Bong Hyun Bae

Comparison of functional results with navigation-assisted minimally invasive and conventional techniques in bilateral total knee arthroplasty.

This study was undertaken to compare the clinical and radiological results achieved using navigation-assisted minimally invasive surgery (NA-MIS) and conventional (CON) techniques in 42 bilateral total knee arthroplasty (TKA) patients with a minimum follow-up of one year. Clinical evaluations were performed using range of motion (ROM), Hospital for Special Surgery (HSS) scores, and Western Ontario and McMaster University (WOMAC) scores (pain, functional, and total) at 3, 6 and 9 months and one year postoperatively. Patients’ subjective preferences and radiological indices, including mechanical axis and coronal inclinations of the prostheses, were compared at one year postoperatively. NA-MIS TKA yielded better HSS and WOMAC total scores than CON TKA up to six months, and a better WOMAC pain score up to 9 months. However, these differences were not significant at one year postoperatively. ROM was comparable in both groups at all times, but more patients preferred the NA-MIS side to the CON side. Radiological results showed no differences in mean values between the two surgical groups, although the NA-MIS group contained fewer outliers than the CON group. In conclusion, NA-MIS TKA was associated with better clinical results up to 6 or 9 months after surgery, giving more accurate leg alignment than CON TKA.

Kinematic study following double-bundle, anterior cruciate ligament reconstruction.

The purpose of this study was to evaluate tibiofemoral kinematics after double-bundle anterior cruciate ligament (ACL) reconstructions and compare them with those of successful single-bundle reconstructions and contralateral normal knees using open MR images. We obtained MR images based on the flexion angle without weight-bearing, from 20 patients with successful unilateral single-bundle (10 patients) and double-bundle (10 patients) ACL reconstructions with tibialis anterior allografts and a minimum 1-year follow-up. The MR images of the contralateral uninjured knees were used as normal controls. Sagittal images of the mid-medial and mid-lateral sections of the tibiofemoral compartments were used to measure the translation of the femoral condyles relative to the tibia. The mean translations of the medial femoral condyles on the tibial plateaus during knee joint motion showed no significant differences among normal, single-bundle, and double-bundle ACL reconstructed knees (all p>0.05). The mean translations of the lateral femoral condyles showed a significant difference between normal and single-bundle reconstructed knees, or between single-bundle and double-bundle reconstructed knees (p<0.05). However, there was no significant difference between normal and double-bundle reconstructed knees (p=0.220). These findings suggest that double-bundle ACL reconstruction restores normal kinematic tibiofemoral motion better than single-bundle reconstruction.RésuméLe but de cette étude était d’évaluer, par les images de résonnance magnétique, la cinématique tibio-fémorale après reconstruction du ligament croisé antérieur par double tunnel et de la comparer avec celle obtenue après réussite des reconstructions à un seul tunnel et celle du genou normal controlatéral. Nous avons étudié des images basées sur l’angle de flexion en décharge chez 20 patients après reconstruction par allogreffe tibiale antérieure suivis au moins un an : 10 avec succés de la reconstruction par un seul tunnel et 10 avec reconstruction par un double tunnel. Les images du genou controlatéral non traumatisé servaient de contrôle. Des images sagittales de la partie moyenne des compartiments fémoro-tibiaux permettaient la mesure de la translation des condyles fémoraux par rapport au tibia. La translation du condyle interne pendant la flexion du genou n’était pas différente entre le genou normal et la reconstruction par simple ou double tunnel (p>0,05). La translation du condyle externe était significativement différente entre le genou normal et la reconstruction par simple tunnel et entre les reconstructions par simple et double tunnel (p<0,05). Cependant il n’y avait pas de différence entre le genou normal et la reconstruction par double tunnel (p=0,220). Ces résultats suggèrent que la reconstruction du croisé antérieur par double tunnel restore mieux la cinématique du genou que la reconstruction par simple tunnel.