To compare the early result of minimum incision surgery (MIS) to standard incision procedures with use of lateral flare hip replacement (Revelation Hip System, DJO, USA). 38 primary total hip arthroplasty of 36 patients were performed using lateral flare hip system. Lateral flare hip has symmetric contact to medial and lateral cortical bone at high proximal part and it provides definite endpoint of stem insertion. From this point of view, we can say that this system is suitable for MIS. Among the 38 hips, 21 hips were performed by MIS (less than 10cm) and 17 hips were performed by Standard incision. MIS were performed from November 2004 to December 2005. And Standard incisions were performed from June 2004 to December 2005. Two surgeons performed all operations (NW and YT). The main surgeon decided whether MIS was applicable or not for each patient. Anterolateral intra gluteal approach (modified Dall) was applied for all surgeries. The same rehabilitation program was applied on both groups postoperatively. The average follow-up period of MIS patients was 28.6 months and 34.7 months in standard incision. We investigated the early result of these patients.

There was a relationship between patients’ height and the length of skin incision (p< 0.05). No significant difference between two groups was proved in CRP, CPK and D-Dimmer (CRP: 13.9/11.9mg/dl, CPK: 405.5/380.5mg/dl, D-Dimmer: 6.1/5.3mg/dl). Both intraoperative blood loss and operation time were less in MIS group (blood loss 530.9ml vs. 772.8ml, operation time 99min vs. 115.4min) (p< 0.05). The days until the patient was able to do active straight leg raising were 17.3 in MIS group and 22.4 in standard incision group and hospital stay days were 26.7 vs. 29.2. But no significant differences were proved in hospitalization. On roentgenografic findings, the inclination of acetabular cup was 42.0 degree in the MIS group versus 41.2 in the standard incision group and no significant difference was found. In Radiographic findings, one stable fibrous fixation was observed in each group. The other cases were bone ingrowth fixation. Japanese orthopedics association (JOA) hip score was not significant different in each group at the final follow up (88.1 in MIS group and 85.9 in Standard group). Also as the result at the term of 6, 12, 18 and 24 months after operation, JOA hip scores was not significant difference in each group. There were no revision cases in this study until the final follow up.

In the present study, intra-operative hemorrhage and operation time were significantly less in MIS group. It was supposed that at the patient selection, each surgeon decided the candidate of MIS due to patient’s hip condition. But in another situation, no significant difference was found for example in serum CRP, CPK and D-Dimmer levels. Clinical and radiological outcomes were not significantly different between MIS and Standard group in this study.

Conventional high tibial osteotomy for osteoarthritis of the medial compartment of the knee with closed-wedge or dome osteotomy (DMO) may produce shortening of the patellar tendon and loss of inclination of the proximal tibial plateau or of the offset of the tibial condyle relative to its bony axis. This can make subsequent total knee arthroplasty technically demanding.

We undertook a prospective study comparing these changes after DMO with those after using open-wedge osteotomy hemicallotasis (HCO). A total of 50 knees with arthritis of the medial compartment in 46 consecutive patients was randomly allocated to either DMO or HCO. There were no significant differences between the groups with regard to age, gender, femorotibial angle before operation or the angle of correction.

Radiological studies showed that HCO caused little change in the length of the patellar tendon or the inclination angle of the tibial plateau, while after DMO both gradually decreased. The degree of tibial condylar offset increased in both groups, but less so in the HCO group.

We investigated the incidence of evidence of irritation of the brachial plexus in 119 patients with whiplash injuries sustained in road-traffic accidents. We compared the symptoms, physical signs, autonomic status, psychological status and findings from radiographs of the cervical spine using examination charts and a modified Cornell Medical Index Health questionnaire, in patients in two distinct groups: those with irritation of the brachial plexus and those without.

There were 45 patients (37.8%) in the first group. The ratio of women to men was significantly higher in patients with irritation of the plexus as was the incidence of symptoms other than neck pain. There was no significant difference between the two groups with regard to psychological status or findings in radiographs of the cervical spine. Symptoms and signs attributable to stretching of the brachial plexus do occur in a significant proportion of patients after a whiplash injury. Their presence and persistence are associated with a poor outcome.

We describe the results of conservative treatment for complete midsubstance tears of the anterior cruciate ligament (ACL) in 18 skeletally immature patients, followed for a minimum of 36 months. Six patients had an ACL reconstruction during the follow-up period and were assessed immediately before their operation. The average time from initial injury to evaluation was 51 months. All patients had symptoms when reviewed. The modified Lysholm knee score showed one excellent result, one good, eight fair, and eight poor with a mean score of 64.3. Only one patient had returned to her preinjury level of athletics. Secondary meniscal tears were confirmed in six patients, and three more had the clinical signs of a tear at follow-up. Radiological evidence of degenerative changes was found in 11 of the 18 patients. We conclude that the results of non-operative treatment for ACL injuries in this age group are poor and not acceptable.