- Total Knee Arthroplasty.
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Dong Chul Lee, Wook Jin Sohn
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Yeungnam Univ J Med. 2004;21(1):1-11. Published online June 30, 2004
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DOI: https://doi.org/10.12701/yujm.2004.21.1.1
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- Total knee arthroplasty has become a common procedure for treatment of severe osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. In the past, failure of total knee arthroplasty was commonly attributable to aseptic loosening, often associated with component malalignment, soft tissue imbalance. With improved surgical instrumentation and soft tissue balancing techiniques, failure secondary to mechanical loosening has been minimal. But surgeons are still dissatisfied with implant malalignment. Correct tibiofemoral alignment seems to be particularly important since it is generally agreed that axial deviation and imprecise implantation may lead to loosening of the implant component. Navigation systems and robotic techniques could potentially solve problems of imprecision in traditional total knee arthroplasty. It is expected that the success rate and longevity of total knee arthroplasty will be improved during the twenty first century.
- Treatment of Tibial Condyle Fracture.
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Dong Chul Lee, Oog Jin Shon, Sung Hyuk Park
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Yeungnam Univ J Med. 2003;20(2):177-186. Published online December 31, 2003
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DOI: https://doi.org/10.12701/yujm.2003.20.2.177
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- BACKGROUND
Clinical and radiological results based on fracture types and associated injuries after the treatment of tibial plateau fracture were evaluated for analyzing prognostic factors. MATERIALS AND METHODS: From June 1997 to June 2002, 50 cases were followed for at least 1 year. Mean age was 47.4 years, and mean follow period was 30.0 months. Fracture classification was performed by the Schatzker method. Clinical and radiological evaluation were performed by the Porter and Rasmussen method. Evaluation was based on degree of reduction and associated injuries, etc. RESULTS: The most common cause of injury was traffic accident (37 cases, 74%), The common fracture types by Schatzker classification were type II (14 cases) and VI (12 cases). Methods of treatment were screw fixation (15 cases), plate and screw (21 cases), external fixator (5 cases), and conservative treatment (9 cases). The most common associated injuries were ipsilateral fibular fracture (18 cases) and MCL (medial collateral ligament) injury (8 cases). CONCLUSION: Acceptable results after treatment of tibial plateau fracture were obtained from the anatomical reduction group, non-associated injury group, the young age group, and the early ROM (range of motion) beginning group.
- The Results of Primary Repair in Acute Injuries of the Posterior Cruciate Ligament.
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Dong Chul Lee, Seung Hee Baek
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Yeungnam Univ J Med. 2001;18(1):101-111. Published online June 30, 2001
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DOI: https://doi.org/10.12701/yujm.2001.18.1.101
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- BACKGROUND
We analyze the functional evaluation, posterior stability after surgery of acute injuries in the femoral detachment and tibial avulsion fracture of posterior cruciate ligament. MATERIALS AND METHODS: Twenty two patient who underwent primary repair were followed more than one year after operation (mean follow-up 33.7 months). The patients were evaluated with KT 2000 arthrometer and posterior stress test for posterior stability. Lysholm knee score was used for knee function. RESULTS: Lysholm score revealed 85.3 in femoral detachment group and 91.1 in tibial avulsion fracture group (p<0.05). Posterior displacement of the posterior stress test showed 17.2 mm at initial injury and 8.6 mm at last follow up in femoral detachment group. 16.8 mm at initial injury and 7.1 mm at last follow up in tibial avulsion fracture group There revealed the tendency of the improved posterior stability of the tibial avulsion group compared with femoral detachment group, but there showed no statistical significance in KT 2000 arthrometer and posterior stress x-ray. CONCLUSION: Functional results of tibial avulsion fracture group revealed the better outcome compared with femoral detachment group, but the degree of posterior stability in tibial avulsion fracture group showed no statistical significance in posterior stability.
- Treatment of Developmental Dislocation of the Hip in Walking Age.
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Se Dong Kim, Jae Hyuk Jang, Dong Chul Lee, Duk Seop Shin
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Yeungnam Univ J Med. 1996;13(2):211-224. Published online December 31, 1996
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DOI: https://doi.org/10.12701/yujm.1996.13.2.211
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- The patients of developmental dislocation of the hip(DDH) are almost found after walking age because of early diagnosis of DDH in younger children is not easy. A controversy still exists as to the relative value of closed and operative management in the treatment of a child who has reached walking age. This study is a report of the results of 16 patients(17 cases) in developmental dislocation of the hip who have visited our hospital at the age of 9 months to 3 years old, and have been followed more than 12 months (12-112 months) on review of plain radiographs and arthrograms. The results were as follows 1. The age at diagnosis was 16.4 months(9-31 months) in average. The methods of treatment were conservative for 8 cases, and operation for 4 cases and secondary operation for 5 cases who were failed with conservative therapy. 2. By Severin's radiologic grade, the result was good in 4 cases, fair in 3 cases and poor in 1 case in conservative treatment. In operative treatment, fair was in 2 cases and poor in 2 cases. In secondary operative -patients who were failed with conservative therapy, good was in 2 cases, fair in 2 cases and poor in 1 case. 3. Avascular necrosis of femoral head was developed in 3 cases. 4. In the good reduction as determined by arthrogram according to Race and Herring, we can get a favorable result in conservative treatment, and in the poor reduction as determined by arthrogram, the better
- Histological Observation of Bone Reaction with Relation to Surface Treatment of Titanium.
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Myun Whan Ahn, Yong Sug Choi, Jong Chul Ahn, Jae Sung Seo, Dong Chul Lee, Jae Hyuk Jang
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Yeungnam Univ J Med. 1996;13(1):116-133. Published online June 30, 1996
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DOI: https://doi.org/10.12701/yujm.1996.13.1.116
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- The biocompatibility of the titanium has been estabilished through various experimental studies such as cell culture toxicity test, pyrogen test, mutagen test and others. In order to confirm biocompatibility after fabrication of titanium and to clarify the difference between the bone reaction after insertion of the lathed titanium rods and the bone reaction after insertion of the finished and polished rods, both rods were implanted into the proximal femur of a rabbit. Histologic reactions in the bone were observed according to the ASTM standards at the intervals of 6 weeks, 12 weeks and 26 weeks after implantation. The result were as follows In 6 weeks after implantation of lathed titanium rods, inflammatory reactions, such as minimal degree infiltration of polymorphonuclear leukocytes and lymphocytes were observed in all cases. This was thought to be caused by surgical trauma. However, inflammatory cell infiltration was not seen after implantation of polished and finished rods in all cases. The cellular infiltration and the histologic reaction of the bone after implantation of lathed group were significantly more pronounced than those after implantation of the finished group. In 12 weekt after implantation of lathed rods, two of four cases revealed a minimal degree of cellular infiliration and histologic reaction seemed to be more pronounced in the lathed group, but they were not significant statistically.
- Treatment of tibial fractures by interlocking intramedullary nailing.
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Kwang Yeoung Jung, Dong Chul Lee, Jae Sung Suh, Se Dong Kim
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Yeungnam Univ J Med. 1993;10(2):388-399. Published online December 31, 1993
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DOI: https://doi.org/10.12701/yujm.1993.10.2.388
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- The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993. 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft. fractures. 3. The Im erlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open-with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major-complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of . fracture and then made early joint motion exercise and ambulation.
- The clinical study of the supracondylar fracture of the femur.
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Jong Chul Ahn, Se Dong Kim, Jae Sung Seo, Dong Chul Lee, Young Joo Lee
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Yeungnam Univ J Med. 1993;10(1):197-211. Published online June 30, 1993
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DOI: https://doi.org/10.12701/yujm.1993.10.1.197
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- Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So compliactions of the supracondyle fractures 'including joint.. stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed. 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989. Dec. To 1992. Jan. The results were as follows 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification, 4 cases were type A, 4 in type B, 12 in type C (10 in type C2&C3). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in consevative treatment and 67 in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.
- Clinical observation and treatment of fracture-dislocation of talus.
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Dong Chul Lee, Se Dong Kim, Hae Hoon Jung
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Yeungnam Univ J Med. 1992;9(2):302-311. Published online December 31, 1992
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DOI: https://doi.org/10.12701/yujm.1992.9.2.302
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- Talus is an important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 years. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down (8 cases), and next traffic accident (2 cases), sports injury (1 case). 3. According to Marti-Weber classification, 1 case was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results (by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved (74%), but in the subtalar joint it was decreased (43%)
- Erythrocyte sedimentation rate and C-reactive protein values in patients with hip arthroplasty.
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Se Dong Kim, Dong Chul Lee, Dong Gu Park
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Yeungnam Univ J Med. 1992;9(2):218-223. Published online December 31, 1992
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DOI: https://doi.org/10.12701/yujm.1992.9.2.218
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- Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured in 46 patients treated with uncomplicated primary hip replacements, 39 total tip replacements and 7 bipolar hip replacements. In uncomplicated primary hip replacements, ESR levels were slightly elevated preoperatively and were variable postoperatively. But CRP was normal before surgery and elevated in postoperative course, but back to normal within three weeks in most cases. Early success of hip arthroplasty is in indicated by normalization of CRP within three weeks, regardless of ESR. Since ESR seems to react somewhat differently from the CRP, both methods are useful in the monitoring of complications after hip arthroplasty.
- Treatment of the tibia shaft fractures with ender nails.
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In Ki Kim, Dong Chul Lee, Jae Sung Seo, Myun Whan Ahn, Se Dong Kim, Jong Chul Ahn
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Yeungnam Univ J Med. 1992;9(1):130-136. Published online June 30, 1992
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DOI: https://doi.org/10.12701/yujm.1992.9.1.130
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- Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their numerous complications. Thirty patients with fractures of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to November 1991. The following results were observed. 1. The average age was 37.3 years and the number of male was three times of the female. The most common cause was traffic accident. 2. Twenty cases out of thirty one were closed fracture and the remaining 11 were open. The comminuted and segmental fractures were 18 (57.7%) in number and the most common fracture site was the middle one third (53%). 3. Average interval from injury to operation was 7.6 days and 19 cases showed associated injuries. 4. The mean duration of the bone union was 18.9 weeks and 2 cases showed the delayed union. 5. Twelve complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.
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