Suture anchor have been used in surgical procedure of tendon or ligament repair. Recently, there has been developed an all suture anchor (soft anchor) which can be used even when the insertion area is narrow. But, the stability of soft anchors due to narrow zone has not been elucidated. This purpose of this study was to investigate stability of soft anchors with respect to their fixation intervals. Polyurethane foams with two different bone densities (10 pcf; 0.16g / cm³, 20 pcf; 0.32g / cm³) were used. All suture anchors and conventional suture anchors were fixed at 10mm, 5mm, and 2.5mm intervals. The failure load was measured using a mechanical testing machine. The average load to failure of conventional suture anchor were 200.4N, 200.2N, 184.7N in the 10mm, 5mm and 2.5mm interval with 10pcf foam bones and 200.4 N, 200.2 N and 184.7 N with the 20 pcf foam bone respectively. Average load to failure load of soft anchor was 97.3N, 93.9N and 76.9N with 10pcf foam bones and 200.4 N, 200.2 N and 184.7 N with 20 pcf foam bone. Suture screw spacing and bone density are important factors in anchor pullout strength. In osteoporotic bone density, insertion of the suture screw interval of 5 mm might be necessary.

Purpose

The purpose of this study is to compare the mid-term outcomes between rotating platform(RP) and posterior cruciate substitute(PS) bearings in LCS-total knee arthroplasty (TKA).

Although the clinical manifestation of ONFH is well summarized as forms of various stages, its etiology, natural history or epidemiology has not been clearly elucidated yet. With this study, we wanted to find out the estimated annual incidence, epidemiologic characteristics and the effect of known risk factors of ONFH. Therefore we can understand the disease better to provide optimal management to the patients.

Among 133 189 patients who diagnosed as osteonecrosis of femoral head (ONFH) in database of national health insurance system in Korea from 2002 to 2006, three hundreds an eighty-two samples were randomly extracted with 5% error range in 95% confidence interval. With a structured worksheet, medical records and radiographs of each sample were reviewed at corresponding clinic or hospital by authors and trained orthopedic surgeons. With these data, we calculated the prevalence and associated risk factors.

The mean number of annual requests was 23 466. Among 382 samples, two hundreds and seventy-four were confirmed to have ONFH. Diagnostic accuracy was 71.7 %. Diagnosis was more accurate when the patient was male or hospitalized. After the logistic regression analysis, calculated diagnostic accuracy during 2002 and 2006 was 60.3% (51 823/85 987). The annual predicted number of cases of ONFH during this period was 14 103. It corresponds to 28.91 patients per 100 000 populations. Alcohol abuse was noted in 45% and 22% was related to use of steroid. 37% showed bilateral involvement. Bone graft procedures in any kind was the most frequently performed joint preserving procedure.

With this, the first epidemiologic study for ONFH in Korea, we estimated nationwide annual prevalence of ONFH as 28.91 per 100,000 populations during 2002 and 2006. There is an absolute male predominance. Alcohol abuse is the most frequent risk factors. We believe that this result can serve as a baseline data for understanding the epidemiology, clinical characteristics and treatment of ONFH.

Instability is one of the leading causes of clinical faiure after total knee arthroplasty. Instability can be categorized according to four type: extension instabiity, flexion instability, genu recurvatum and global instabi;ity. Basically flexion and extenion gap should be equal. And also medial and lateral gap should be equal balance. we should know basic concepts, the effect of the ligament or capsular structure release. And also surgeon should understand of the nine gap- balancing permutaiion that can occur during revision TKA. After bony mechnical and rotational alignment correction, flexion gap correction first then adjust extension gap methode will be easier to adjust ligament balancing. Joint line elevation should be avoid if possible because this can lead to mid-flexion instability, decreased range of motion soft tissue impingement or anterior knee pain associated with patella infera.

Varus/valgus constrained components should be considered only in the presence of adequate inherent or to stabilize the knee until a ligament repair or reconstruction heal. In a situation of severe varus/valgus, or gobal instability where the knee cannot be stabilized other than through the implant, use of a rotating hinge or linked component is advocated.

The aims of this study were to assess the clinical outcomes especially range of motion of the knee after total knee arthroplasty with sigma RP-F versus LCS RP.

110 knees underwent total knee arthroplasty with LCS, and 59 knees with PFC sigma RP-F. We performed a prospective clinical trial. At the time of the one-year follow-up, we compared the clinical outcomes of two groups. In LCS group, LCS AP glide type group was excluded. Range of motion, the knee score, functional score and HSS score etc. were assessed.

91 knees were available. The mean active non-weight-bearing range of motion at one year was 124 (95% confidence interval) in the fifty-six knees that underwent a LCS and 127 (95% confidence interval) in the thirty-six knees that underwent a PFC sigma RP-F (p=0.55). There were no significant differences in the knee score (the mean 94.12 in LCS, 93.54 in RP-F, p=050), functional score(the mean 62.58 in LCS, 65.14 in RP-F, p=0.91) and HSS score (the mean 87.73 in LCS, 87.85 in RP-F, p=0.50).

Although PFC sigma RP-F has the design that is advantageous in knee flexion, we found no significant differences between the groups with regard to range of motion or clinical outcomes.

Purpose: The aim of this study was to elucidate the continiuty of ligament in chronic injury of the posterior cruciate ligament(PCL).

Method: Magnetic resonance imaging(MRI) of twenty-six PCL injury patients with grade II or III laxity and more than 5mm side to side difference on stress radiographs were reviewed in terms of ligamentous continuity and thickness of the ligament at average 7.2 months(range:1–36) after injury. The results were compared with arthroscopic findings in fifteen patients.

Results: Eighteen PCLs(69%) showed continuity of PCL, in which average thickness of the injured portion was 61% of the intact portion. When thickness of the ligament in cases without continuity was rated as zero, the average thickness of the PCLs as compared to intact portion of the ligament increased as the time from injury elapsed; 16.4% in 0–2 months group (7 cases), 30.0% in 3–5 months group (6 cases), 53.8% in 6–8 months group (9 cases) and 80.0% in over 9 months group (4 cases). Of the fifteen cases with confirmed continuity of PCL in arthroscopic examination, nine cases showed continuity on MRI, while the remaining six cases didn’t.

Conclusion: More than two thirds of PCLs in symptomatic chronic injury showed ligamentous continuity on MRI. The longer the interval from injury was, the thicker the PCL was. In cases over 6 months after injury, the PCLs were of more than 50% thickness of the intact portion.

Purpose: To introduce modified tibial inlay technique for autogenous bone-patellar tendon-bone (BPTB) posterior cruciate ligament (PCL) reconstruction and evaluate the outcomes of PCL reconstruction by this method.

Methods: Fifty patients who underwent autogenous BPTB PCL reconstruction using modified tibial inlay technique were evaluated at average 30.9 months (range 12–52).

The outcomes were assessed by stress radiographs, maximal manual test with KT-2000 arthrometer, IKDC grading and OAK knee score.

Results: Average side to side difference in push view with Telos stress device decreased from 11.7mm to 3.2mm. Difference in maximal manual test with KT-2000 arthrometer also decreased from 11.5mm to 3.1mm. Final IKDC grading was A in six patients, B in thirty four, C in nine and D in one.

Average OAK score improved from 64.3 to 86.4

Conclusion: We consider that the modified tibial inlay technique is a method to reduce technical effort and contribute to satisfactory clinical results in autogenous BPTB PCL reconstruction.