Injection before total knee arthroplasty(TKA) is the one of the postoprative risk factors after TKA and Infection after TKA can result in disastrous consequences. When the duration between injection and TKA is longer than 6 months, the risk is no longer elevated. Evaluation of synovial WBC number in frozen section slide is needed to check the presence of infection in revision total knee arthroplasty. Currently many patients have a history of multiple intraarticular injection before the primary TKA. Purpose of this study is to evaluate the synovial WBC findings in primary TKA and compare between injection group and no injection group. Materials and Methods. The synovial specimen(suprapatella pouch and posterior capsule) of 68 primary total knee arthroplasty were evaluated by the pathologist and reported the number of the WBC in frozen section /5 separate high power fields(HPF) (500x).. Injection group were 37 cases and non -injection group were 31 cases. Preoperative CRP and ESR were recorded and followe-up duration was more than 2 years. Joint fluid was sent to be cultured and analysed. Results. WBC count in frozen section shoed was average 4 WBCs/HPF (range < 0∼ 25) in both specimen and the suprapatella specimen was 3 WBCs/HPW (range 0∼25) and posterior capsule specimen was 1 WBCs/HPF(range 0∼14). The WBC count of injection group was 8 (range, 0∼25) and that of no injection group was 1.2 cells (range 0∼12) (p<0.05). The WBC counts in joint fluid was average 240 cells/ml (range. 1∼300) in non injection group and 643 cells/ml(range, 50∼1000) (p<0.05). The duration from the intraarticular injection to index surgery was 9 months(range, 6 weeks∼ 7 momths). The number of injection and duration bwtween injection and operationto has no significant correlation with the WBC counts. Eight percentage of specimen showed more than 10 WBCs in injection group and these patients have been not infected after more than 24 moths after TKA. Conclusion. The WBC count of the synovium in priamry TKA with injection history for degenerative osteoarthritis is variable and we could not recommend the routine frozen section analysis in primary TKA who have a history of intraarticualr injection..

Background

Total ankle arthroplasty (TAA) with the use of third generation implants has demonstrated favorable clinical results and improved survival. However, few studies have compared the different types of implants. The purpose of this study was to perform a retrospective evaluation of patient outcomes and complications by comparing TAA procedures performed with HINTEGRA versus MOBILITY systems.

Introduction

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.

Demineralized Bone Matrix (DBM) is currently used in various types of orthopaedic applications because of osteoconductive and osteoinductive properties. Fibrin glue is also used in cardiovascular and thoracic surgery due to its hemostatic, chemotactic and mitogenic properties. There is some possibility of being good biomaterial and biodegradable scaffold with DBM-fibrin glue mixture for bone void filler. After total hip replacement surgery, it takes long time to complete bone fusion. If patients have excess weight load after surgery, the artificial joint may not be adhered with patients’s bone.

That is why surgeons have to use any effective treatments for bone fusion for patient’s safety. In order to adapt to these surgical sites, DBMs are shaped in blocks or granules and preferable in porous forms. Combining these DBMs with fibrin glue provides a moldable and self-hardening composite biomaterial. This material will be applied to total hip replacement surgery for the effective fusion between bone and artificial joint. The aim of this work is to study the osteogenic properties of this composite material using in vivo and ex vivo. In radiological study, the DBM composite had been absorbed during one week since implantation surgery and after two weeks, some radio-opaque spots were observed in implantation sites. In histology study, Bone tissue had formed exotically in contact with the surface of the appeared well-mineralized, forming trabeculae between the granules, and had characteristics similar to those of cancellous bone. Bone growth in the tissue engineered filled with DBM and fibrin glue materials increased with implantation time.

In summary, these DBM and fibrin glue composites exhibited interesting biological and mechanical properties for filling large bone defect. These composites may be used in total hip replacement surgery for the effective filler between patient’s bone and artificial joint.

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.