients with unilateral PDFFs undergoing LLP fixation, patients prescribed WBAT were compared with those prescribed 6 weeks of RWB. The primary outcome measure was reoperation. Kaplan-Meier and Cox multivariable analyses were performed.
Results: There were 43 patients (mean age 80.9 ± 11.7 years, body mass index 26.8 ± 5.7 kg/m2 and 86.0% female): 28 WBAT and 15 RWB. There were more interprosthetic fractures in the RWB group (p = 0.040). Mean follow-up was 3.8 years (range 1.0-10.4). Eight patients (18.6%) underwent reoperation. Kaplan-Meier analysis demonstrated no difference in 2-year survival between WBAT (80.6%, 95% CI 65.3-95.9) and RWB (83.3%, 95% CI 62.1-100.0; p = 0.54). Cox analysis showed increased reoperation risk with medial comminution (hazard ratio 10.7, 95% CI 1.5-80; p = 0.020) and decreased risk with anatomic reduction (hazard ratio 0.11, 95% CI 0.01-1.0; p = 0.046). Immediate weightbearing did not significantly affect the risk of reoperation compared with RWB (relative risk 1.03, 95% CI 0.61-1.74; p = 0.91).
Conclusions: LLP fixation failure was associated with medial comminution and non-anatomic reductions, not with postoperative weight-bearing. Medial comminution should be managed with additional fixation. Weight-bearing restrictions additional to this appear unnecessary and should be avoided.

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6Systematic review: total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS)

저자 : Yi Chuen Tan , Jia Yin Tan , Konstantinos Tsitskaris

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-7 (7 pages)

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Background: To determine the functional outcomes, complications and revision rates following total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS).
Materials and methods: We conducted a systematic review of the literature. Five studies with a total of 552 TKAs were included for analysis. The methodological quality of the articles was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale. Functional outcomes, complications and revision rates were assessed. The mean age was 61 years (range 33-94 years) and the mean follow-up period was 61.1 months (range 0.2-35 years).
Results: All the studies reported improvement in knee function following TKA. Post-operative stiffness was the most frequently reported complication, affecting 32.7% (n = 32) of patients in our review. Symptomatic recurrence of PVNS, component loosening, tibial-component fracture, instability and periprosthetic infection were the main factors leading to the need for revision TKA.
Conclusion: The findings of this review support the use of TKA to alleviate the functional limitations and pain due to knee degeneration in patients with PVNS. The operating surgeon should be aware of the increased risk of postoperative stiffness, as well as a potentially higher risk of infection. Implant survival should also be considered inferior to the one expected for the general population undergoing TKA.

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7Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 2. Mechanical venous thromboembolism prophylaxis

저자 : Chavarin Amarase , Aree Tanavalee , Viroj Larbpaiboonpong , Myung Chul Lee , Ross W. Crawford , Masaaki Matsubara , Yixin Zhou

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-9 (9 pages)

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8The association between bone mineral density and postoperative drainage volume following cruciate-substituting primary total knee arthroplasty: a cross-sectional study

저자 : Yuthasak Peerakul , Jirapong Leeyaphan , Karn Rojjananukulpong

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-7 (7 pages)

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Background: The prevalence of osteoporosis in patients who undergo a primary total knee arthroplasty (TKA) is increasing. Low bone mineral density (BMD) is related to unfavorable outcomes following TKA such as migration of uncemented tibial components. Postoperative blood loss in TKA is an important complication. Non-modifying predicting factors for postoperative blood loss in patients undergoing primary TKA need further elucidation. Studies on the association between BMD and blood loss after TKA are limited. We aimed to demonstrate the relationship between BMD and postoperative drainage volume following primary TKA.
Methods: A cross-sectional study was conducted between January 2014 and August 2020. A total of 119 primary varus osteoarthritis knees with BMD results were included in the study. Patients with secondary causes of osteoporosis were excluded.
Results: The median postoperative drainage volume of participants in the normal total hip BMD group and the normal trochanter BMD group was higher than that of patients in the low total hip BMD group and the low trochanter BMD group (285.0 ml vs 230.0 ml, P = 0.003; 282.5 ml vs 240.0 ml, P = 0.013, respectively). Multivariate regression analyses showed that operative time, spinal anesthesia, and normal total hip BMD status were significant predictive factors associated with increased postoperative drainage volume (P = 0.014, 0.022, and 0.013, respectively). No association was identified between the lumbar spine BMD status and postoperative drainage volume.
Conclusions: The relationship between BMD and postoperative blood loss in primary TKA was identified in this study. Normal total hip BMD was found to be associated with an increased postoperative drainage volume after primary TKA compared with low BMD.

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10Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 3. Pharmacological venous thromboembolism prophylaxis

저자 : Satit Thiengwittayaporn , Nicolaas Budhiparama , Chotetawan Tanavalee , Saran Tantavisut , Rami M. Sorial , Cao Li , Kang-il Kim

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 33권 0호 발행 연도 : 2021 페이지 : pp. 1-12 (12 pages)

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1Navigated versus Conventional Technique in High Tibial Osteotomy: A Meta-Analysis Focusing on Weight Bearing Effect

저자 : Kyung Wook Nha , Young-soo Shin , Hyuk Min Kwon , Jae Ang Sim , Young Gon Na

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 81-98 (18 pages)

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Purpose: We aimed to determine whether navigated opening wedge high tibial osteotomy (HTO) is superior to the conventional technique in terms of accuracy of the coronal and sagittal alignment correction, functional outcome, and operative time.
Methods: Studies comparing navigated and conventional HTO were included in this meta-analysis. We compared the incidence of radiological outliers in coronal alignment and tibial slope maintenance, mean differences in functional outcome scales, and operative time. Subgroup analyses were performed on coronal alignment accuracy based on the intraoperative method of alignment confirmation: fluoroscopy vs. gap measurement method.
Results: Twelve studies were included: there were 434 knees in the navigated HTO studies and 405 knees in the conventional HTO studies. The risk of outlier was lower in navigated HTO than in conventional HTO; however, the difference was not significant when navigated HTO was compared with conventional HTO performed using the gap measurement method. Tibial slope maintenance was comparable or better in navigated HTO. No difference was found in the American Knee Society function and Lysholm scores. Navigated HTO necessitated a longer operative time of approximately 10 minutes.
Conclusions: The use of navigation in HTO can improve accuracy in both coronal and sagittal alignments, but its clinical benefit is unclear.

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2Arthroscopic Treatment of Popliteal Cysts with and without Cystectomy: A Systematic Review and Meta-Analysis

저자 : Ji Hoon Han , Ji Hoon Bae , Kyung Wook Nha , Young Soo Shin , Dae Hee Lee , Hyun Jae Sung , Jae Gyoon Kim

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 103-112 (10 pages)

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Purpose: To compare the clinical outcomes of the arthroscopic treatments for popliteal cysts with and without cystectomy.
Methods: PubMed/MEDLINE, EMBASE, KoreaMed, and Cochrane Library were searched from the earliest available date of indexing through August 2016. The methodological quality of all articles was assessed according to the Coleman methodology score (CMS). Studies were grouped according to the surgical method, and a meta-analysis was conducted to identify the unsuccessful clinical outcome and complication rates.
Results: Nine studies were included; the mean CMS was 67.33 (standard deviation, 8.75 points). Cystectomy was reported in five studies; cystectomy was not performed in four studies. The odds ratio of unsuccessful clinical outcomes evaluated by Rauschning and Lindgren score was 122.05 (p<0.001) with cystectomy and 58.12 (p<0.001) without cystectomy. The effect size of complications was 0.16 (p<0.001) with cystectomy and 0.03 (p<0.001) without cystectomy. The recurrence rate was 0% with cystectomy and 6.4% without cystectomy.
Conclusions: All the currently available studies showed satisfactory outcomes in both with and without cystectomy groups. However, arthroscopic cystectomy concurrently performed with management of intra-articular lesions was associated with a relatively low recurrence rate and a relatively high incidence of complications.

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3Beta- Tricalcium Phosphate Block for Donor Site Morbidity of the Patella in Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft

저자 : Yuki Kato , Joverienne Chavez , Shin Yamada , Soichi Hattori , Shuzo Takazawa , Hiroshi Ohuchi

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 113-119 (7 pages)

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Purpose: This study aimed to investigate anterior knee symptoms in patients who underwent anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) graft followed by implantation of a beta-tricalcium phosphate (β-TCP) block as a bone void filler.
Materials and Methods: We retrospectively reviewed 84 cases of synthetic bone grafting using a β-TCP block for the patellar bone defect in ACL reconstruction with a BPTB autograft. Computed tomography of the operated knee was performed immediately after the surgery to evaluate whether the grafted β-TCP block protruded forward from the anterior surface of the patella. On the basis of the results, the cases were divided into a protrusion group (n=31) and a non-protrusion group (n=53). Anterior knee symptoms at 12 months postoperatively and absorption of the grafted β-TCP block were compared between the two groups.
Results: Except for patellofemoral crepitus, there was no significant difference in anterior knee symptoms between the two groups (p>0.05). The incidence of patellofemoral crepitus was significantly lower in the protrusion group than in the non-protrusion group (p=0.027). The groups showed no significant difference in β-TCP absorption.
Conclusions: The present study demonstrated that the protrusion of β-TCP that was used as a bone void filler had no adverse effects.

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4Time-Dependent Increase in Medial Meniscus Extrusion after Medial Meniscus Posterior Root Tear Analyzed by Using Magnetic Resonance Imaging

저자 : Yoshiki Okazaki , Takayuki Furumatsu , Yasunori Shimamura , Kenta Saiga , Hideki Ohashi , Takahiko Uchino , Yusuke Kamatsuki , Yuki Okazaki , Toshifumi Ozaki

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 120-125 (6 pages)

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Purpose: Medial meniscus posterior root tear (MMPRT) causes progression of medial meniscus extrusion (MME). This study aims to calculate the progression rate of MME based on findings in two preoperative magnetic resonance imaging (MRI) scans and determine the associated factors.
Materials and Methods: We retrospectively reviewed 33 patients (27 females and 6 males; mean age, 60 years) who underwent MRI twice, at a mean interval of 48 days. We measured the medial meniscus body width, medial joint space width (MJSW), and MME. The MME progression rate was derived from regression analysis of the increase in MME (ΔMME) between the two MRI scans. In addition, the correlations of the MME increase rate with age, body mass index, femorotibial angle, and MJSW were evaluated.
Results: The mean MME increased from 3.4 mm to 4.5 mm (p<0.001). A good correlation was observed between ΔMME and the interval of MRI scans (R2=0.621), and the MME progression rate was 0.020 mm per day. A moderate correlation was observed between the MME increase rate and the MJSW (R2=0.432).
Conclusions: The MME progression rate was rapid in MMPRT and narrowing of the MJSW was associated with the progression of MME. Level of Evidence: V, Cross-sectional study

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5Disparity between Preoperative Target Correction Amount and Postoperative Correction Amount in Open Wedge High Tibial Osteotomy

저자 : O-sung Lee , Eui Soo Lee , Yong Seuk Lee

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 126-131 (6 pages)

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Purpose: The purpose of this study was to evaluate the disparity between the preoperative target correction amount and the postoperative correction amount in open wedge high tibial osteotomy (OWHTO) in patients divided according to the planned osteotomy gap.
Materials and Methods: Seventy-two patients were divided into two groups (group 1 with the planned opening gap lager than the mean opening gap length of total patients and group 2 with a smaller opening gap). The opening gap was determined according to the target weight bearing line (WBL) ratio on the preoperative whole leg radiograph. Absolute and relative values of the disparity between the target and postoperative WBL ratios were compared between groups in order to clarify whether the disparity was deviated toward over- or under-correction.
Results: The absolute value of disparity between the target and postoperative WBL ratios in group 1 was significantly larger than that in group 2 (6.01%±5.68% vs. 3.32%±3.38%; p=0.02). However, there was no statistically significant difference in relative values between groups (p=0.54).
Conclusions: The postoperative WBL ratio after OWHTO was different from the preoperative target WBL ratio if the planned osteotomy gap was large. This mismatch was not deviated toward one side, either over- or under-correction.

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6The Migratory Cortical Button: A Rare Case of Hypersensitivity to Titanium after an Anterior Cruciate Ligament Reconstruction

저자 : Nicolas Bouguennec , Philippe Colombet , Nicolas Graveleau , Stephane Jambou

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 132-136 (5 pages)

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Allergy to metal, especially to titanium, is a poorly known subject in orthopedic surgery and is mostly found after arthroplasty. Here, we describe an original case of titanium allergy that developed after an anterior cruciate ligament (ACL) reconstruction of the left knee in a patient with a history of severe atopic dermatitis. Three years after the surgery, he returned to the clinic with the femoral cortical button in his hand; he removed the device from the wound when the skin spontaneously opened at the lateral part of the thigh. The wound healed with dressings without use of any antibiotics. Clinical and functional results were favorable and magnetic resonance imaging signal of the graft was normal. We ruled out the possibility of infection and the final diagnosis was allergy to titanium. This case demonstrates the need to investigate the presence of allergy to metal, including titanium, before an ACL reconstruction.

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7Femoral Avulsion of the Anterior Cruciate Ligament in a Multiligament Setting: A Unique Case

저자 : Vikram Arun Mhaskar , Jitendra Mahehswari , Manjeet Sansanwal

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 137-142 (6 pages)

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Anterior cruciate ligament (ACL) femoral avulsions are a rare entity mainly seen in children. We describe a unique case of a bony ACL avulsion with a medial collateral ligament (MCL) and lateral meniscus (LM) tear in a 37-year-old patient who sustained a two-wheeler accident. The ACL femoral avulsion was fixed arthroscopically using a Knee Scorpion and a FiberTape fixed over a suture disc on the lateral cortex. The MCL was repaired with an internal brace using a FiberTape and two SwiveLocks and the torn LM was repaired using all-inside sutures. At 2 years of follow-up, the fragment was united, knee range of motion was 0° to 130°, and Knee Society Score was 98. This is the first case report of a femoral avulsion of the ACL combined with an MCL injury and a meniscus tear where all three were repaired with a unique technique and good results were obtained.

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8Treatment of Osteochondritis Dissecans of the Knee with Autologous Iliac Bone Graft and Hyaluronic Acid Scaffold

저자 : Jaime Hinzpeter , Alvaro Zamorano , Maximiliano Barahona , Pablo Campos

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 143-146 (4 pages)

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Osteochondritis dissecans (OCD) is a condition that corresponds to an idiopathic focal lesion affecting the subchondral bone with possible compromise of the stability of the adjacent cartilage. Treatment depends on the size of the lesion, cartilage stability, and the physeal status. The case reported is about an 18-year-old male patient who complained of suffering from knee pain for a period of ten months. Magnetic resonance imaging (MRI) revealed a lesion of 2 cm2 in the medial femoral condyle that compromised the subchondral bone, compatible with OCD. He underwent surgery that consisted of filling the subchonral defect with an iliac crest autograft and sealing the defect with a hyaluronic acid scaffold. At the 12-month follow-up, the MRI shows complete healing and the patient has resumed sports activities. Management with autologous iliac crest graft and hyaluronic acid scaffold represents an effective alternative treatment for OCD.

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9Snapping Knee due to a Femoral Osteochondroma after Total Knee Arthroplasty

저자 : Sang Jun Song , Dae Kyung Bae , Cheol Hee Park

발행기관 : 대한슬관절학회 간행물 : Knee Surgery & Related Research(구 대한슬관절학회지) 31권 2호 발행 연도 : 2019 페이지 : pp. 147-150 (4 pages)

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A female patient who underwent total knee arthroplasty presented with a snapping sensation over the left knee at 10 years postoperatively. Initially, the bony mass was visible on the medial femoral condyle radiographically at 5 years postoperatively. The mass had enlarged over time and her symptoms were progressive. The mass was excised at postoperative 18 years and confirmed as an osteochondroma histopathologically. The patient's symptoms have been completely resolved for 3-year follow-up after excision.
Level of Evidence: V

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