共查询到20条相似文献，搜索用时 15 毫秒
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Young-Kyun Lee Jong-Min Kim Byung-Il Yoon Jae-Yoon Kim Guen Young Lee Sujin Kim Yong-Chan Ha 《Arthroscopy》2019,35(3):809-815
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Jong woo Kang Jong woong Park Soon hyuck Lee Jong hoon Park Seung bum Han Si young Park Woong Kyo Jeong 《Journal of orthopaedic science》2017,22(2):270-274
Background
This study was designed to evaluate the accuracy of ultrasound-guided injection targeting EPB tendon sheath and influenceable anatomical variances to the accuracy in the first extensor compartment of fresh cadaver wrists.Methods
Thirty wrists of 15 cadavers were used. The wrists were divided into right-sided wrists (control group) and left-sided wrists (group A) to compare the accuracy of the manual injection technique (control group) and ultrasound-guided injection technique (group A) targeting EPB tendon sheath. To estimate the influence of anatomical variances within first extensor compartment to the accuracy of each injection techniques, control group (manual injection group) was divided into Control group I (right-sided wrists without septum) and II (right-sided wrists with septum) and group A (ultrasound-guided injection group) was also divided into group AI (left-sided wrists without septum) and group AII (left-sided wrists with septum), respectively. After the methylene blue dye injection, the location of methylene blue dye and anatomical variances in the first extensor compartment was identified by dissection.Results
The accuracy was higher in the group A (93.3%) than in control group (40.0%, p < 0.05). The accuracy in control group I (55.6%) was higher than in control group II (16.7%, p < 0.05). The accuracy between group AI (100%) and group AII (85.7%) was not significantly different (p > 0.05). Wrists with more EPB or APL tendon slips showed a tendency not to have septum and all intratendinous injections was occurred in the wrist with 1 EPB tendon slip or 1 or 2 APL tendon slip.Conclusions
Ultrasound-guided injection targeting EPB tendon ensures correct needle placement through the visualization of compartmental anatomy and improves accuracy of injection though the septum in first extensor compartment encourage inaccurate injections. 相似文献8.
Dae Kyung Bae Sang Jun Song Cheol Hee Park Hu Liang Jung Kwon Bae 《Journal of orthopaedic science》2017,22(3):495-500
Background
The purpose of this study was to compare mid-term clinical and radiographic results of conversion total knee arthroplasties (TKA) following a closed-wedge high tibial osteotomy (HTO) and primary TKAs.Methods
A total of 32 conversion TKAs (29 patients) were compared with a matched control group of patients who had undergone primary TKA. The clinical results were evaluated using the Knee Society Knee and Function score, the Western Ontario and McMaster Universities score, patella score, and range of motion (ROM). The radiographic results were evaluated using femorotibial angle, mechanical axis (MA), the method employed by the American Knee Society, joint line height (JLH), the amount of tibial bone resection, and the Insall–Salvati ratio. The clinical and radiographic results of conversion TKAs were compared with primary TKAs. The thickness of the polyethylene insert was also compared.Results
No significant differences were observed in the clinical scores or ROM between two groups. No significant differences were detected in femorotibial angle, MA, and position of the components between two groups. The amount of tibial bone resection and pre-operative JLH both were significantly lower in the conversion group than those in the control group, although postoperative JLH and pre and postoperative Insall–Salvati ratio did not differ between two groups. No significant difference in the thickness of the polyethylene insert was identified between two groups.Conclusions
The previous closed-wedge HTO itself had no detrimental effect on the mid-term outcome of the subsequent TKA, including patellar symptom and position. No significant differences in the postoperative joint line and patella height were detected between the conversion and primary TKA groups. 相似文献9.
Young Moon Kee Hwan Jin Kim Jung Youn Kim Yong Girl Rhee 《Journal of orthopaedic science》2017,22(5):846-851
Background
The risk factors of glenohumeral arthritis after the Latarjet procedure remain relatively unexplored. The purposes of this study are to evaluate the clinical significance of glenohumeral arthritis after the Latarjet procedure, and to investigate risk factors associated with arthritis progression.Methods
We evaluated 110 patients (110 shoulders) who underwent the Latarjet procedure for recurrent anterior shoulder instability. Patients had a mean age of 23.8 years (range, 14–52 years) at the time of the operation, and the mean duration of follow-up was 31 months (range, 24–111 months).Results
At the last follow-up, the mean Visual Analog Scale (VAS), Rowe and University of California at Los Angeles (UCLA) scores significantly improved from 3.1, 36.5 and 23.6 points preoperatively to 1.6, 87.6 and 32.6 points (all P < 0.05, respectively). The postoperative rate of recurrence was 5.4%. Among the 14 shoulders with preoperative arthritis, 8 (57.1%) showed progression of arthritis at the last follow up. New occurrence or progression of arthritis after the Latarjet procedure was in 20 shoulders (18.2%). At the final, overall prevalence of arthritis was 23.6% (26 shoulders). The non-arthritis group showed significantly better functional outcomes (VAS score: 0.9, Rowe Score: 89.3, UCLA score: 33.5) than the arthritis group (2.1, 84.9, 29.2; all P < 0.05, respectively). Preoperative generalized laxity and lateral overhang were associated with glenohumeral arthritis progression after surgery. (all P < 0.05, retrospectively).Conclusion
The Latarjet procedure yielded satisfactory functional outcomes with low recurrent rate at mid-term follow-up. Development or progression of arthritis was observed in 18.2% of patients, postoperatively. Glenohumeral arthritis after the Latarjet procedure had an adverse effect on clinical outcome. Generalized laxity and lateral overhang should be considered as risk factors of progression to glenohumeral arthritis after the Latarjet procedure. 相似文献10.
Ji Wan Kim Jin-Sook Ryu Sora Baek Seong-Eun Byun Jae Suk Chang 《Journal of orthopaedic science》2017,22(3):457-462
Background
Bone SPECT can be used after a femur neck fracture to assess the circulation of the femoral head in the immediate postoperative period because the blood supply is one of the major factors affecting bone uptake of radiotracer on bone scintigraphy. The purpose of our present study was to investigate whether osteonecrosis of the femoral head (OFH) after internal fixation of femoral neck fracture could be predicted by early and late bone SPECT.Methods
This retrospective cohort study enrolled 44 patients (33 women; mean age, 66.9 years) who underwent surgical fixation for femoral neck fractures. Early and late bone SPECT images were obtained within 2 weeks postoperatively and at 3 months postoperatively. Patients were followed up for a minimum of 24 months (average, 34 months).Results
OFH developed in 9 out of 44 patients but no patient showed nonunion. Seventeen patients with normal femoral head uptake on early bone SPECT were healed. Of 27 patients with decreased femoral head uptake on early bone SPECT, 2 patients developed OFH on radiography before 3 months postoperatively, 18 patients recovered to normal uptake on the late SPECT, and the remaining 7 patients still showed decreased uptake on the late SPECT at 3 months postoperatively. All of these 7 cases finally developed OFH on radiography.Conclusion
Bone SPECT can reliably predict the possibility of OFH with after femoral neck fracture at least 3 months after surgery, while early bone SPECT showed low specificity.Study design
Clinical. 相似文献11.
Sang-Min Park Jae-Woo Park Hyoungmin Kim Ho-Joong Kim Jin S. Yeom Choon-Ki Lee Bong-Soon Chang 《Journal of orthopaedic science》2018,23(2):237-247
Background
Vertebroplasty represents an established treatment option for osteoporotic vertebral compression fracture (OVCF), but its radiographic and clinical outcomes have not been clearly described in patients with intra-vertebral cleft (IVC). The aim of this study was to assess vertebral height restoration, recollapse and change of back pain in OVCF patients with or without IVC.Methods
The records of 108 patients with IVC (group I) and 233 patients without IVC (group II) were included in our analysis between March 2001 and February 2014. The heights of the anterior, middle, and posterior columns, as well as the wedge angle (WA) of the fractured vertebral body were measured. For each vertebral column, the mean height of the superior and inferior vertebral body served as reference. Pre-operative, postoperative, and final compression rates (CR), as well as restoration and recollapse rates were calculated for each column. Subjective back pain was assessed as the numeric rating scale (NRS) score.Results
The overall incidence of IVC in OVCF patients who underwent vertebroplasty was 20.8% (127/611 patients). Group I showed significantly higher CR over the entire follow-up period, with the exception of CR for the anterior column at final follow-up, and CR for the posterior column throughout the follow-up. The mean restoration rates at the anterior and middle column immediately after vertebroplasty were also significantly larger in group I. Recollapse rate in all columns was similar for groups I and II. The mean wedge angle was significantly larger in group I over the entire follow-up period. The groups did not differ in terms of NRS score at final follow-up.Conclusions
Vertebroplasty restores vertebral body heights and WA more effectively in OVCF patients with IVC, and provides satisfactory radiographic and clinical outcomes regardless of the presence of IVC. 相似文献12.
Ki Hyuk Sung Soon-Sun Kwon Seung Jun Moon Seung Yeol Lee 《Journal of orthopaedic science》2018,23(4):658-664
Background
The purpose of this study was to determine the reliability of numerous radiographic measurements of the skeletally immature ankle joint, timing of ossification of medial malleolus and appearance of tibial incisura and differences in the values of radiographic measurements based on age and sex.Methods
This study included 590 subjects (0–15 years), who underwent ankle AP, lateral and mortise radiographs. Presence of the medial malleolus and incisura fibularis were recorded. Tibiofibular overlap, tibiofibular clear space, medial clear space, talar tilt, talocrural angle, relative fibular width and fibular position were measured.Results
All radiographic measurements showed good to excellent intraobserver and interobserver reliability (ICCs, 0.603 to 0.949). The timing of ossification of medial malleolus and appearance of tibial incisura between boys and girls were not different. Tibiofibular clear space on mortise views, and medial clear space on AP and mortise view significantly decreased by age. Tibiofibular overlap on AP and mortise views, relative fibular width on AP view significantly increased by age. Talocrural angle, tibiofibular overlap on AP view, tibiofibular clear space on AP and mortise views, medial clear space on AP and mortise views and fibular position were significantly larger in boys than in girls. The difference in tibiofibular overlap, tibiofibular clear space and medial clear space on AP view of both sides was <50% in 97.1%, 93.1%, and 97.2% of patients, respectively. The difference in tibiofibular overlap, tibiofibular clear space and medial clear space on mortise view of both sides was <50% in 98.0%, 96.5%, and 100% of patients, respectively.Conclusions
For skeletally immature patients, the criteria for absolute radiographic values used in adults to assess distal tibiofibular syndesmosis or deltoid ligament injury cannot be applied, but comparison of both sides of ankle joint could help physicians to predict the need for additional evaluations. 相似文献13.
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Yong-Chan Ha Young-Kyun Lee Kyung-Hoi Koo Ki-Bum Kwon Sang-Heon Song 《Journal of orthopaedic science》2017,22(3):512-516
Background
Hypertrophic labrum in dysplastic hip has been frequently reported and is known as limbus in developmental dysplasia of the hip. However, hypertrophic labrum without hip dysplasia has not been reported to date. The purpose of this study was to define hypertrophic labrum and to investigate the prevalence and clinical significance of an abnormally hypertrophic labrum in non-dysplastic hips.Methods
Between 2007 and 2014, direct CT arthrography was performed in 464 patients (470 hips) who had chronic groin pain and positive impingement or Faber test. There were 189 male (192 hips) and 275 female (278 hips) patients. The mean age was 46.8 years (range, 16–74 years). The hypertrophic labrum was defined as a labrum wider than two standard deviations away from the mean. Surgical correlation of hypertrophic labrum was obtained in cases with hip arthroscopy by a single surgeon.Results
Seventeen hips (3.6%) were found to have a hypertrophic labrum which had a mean width of 11.2 mm (±1.1) (range, 9.8–14.1 mm). The average width (±SD) of the labrum without hypertrophy was 5.5 mm (±2.4) (range, 2–9.8 mm). Arthroscopic findings of the hypertrophic labrum included fissure and longitudinal tear at the chondrolabral junction and they were associated with chondral abnormality adjacent to the lesion.Conclusions
Hypertrophic labrum without hip dysplasia is not rare with a high incidence of tears. Care should be taken during arthroscopic access to the hip joint in patients with this morphologic variation as iatrogenic damage can occur more easily.Level of evidence
Case Series; Level IV. 相似文献16.
Background
In oblique lateral interbody fusion (OLIF), the lateral cage enters into the disc space obliquely, and is then turned to the true lateral direction to achieve a lateral lumbar interbody fusion. The OLIF cage is sometimes placed asymmetrically although it seemed to be placed accurately on intraoperative C-arm images. The present study aimed to investigate the accuracy of cage placement and its effect on the radiological outcome in OLIF.Methods
This study involved a retrospective radiological analysis of 127 lateral cages in 75 consecutive OLIF patients. The cage deviations from the midline and cage obliquity were evaluated using three sets of images: (1) intraoperative C-arm fluoroscopy, (2) postoperative standing radiographs, and (3) postoperative computed tomography (CT).Results
The mean cage deviation from the midline was measured as 2.5 ± 2.7 mm on intraoperative C-arm images, but was found to be more deviated on postoperative radiographs and CT (5.4 ± 3.8 mm and 3.8 ± 3.7 mm; P = 0.000 and 0.005, respectively). The cage obliquity on the intraoperative lateral C-arm was minimal in 26 (20.5%) cases, mild in 69 (54.3%), and moderate in 32 (25.2%), but was found to be more obliquely on postoperative radiographs as minimal in 9 (7.1%), mild in 55 (43.3%), and moderate in 63 (49.6%) (P < 0.001). Anterior/posterior disc heights, disc lordotic angle, fusion rate, and cage subsidence rate were not different according to cage obliquity (all P > 0.05).Conclusions
Cage deviation from the midline and obliquity is underestimated on intraoperative C-arm images in OLIF. Although minimal cage deviation and obliquity did not affect the radiological outcome, great care should be made for the orthogonal cage insertion. 相似文献17.
Jisook Yi Young Han Lee Sang Kyum Kim Seung Hyun Kim Ho-Taek Song Kyoo-Ho Shin Jin-Suck Suh 《Journal of orthopaedic science》2018,23(3):570-577
Background
This study aimed to compare computed tomography (CT) features, including tumor size and textural and histogram measurements, of giant-cell tumors of bone (GCTBs) before and after denosumab treatment and determine their applicability in monitoring GCTB response to denosumab treatment.Methods
This retrospective study included eight patients (male, 3; female, 5; mean age, 33.4 years) diagnosed with GCTB, who had received treatment by denosumab and had undergone pre- and post-treatment non-contrast CT between January 2010 and December 2016. This study was approved by the institutional review board. Pre- and post-treatment size, histogram, and textural parameters of GCTBs were compared by the Wilcoxon signed-rank test. Pathological findings of five patients who underwent surgery after denosumab treatment were evaluated for assessment of treatment response.Results
Relative to the baseline values, the tumor size had decreased, while the mean attenuation, standard deviation, entropy (all, P = 0.017), and skewness (P = 0.036) of the GCTBs had significantly increased post-treatment. Although the difference was statistically insignificant, the tumors also exhibited increased kurtosis, contrast, and inverse difference moment (P = 0.123, 0.327, and 0.575, respectively) post-treatment. Histologic findings revealed new bone formation and complete depletion or decrease in the number of osteoclast-like giant cells.Conclusion
The histogram and textural parameters of GCTBs changed significantly after denosumab treatment. Knowledge of the tendency towards increased mean attenuation and heterogeneity but increased local homogeneity in post-treatment CT histogram and textural features of GCTBs might aid in treatment planning and tumor response evaluation during denosumab treatment. 相似文献18.
Yusuke Osawa Yukiharu Hasegawa Taisuke Seki Yasuhiko Takegami Takafumi Amano Naoki Ishiguro 《Journal of orthopaedic science》2018,23(2):346-349
Background
There has been constant discussion about whether the clinical outcome of THA after periacetabular osteotomy (PAO) is equivalent to that after primary total hip arthroplasty (THA). However, there have been few reports about patient-reported outcomes (PRO) for those who undergo THA after PAO. We compared the pre- and postoperative PRO of patients who underwent THA after PAO and those who underwent primary THA alone.Methods
We performed a case–control study. Twenty-seven patients (29 hips) underwent THA after PAO (osteotomy group); their mean age at surgery was 57.2 years, and they underwent postoperative follow-up for a mean period of 3.0 years. For the control group, after matching age, sex, and Crowe classification, we included 54 patients (58 joints) who underwent primary THA for hip dysplasia. Assessment performed preoperatively and at the last follow-up included the Harris hip score, the Short Form 36 (SF-36) for the Physical Component Summary (PCS), Mental Component Summary (MCS), and Role/Social Component Summary (RCS) domains, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) for pain, movement, and mental health, and the visual analog scale (VAS) score of hip pain and satisfaction.Results
The two groups demonstrated no significant difference in the preoperative Harris hip score, each domain of the SF-36, JHEQ, and the VAS score of hip pain and satisfaction. The osteotomy group demonstrated significantly poor Harris hip scores for gait and activity, and JHEQ for movement at the last follow-up. There was no significant difference in each domain of the SF-36 and the VAS score of hip pain and satisfaction at the last follow-up.Conclusion
Previous PAO affects the quality of physical function in patients who undergo subsequent THA. 相似文献19.
Purpose
To identify factors influencing overall radiologic changes in the distal radioulnar joint after ulnar shortening osteotomy (USO) in patients with idiopathic ulnar impaction syndrome.Materials and methods
A total of 310 patients who had undergone USO between May 2007 and December 2013 were included in this retrospective case–control study. The patients were classified into two groups (with or without radiologic findings of new arthritic changes), after which the following factors were analyzed: 1) demographic factors; 2) radiologic aspects, including ulnar variance (UV), morphological DRUJ type (classified according to Tolat et al.), and union period after USO; and 3) operative aspects, including the triangular fibrocartilage complex degeneration type, use of a parallel double-blade saw, type of plate used for fixation, and plate position on the volar or dorsal ulnar surface.Results
Group 1 (no arthritic changes) consisted of 243 patients, whereas Group 2 (arthritic changes) consisted of 67 patients. Univariate and multivariate analyses showed that the presence of lunate cystic changes, amount of shortening, and the union period were significantly associated with newly developed arthritic changes in the distal radioulnar joint (DRUJ) after USO. The morphological DRUJ type was not a significant factor. Arthritic changes were significantly more prevalent in patients with a shortening amount >4.5 mm and a union period <3.25 months.Conclusions
Radiologic arthritic changes after USO, were associated with the presence of cystic changes in the lunate, a shortening amount (>4.5 mm), and early bony union (<3.25 months).Type of study/level of evidence
Therapeutic level III. 相似文献20.
Yeesuk Kim Jin Kyu Lee Kyu-Sung Chung Doo-Yeon Lee Choong Hyeok Choi 《Journal of orthopaedic science》2017,22(4):693-697