Jehyoung Yeo

Comparison of two surgical approaches for displaced intra-articular calcaneal fractures: sinus tarsi versus extensile lateral approach

BackgroundTwo common surgical approaches included the sinus tarsi and extensile lateral are used for displaced intra-articular calcaneal fractures. However, few studies have compared outcome of treated by the two approaches. The purpose of this study was to compare the outcome between these two approaches for Sanders type-II and type-III fractures.MethodsThis retrospective cohort study was performed from 2004 to 2011. Open reduction and internal fixation using the sinus tarsi and extensile lateral approach was studied in 100 cases (40 sinus tarsi and 60 extensile lateral) with displaced intra-articular calcaneal fractures. All patients were evaluated both clinically and radiologically.ResultsMedian Böhler and Gissane angle were improved to 26.5 degree (4.6 to 45), 115.5 degree (101.2 to 127.4) in the sinus tarsi group and 25.3 degree (3.7 to 44.6), 119.0 degree (73.5 to 145.6) in extensile lateral group at the final follow-up, respectively. Median calcaneal height, length, and width in the sinus tarsi and extensile lateral groups showed improvement to 45.1xa0mm (23.2 to 54.1), 75.9xa0mm (64.9 to 90.3), 37.6xa0mm (29.2 to 53.9) and 46.5xa0mm (32.7 to 59.5), 76.1xa0mm (67.3 to 97.9), 39.3xa0mm (29.2 to 47.8) at the final follow-up, respectively. Median AOFAS score was checked to 90 points (76 to 94) in the sinus tarsi group and 86 points (76 to 94) in the extensile lateral group at the final follow-up. No significant differences in clinical and radiologic outcomes were observed between the two groups. However, wound complication rate (13.3%) in the extensile lateral group was significantly higher compared to the sinus tarsi group (p-valueu2009=u20090.022).ConclusionsThe final clinical and radiographic outcomes between the two approaches for Sanders type-II and type-III intra-articular calcaneal fractures were comparable and equally successful. The selective sinus tarsi approach appears to be an effective and reliable method for the treatment of Sanders type-II and type-III fractures.

No difference in outcomes and gait analysis between mechanical and kinematic knee alignment methods using robotic total knee arthroplasty

PurposeThe purpose of this study was to compare clinical outcomes and perform gait analysis during walking to identify differences in kinematic and kinetic parameters between two alignment methods in robotic-assisted total knee arthroplasty (TKA).MethodsSixty patients were randomly assigned to undergo robotic-assisted TKA using either mechanical (30 patients) or kinematic (30 patients) alignment method. Clinical outcomes including varus and valgus laxities, range of motion (ROM), Hospital for Specific Surgery (HSS), Knee Society Score (KSS), and Western Ontario and McMaster Universities (WOMAC) scores and radiological outcomes were evaluated. Gait analysis of 3D spatiotemporal, kinetic, and kinematic parameters during walking was then performed for 10 age and gender matched patients of each group to determine differences between the two alignment methods.ResultsThe median follow-up duration of the mechanical method group was 8.7 (range 8.1–9.4)xa0years and that of the kinematic method group was 8.4 (range 8.0–9.1)xa0years. Clinical outcomes between the two groups showed no significant difference in HSS, WOMAC, ROM, KS pain, or function score at the last follow-up. No significant difference in varus and valgus laxity assessment, mechanical alignment of the lower limb, or perioperative complications was shown between the two groups. In gait analysis, no significant difference in kinematic or kinetic parameters was found except for varus angle (pu2009<u20090.05) and mediolateral ground reaction force (pu2009<u20090.05).ConclusionsResults of this study show that mechanical and kinematic knee alignment methods provide comparable clinical and radiological outcomes after robotic total knee arthroplasty with an average follow-up of 8xa0years. There were no functional difference during walking between the two alignment methods either.Level of evidenceII.

Comparison of Outcome and Gait Analysis after Robotic Total Knee Arthroplasty Between Mechanical and Kinematic Knee Alignment Methods with Average 8 Years Follow Up

Background There are limited previous findings detailed biomechanical properties following implantation with mechanical and kinematic alignment method in robotic total knee arthroplasty (TKA) during walking. The purpose of this study was to compare clinical and radiological outcomes between two groups and gait analysis of kinematic, and kinetic parameters during walking to identify difference between two alignment method in robotic total knee arthroplasty. Methods Sixty patients were randomly assigned to undergo robotic-assisted TKA using either the mechanical (30 patients) or the kinematic (30 patients) alignment method. Clinical outcomes including varus and valgus laxities, ROM, HSS, KSS and WOMAC scores and radiological outcomes were evaluated. And ten age and gender matched patients of each group underwent gait analysis (Optic gait analysis system composed with 12 camera system and four force plate integrated) at minimum 5 years post-surgery. We evaluated parameters including knee varus moment and kne...