Correlation of Detachment of Proximal Tibia Superficial Medial Collateral Ligament and Medial Meniscus Extrusion with Knee Osteoarthritis.

Introduction: The aim of the study is to assess the correlation of detachment of proximal tibia superficial medial collateral ligament (sMCL) and medial meniscus (MM) extrusion with knee osteoarthritis (OA) and its progression.

Materials And Methods: This is a prospective study where 165 knees were evaluated using radiographs and magnetic resonance imaging for the severity of OA knee according to Kellgrence-Lawrence grading, MM extrusion, and status of proximal tibia attachment of sMCL. Chi-square test of Independence and Pearson's correlation test were used to assess any correlation among the variables.

Cartilage regeneration and long term survival in medial OA knee patients treated with HTO and OATS.

Background: Osteoarthritis (OA) of the knee, in most instances primarily, affects medial compartment of knee. Combining Osteochondral Autologous Transfer System (OATS) with Medial Open-Wedge High Tibial Osteotomy (MOWHTO) may represent an integrated approach to sustaining long-term knee functionality in OA patients.

Materials And Methods: From 2009 to 2016, combined OATS and MOWHTO was performed in 66 knees of 63 patients with medial compartment knee OA.

ACL Reconstruction using Achilles Allograft in a Case of Genu Recurvatum with Supracondylar Osteotomy.

Introduction: People with post-polio syndrome usually have some residual deformities. Genu recurvatum is very commonly seen in such cases which are a risk factor for anterior cruciate ligament (ACL) injury due to the altered biomechanics. To the best of our knowledge, this is the first report in literature presenting ACL reconstruction in a limb with genu recurvatum deformity treated with supracondylar osteotomy.

Can status of superficial medial collateral ligament proximal tibial attachment predict progression of OA knee?

Objective: This study aims to identify, whether knee OA progression is affected by the sMCL proximal tibial attachment status and probably is the first one trying to identify such association.

Methods: 90 OA knees and 80 normal knees were evaluated using radiographs and MRI for severity of OA knee (K-L grade), sMCL length (L), distance of distal tibial attachment of sMCL from tibial articular surface (I), MCL ratio (L/I) and proximal tibial attachment of sMCL, attached or detached.

Results: Mean age of the study population was 52.

Association of Gap Healing With Angle of Correction After Opening-Wedge High Tibial Osteotomy Without Bone Grafting.

Background: Studies have reported that opening wedge high tibial osteotomy (OWHTO) without bone grafting has outcomes that are similar to or even better than those of OWHTO with bone grafting, especially after use of a locking plate. However, a consensus on managing the gap after OWHTO has not been established.

Purpose: To determine the degree of gap healing achieved without bone grafting, the factors associated with gap healing, and whether additional gap healing would be obtained after plate removal.

Combination of Cylindrical Autologous Bone Grafting Technique With a Metallic Block Insertion in Open-Wedge High Tibial Osteotomy.

Open-wedge high tibial osteotomy (OW-HTO) is an effective surgical intervention for medial-compartment knee osteoarthritis. However, the osteotomized gap might be a disadvantage in OW-HTO because it can cause problems such as delayed bone union or loss of correction. These issues can be minimized by using autologous bone graft in the osteotomized gap, which is known to be the fastest and most clinically satisfactory gap filler.

Preventing ceramic liner fracture after Delta ceramic-on-ceramic total hip arthroplasty.

Background: The results of total hip arthroplasty (THA) with use of Delta ceramic articulation were successful at medium term follow-up. The use of this newest ceramic has markedly reduced the incidence of ceramic head fractures, but not the incidence of ceramic liner fractures. We tested a hypothesis that the ceramic fractures are prevented by use of a metal shell with 18° inner taper angle and a stem design with a reduced neck geometry.

Optimal rotational positioning of tibial component in total knee arthroplasty: determined by linker surgical technique using a high definition CT.

Introduction: The rotational alignment of femoral and tibial components is an important determinant of the success of Total Knee Arthroplasty (TKA). The optimal rotational position of the tibial component is still unclear. The purpose of this study was (1) to determine the pre-operative S-TEA (surgical-transepicondylar axis) derived tibialanteroposterior (AP) axis angle and postoperative tibial component axis angle using a "Bird's eye" high-definition CT image in TKA performed by Linker surgical technique; (2) to determine the femorotibial mismatch angle; and (3) to determine the optimal tibial component rotation in a well-aligned femoral and tibial components.

Faster union rate and better clinical outcomes using autologous bone graft after medial opening wedge high tibial osteotomy.

Purpose: To compare the radiological bone union rate after medial opening wedge high tibial osteotomy (MOW-HTO) and stabilization using a TomoFix™ plate (Synthes, Oberdorf, Switzerland) in three patient groups.

Methods: Retrospective analysis of 137 knees that underwent MOW-HTO between January 2014 and January 2017 was using a TomoFix™ plate. Osteotomy gaps were filled with β-tricalcium phosphate (β-TCP) (group A), left unfilled (group B), and subject to autologous bone graft and β-TCP (group C).

Hybrid closed wedge high tibial osteotomy improves patellofemoral joint congruity compared with open wedge high tibial osteotomy.

Purpose: To evaluate clinical outcomes and radiographic changes in patellofemoral (PF) joint congruity between open wedge high tibial osteotomy (OWHTO) and hybrid closed wedge HTO (HCWHTO).

Methods: From 2011 to 2013, 36 knees in 31 patients who underwent OWHTO and 21 knees in 17 patients who underwent HCWHTO were evaluated in this retrospective study with a minimum 5-year follow-up. Radiological outcomes including hip-knee-ankle angle (HKA), femoral patellar height index (FPHI), preoperative PF osteoarthritis (OA) grade, medial and lateral joint spaces of the PF joint, and congruence angle were measured.

D-hole breakage of 2 angular stable locking plates for medial opening-wedge high tibial osteotomy: Analysis of results from 12 cases.

An adequate stable fixation implant should be used for medial opening-wedge high tibial osteotomy (MOWHTO) to promote rapid bone healing without complications. To date, the highest fixation stability has been observed for angular stable locking plates. However, there is still little medical literature regarding breakage of these plates.

Primary stability of different plate positions and the role of bone substitute in open wedge high tibial osteotomy.

Background: The purpose of this study was to compare the mechanical fixation strengths of anteromedial and medial plate positions in osteotomy, and clarify the effects of bone substitute placement into the osteotomy site.

Methods: Twenty-eight sawbone tibia models were used. Four different models were prepared: Group A, the osteotomy site was open and the plate position was anteromedial; Group B, bone substitutes were inserted into the osteotomy site and the plate position was anteromedial; Group C, the osteotomy site was open and the plate position was medial; and Group D, bone substitutes were inserted into the osteotomy site and the plate position was medial.

Could larger diameter of 4th generation ceramic bearing decrease the rate of dislocation after THA?

Background: Fourth generation (Delta) ceramic bearing was developed to reduce dislocation after total hip arthroplasty (THA) by increasing the head diameter. We tested a hypothesis that 32/36 mm Delta ceramic bearing decreases the dislocation rate. We also evaluated ceramic-related complications and early outcome of this thin liner-on-large head ceramic bearing.

Anisakiasis: Report of 15 Gastric Cases Caused by Anisakis Type I Larvae and a Brief Review of Korean Anisakiasis Cases.

The present study was performed to report 15 anisakiasis cases in Korea and to review the Korean cases reported in the literature. Total 32 Anisakis type I larvae were detected in the stomach of 15 patients by the endoscopy. Single worm was detected from 12 cases, and even 9 larvae were found from 2 cases.

Comparison of results of medial opening-wedge high tibial osteotomy with and without subchondral drilling.

Purpose: The purposes of this study were to compare the results of medial opening-wedge high tibial osteotomy (MOWHTO) with and without subchondral drilling and to assess the formation of fibrocartilage at 2 years postoperatively.

Methods: Patients were divided into 2 groups. Thirty knees were treated with osteotomy and subchondral drilling (group 1), and 31 knees were treated with osteotomy alone (group 2).

Efficacy of periarticular multimodal drug injection after medial opening-wedge high tibial osteotomy: a randomized, controlled study.

Purpose: The purpose of this study was to evaluate the efficacy of periarticular multimodal drug injection after medial opening-wedge high tibial osteotomy regarding the postoperative pain level.

Methods: From January 2011 to January 2012, 70 patients underwent medial opening-wedge high tibial osteotomy. Thirty-five patients were randomly assigned to receive no injection (group I), and 35 patients were assigned to receive periarticular multimodal drug injection (group II).

Second-look arthroscopic assessment of cartilage regeneration after medial opening-wedge high tibial osteotomy.

Purpose: The purposes of this study were to evaluate regeneration of the articular cartilage after medial opening-wedge high tibial osteotomy for knees with medial-compartment osteoarthritis and to assess the clinical outcome and cartilage regeneration according to the postoperative limb alignment at 2 years postoperatively.

Methods: The study involved 159 knees in 159 patients. For evaluation of cartilage degeneration, the International Cartilage Repair Society grading system was used for arthroscopic grading on initial arthroscopy during high tibial osteotomy.

Comparative study of medial opening-wedge high tibial osteotomy using 2 different implants.

Purpose: The purpose of this study was to perform a retrospective clinical and radiographic evaluation after opening-wedge high tibial osteotomy (HTO) using a short spacer plate (Aescula; B. Braun Korea, Seoul, South Korea) and rigid long plate (TomoFix plate; Mathys, Bettlach, Switzerland) at follow-up 2 years postoperatively.

Methods: We performed 94 opening-wedge HTOs with the Aescula plate (group I) and 92 HTOs with the TomoFix plate (group II).

No difference in total blood loss, haemoglobin and haematocrit between continues and intermittent wound drainage after total knee arthroplasty.

Purpose: The purpose of this prospective randomized study was to compare the visible, hidden, total blood loss and postoperative haemodynamic change of 4-h clamping and nonclamping of the drain after TKA. The hypothesis in the present study was that intermittent drain clamping with injection of diluted epinephrine solution would decrease the visible, hidden blood loss and reduction of postoperative haemoglobin or haematocrit change after TKA.

Methods: From January 2010 to January 2011, 100 TKAs were performed at our hospital.

The accuracy of the extramedullary and intramedullary femoral alignment system in total knee arthroplasty for varus osteoarthritic knee.

Purpose: The intramedullary (IM) femoral alignment system does not alway guarantee accuracy of the component position in the total knee arthroplasty (TKA). In some cases, the extramedullary (EM) femoral alignment system in total knee arthroplasty (TKA) is a useful alternative surgical option to adjust femoral component alignment. In the EM technique, accuracy of the femoral head center location is mandatory.

Arthroscopic, suture anchor repair through a novel medial quadriceptal portal for medial meniscal root tear.

Current options for meniscal root repair include repair into trans-osseous bone tunnels, trans-osseous suture passage for surface fixation, and suture anchor fixation. Suture anchor repair techniques have been developed since it eliminates the issue of the suture abrasion, tunnel drilling, and distal fixation inherent to trans-osseous tunnel. We present a description of a new variation in the more vertical suture anchor repair technique for meniscal root tear using a novel medial quadriceptal portal.

High early failure rate of the Columbus posterior stabilized high-flexion knee prosthesis.

Background: Most studies report high survivorship rates for TKAs, however, we observed higher than anticipated rates of dislocation and femoral component loosening after implanting a Columbus posterior stabilized prosthesis.

Questions/purpose: We therefore determined (1) the incidence of dislocation and aseptic loosening that occurred after implantation of posterior stabilized high-flexion prostheses in TKAs, (2) the causative factors of dislocation and aseptic femoral component loosening when comparing two designs of prostheses, and (3) the mechanisms of dislocation.

Methods: We retrospectively reviewed 319 patients who underwent 384 TKAs from May 2007 to July 2008.