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Intraosseus ganglion cysts are uncommon, benign, and usually found within long bone, the lesions appear grossly and histologically similar to their tissue counterparts exhibiting a thick fibrous wall and filled with a slimy, mucin rich gelatinous material. A 70 aged woman presented with 2-year history of progressive hip joint pain with osteoarthritis. No history of trauma was presented. Hip joint motion was moderately limited & radiographically, they presented a lucent area with sclerotic margin within the femoral head that was deformed and severe hip joint degenerative change. Treatment was consist of total hip replacement arthroplasty, because of severe hip joint osteoarthritis.
Purpose : The management of patella in total knee arthroplasty is still problematic. The purpose of this study was to evaluate the changes of clinical and radiological results after total knee arthroplasty without patellar resurfacing. Materials and Methods : We retrospective evaluated the nonresurfaced patella in 50 knees(65 patients) at an average of 77.5 months after total knee arthroplasty(Duracon^(®), Howmedica, Rutherford, NJ). Patients were diagnosed as osteoarthritis in 45 and rheumatoid arthritis in 3 and the others were osteonecrosis , and evaluated using the knee society knee score and functional knee score, modified patellar score. Results : The mean preoperative knee society knee score in osteoarthritis and rheumatoid arthritis were 58.2 and 36.7 points, and functional score were 35.8 and 34 points. The mean postoperative knee society knee score in osteoarthritis and rheumatoid arthritis were 95.5 and 93.2 points, and functional score were 75.2 and 83 points and the mean modified patellar score was 28.5 points, and 26 cases(52%) were excellent(30 35 points, 18 cases(36%) were good(25 29 points) and 6 cases(12%) were fair(20 24 points). There were no patella associated complications and in 8 cases(16%) of anterior knee pain which resolved with conservative treatment at latest follow up. Conclusion : Total knee arthroplasty with patelloplasty, without patellar resurfacing , provided satisfactory results without significant problems, and can avoid the complications (patellar dislocation and subluxation, fracture and component loosening, rupture of patellar and quadriceps tendon). But long term radiological and clinical follow up is recommended.
Patellar clunk syndrome after total knee arthroplasty is a complication that causes pain and poping or catching of patella. We experienced a case after mobile bearing total knee arthroplasty that medial synovial tissue was impinged between patella and femoral component and intra-articular fibrotic nodule of superior pole of patella was observed. Also, wear of Polyethylene were observed at anterio side. We resolved the patient symptom after excision of fibrotic nodule, synovectomy of medial synovial hypertrophy, and change of polyethylene. We report this case with literature review.
Purpose: This study compared the clinical and radiographic results of two proximal femoral nail antirotation II (PFNA-II) angled by 125° and 130° in patients with intertrochanteric fractures. Materials and Methods: From March in 2015 to September in 2016, 65 patients who underwent a closed reduction and internal fixation with PFNA-II for a femoral intertrochanteric fracture were evaluated retrospectively. The minimum follow-up period was two years. Of those, 30 and 35 patients underwent 125° angled PFNA-II and 130° angled PFNA-II, respectively. The clinical performance was evaluated using the Harris hip score, WOMAC (Western Ontario and McMaster Universities Osteoarthrtis Index), and UCLA (University of California Los Angeles) score. Radiographic analyses were performed using standardized anteroposterior and lateral radiographs to assess the implant position and quality of reduction. The blade length, distance between the blade tip and the tip of the greater trochanter, and distance between the blade tip and the most lateral protrusion point of the greater trochanter in the two groups were measured and compared. Results: The clinical results, including the Harris hip score, WOMAC, and UCLA, were similar in the two groups at the last follow-up postoperatively. In the radiography evaluation, the implant position, quality of reduction, and the blade length were similar in the two groups. The distances between the blade tip and the tip of the greater trochanter were 52.60±3.53 mm and 58.07±5.54 mm in the 125° angled PFNA-II and 130° angled PFNA-II groups, respectively. The distance between the blade tip and the most lateral protrusion point of greater trochanter were 16.48±2.54 mm and 21.19±4.43 mm in the 125° angled PFNA-II and 130° angled PFNA-II groups, respectively. The differences were significant (p=0.031, p=0.012). Conclusion: The operation with the 125° angled PFNA-II showed a more superior and lateral position of the blade than that with the 130° angled PFNA-II. Nevertheless, lateral thigh pain can occur when the blade is positioned superolaterally. 목적: 대퇴골 전자간 골절 환자에서 125도, 130도의 제2형항회전 근위 대퇴 골수정(PFNA-II)을 이용한 수술의 결과를분석하였다. 대상 및 방법: 대퇴골 전자간 골절로 PFNA-II를 이용한 수술을 시행 받은 환자 65예를 후향적으로 분석하였다. 이 중 30 예는 125도 PFNA-II를 사용하였고, 35예는 130도 PFNA-II 를 사용하였다. 수술 후 대퇴부 동통 외 임상적 점수를 조사하였고 삽입물의 위치 및 정복 정도, 추가적으로 대전자 끝에서 나선형 칼날 삽입구까지의 거리, vastus ridge 끝에서 나선형 칼날 삽입구까지의 거리를 측정하여 비교하였다. 결과: 대전자 끝에서 나선형 칼날 삽입구까지의 거리는 125 도 PFNA-II 집단에서는 52.60±3.53 mm였고, 130도 PFNA- II 집단에서는 58.07±5.54 mm였다. Vastus ridge 끝에서 나선형 칼날 삽입구까지의 거리는 125도 PFNA-II 집단에서는 16.48±2.54 mm였고(p=0.031), 130도 PFNA-II 집단에서는 21.19±4.43 mm였다(p=0.012). 결론: 125도 PFNA-II 집단이 130도 PFNA-II 집단보다 나선형 칼날의 위치가 좀 더 상방, 외측에 위치하였다.
The gallbladder is known to have the function of the storage and the concentration of the bile produced by the liver. This function is carried out by the removal of water and inorganic electrolytes. Extrahepatic cholestasis or the impairment of excretion of the bile leads to the distension and loss of the function of the gallbladder. The purpose of this study was to examine the ultrastructural characteristics of the normal gallbladder epithelial cells, and their structural changes induced by the ligation of common bile duct of the rabbit. Common bile duct ligation was performed under ether anesthesia. The rabbits were sacrificed on the 1st, 3rd, 5th, 7th and 14th day, respectively after operations. The tissue blocks of the gallbladder were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde prior to fixation in 1% osmium tetroxide, and embedded in the araldite mixture, and observed with JEM 100 CX-II electron microscope. The results were as follows: 1. The normal gallbladder epithelium of adult rabbit demonstrated two cell types, the ordinary epthelial cell and the dark cell. The dark cells have electron dense cytoplasm, and were found much infrequently, whereas ordinary epthelial cells were found quite numerous. 2. The ordinary epthelial cells of normal gallbladder were provided with the regular microvilli at the free surface and the images of pinocytotic activities in the apical cytoplasm, and exhibit highly convoluted lateral surfaces with elaborated microfolds. These figures of the cells suggest that they are resorptive in functional activity. 3. In the early stages (1st, 3rd, 5th day groups) following the ligation, the apical cytoplasm of some cells is protruding from the free surface and lost their microvilli. Numerous mucous granules filled in the apical and supranuclear cytoplasm compactly. 4. In the late stages (7th, 14th day groups) following the ligation, many light cells containing mumerous mucous granules are seen, between the ordinary epthelial cells. Mucous granules are fused each other, and are discharged into the lumen from the apical cytoplasm. The lateral membranes are straight or undulating without any interdigitations. From the above results, it was concluded that in the cholestasis induced by the common bile duct ligation, there is a tendency for the mucosal epithelium of the rabbit gallbladder to have secretory rather than an absorptive function.