[show abstract][hide abstract] ABSTRACT: We evaluated the cartilage repair potential of a hyaluronic acid and fibrin mixture when transplanted into cartilage defects. Circular, articular, cartilage defects 4-mm in diameter were made in the trochlear region in 21 New Zealand white rabbits divided into three groups. The seven rabbits in the control group underwent microfracture (M group), the seven rabbits in the experimental group underwent microfracture with subsequent injection of hyaluronic acid mixed with fibrin (MH group), and seven rabbits in the other experimental group underwent microfracture followed by injection of bone marrow concentrate and hyaluronic acid mixed with fibrin (MBH group). At week 12 following surgery, the cartilage was observed and histologically compared in the three groups. The surface of the newly generated cartilage was very smooth and even, and we noticed that the entire area was completely regenerated in both experimental groups. The control group showed incomplete and irregular cartilage formation in the defect. In histologic scoring, comparison of the MBH group (M= 2.333) and the M group (M= 9.000) differed significantly (P= 0.046). Therefore, injection of a mixture of bone marrow concentrate, hyaluronic acid and fibrin to treat articular cartilage defects of the knee appears to be an effective method of cartilage regeneration.
Fetal ovine model for in-situ esophagus tissue engineering. 08/2013; 10(1). · 3.16 Impact Factor
[show abstract][hide abstract] ABSTRACT: We compared the bone regeneration potentials of autologous cultured osteoblasts and of bone-marrow-derived autologous MSCs in combination with allogeneic cancellous bone granules in a rabbit radial defect model. Radial shaft defects over 15 mm were made in 26 New Zealand white rabbits. The animals underwent insertion of allogeneic cancellous bone granules containing autologous osteoblasts into right-side defects (the experimental group) and of allogeneic cancellous bone granules with autologous MSCs into left-side defects (the control group). To quantitatively assess bone regeneration, radiographic evaluations as well as BMD and BMC measurements were performed 3, 6, 9 and 12 weeks post-implantation and histology as well as micro-CT image analysis were performed at 6 and 12 weeks. Radiographic evaluations 3 weeks post-implantation showed that the experimental group had a higher mean bone quantity index (p < 0.05) and micro-CT image analysis showed that experimental sides had a greater mean total regenerated bone volume and surface area than the control sides (p < 0.05). Histologic evaluations obtained at 6 and 12 weeks revealed distinctly greater granule resorption and new bone formation in the experimental group. This in vivo study demonstrates that a combination of autologous osteoblasts and small-sized, allogeneic cancellous bone granules leads to more rapid bone regeneration than autologous MSCs and small-sized, allogeneic cancellous bone granules.
Cell and Tissue Research 11/2011; 347(2):303-10. · 3.68 Impact Factor
[show abstract][hide abstract] ABSTRACT: We use a straightforward technique to remove a locking compression plate and a screw with a stripped hexagonal recess. If the hexagonal recess of the screw had been stripped during attempts at screw removal using a conical extraction device, we perform the following procedure after loosening the contact surface between the bone and the plate. Using a larger drill bit, another hole is drilled immediately adjacent to the screw through the nonlocking portion of the combination hole. The plate is struck along the line connecting the screw to the newly formed hole. Using an elevator, leverage force is then applied to the plate, which can be removed with the stripped screw attached. This technique can be used to remove plates with several stripped screws and does not require any special tools.
Journal of orthopaedic trauma 10/2011; 26(6):e51-3. · 1.78 Impact Factor
[show abstract][hide abstract] ABSTRACT: We report a case involving an avulsion fracture of the iliac crest apophysis in a 16-year-old boy. Occasionally, apophyseal avulsion fractures of the pelvis occur; however, those that occur at the iliac crest are rare. As a result of the large size of the fracture fragment and marked displacement (more than 3 cm), the fracture was managed operatively with open reduction and internal fixation. The patient returned to preinjury physical activity levels 2 months after surgery without complication.
Journal of orthopaedic trauma 06/2011; 25(6):e56-8. · 1.78 Impact Factor
[show abstract][hide abstract] ABSTRACT: Gel-type autologous chondrocyte (Chondron) implantations have been used for several years without using periosteum or membrane. This study involves evaluations of the clinical results of Chondron at many clinical centers at various time points during the postoperative patient follow-up.
Data from 98 patients with articular cartilage injury of the knee joint and who underwent Chondron implantation at ten Korean hospitals between January 2005 and November 2008, were included and were divided into two groups based on the patient follow-up period, i.e. 13~24-month follow-up and greater than 25-month follow-up. The telephone Knee Society Score obtained during telephone interviews with patients, was used as the evaluation tool.
On the tKSS-A (telephone Knee Society Score-A), the score improved from 43.52 +/- 20.20 to 89.71 +/- 13.69 (P < 0.05), and on the tKSS-B (telephone Knee Society Score-B), the score improved from 50.66 +/- 20.05 to 89.38 +/- 15.76 (P < 0.05). The total improvement was from 94.18 +/- 31.43 to 179.10 +/- 24.69 (P < 0.05).
Gel-type autologous chondrocyte implantation for chondral knee defects appears to be a safe and effective method for both decreasing pain and improving knee function.
[show abstract][hide abstract] ABSTRACT: We performed a multicenter, open, randomized, clinical study of autologous cultured osteoblast injection for long-bone fracture, to evaluate the fracture healing acceleration effect and the safety of autologous cultured osteoblasts.
Sixty-four patients with long-bone fractures were randomly divided into two groups, i.e. those who received autologous cultured osteoblast injection and those who received no treatment. The sum of the difference in the callus formation scores after four and eight weeks, was used as the first efficacy variable.
The autologous cultured osteoblast injection group showed fracture healing acceleration of statistical significance, and there were no specific patient complications when using this treatment.
Autologous cultured osteoblast injection should therefore be considered as a successful treatment option for treating long-bone fracture.
[show abstract][hide abstract] ABSTRACT: Although pharmacologic treatment remains the mainstay for treating rheumatoid arthritis, there is an increasing need for a method that biologically regenerates arthritic knee lesions as patient longevity continually increases.
We treated rheumatoid arthritis of the right knee in a 35-year-old female Korean patient using autologous chondrocyte implantation. Twelve months after surgery, the patient could walk without pain.
Autologous chondrocyte implantation appears to be effective for treating rheumatoid arthritis of the knee.
[show abstract][hide abstract] ABSTRACT: The authors investigated the agreements between three different methods of estimating gap balance in cruciate-retaining (CR) total knee arthroplasty (TKA) with the use of a subvastus approach. One hundred consecutive CR TKAs were prospectively included in this study. After completing soft tissue release and bone cutting for CR TKA, flexion-extension gap balance was assessed using a distractor, spacer blocks, and trial components. Levels of agreement between the estimation techniques used were substantial. All three techniques were reliable in the assessment of gap balance. But, observations made during this study suggest that if more than one estimation technique is applied during CR TKA, the incidence of undetected gap imbalance can be reduced.
[show abstract][hide abstract] ABSTRACT: Osteonecrosis of the femoral head is a progressive disease that leads to femoral head collapse and osteoarthritis. Our goal in treating osteonecrosis is to preserve, not to replace, the femoral head.
We present the case of a patient with bilateral osteonecrosis of the femoral head treated with autologous cultured osteoblast injection.
Although our experience is limited to one patient, autologous cultured osteoblast transplantation appears to be effective for treating the osteonecrosis of femoral head.
[show abstract][hide abstract] ABSTRACT: Nine patients aged over 8 years with developmental dislocation of the hip were treated by an open reduction, femoral shortening and varus derotation osteotomy with or without a Chiari osteotomy. The mean age of the patients was 11.1 years (range 8-17 years), and the mean follow-up period was 7.1 years (range 1-13 years). The left hip was involved in four cases: the right in three and two cases were bilateral. One hip redislocated. The remaining patients recovered nearly full movement of the affected hip. Five out of eight patients had a normal gait without limping or pain. Two others limped secondary to a leg-length discrepancy, which was corrected with leg equalization. The remaining patient had an improvement of her preoperative limp and was pain-free. These results indicate that it is possible to obtain good hip function after open reduction of a developmentally dislocated hip, even after the age of 8 years.
Journal of Pediatric Orthopaedics B 08/2007; 16(4):256-61. · 0.53 Impact Factor
[show abstract][hide abstract] ABSTRACT: The osteogenic potential of autologous cultured osteoblasts mixed with fibrin when transplanted to bone defects was evaluated. Radial shaft defects over 15 mm were made in 30 New Zealand white rabbits. A total of 15 rabbits in the control group underwent an iliac bone graft and 15 rabbits in the experimental group underwent an autologous cultured osteoblast injection mixed with fibrin. Both groups were compared radiologically and 5 rabbits in each group were sacrificed for histological evaluation using H-E and Masson's trichrome stain at 3, 6, and 9 weeks. Osteogenesis in the control group progressed more rapidly than in the experimental group. However, at 9 weeks, bone formation in both groups were similar and showed no significant difference in terms of the amount of bone formation and the quality of bone union. Autologous cultured osteoblast transplantation mixed with fibrin in bone defects was found to produce bone efficiently.
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to determine the thigh girth cutoff limit for the subvastus approach in primary total knee arthroplasty. One hundred forty-three consecutive total knee arthroplasties were done using the subvastus approach by one surgeon. The larger the thigh girth, the higher the risk for inability to evert the patella. We found that patients with a thigh girth greater than 55 cm had 27.212 times higher risk for inability to evert the patella during the subvastus approach as compared with patients with a small thigh girth (ie, <45 cm; odds ratio = 27.212; 95% confidence interval = 4.394-168.530). If we could not evert the patella in patients with a large thigh girth, although we could slide the patella, the extensor mechanism and excessive soft tissues were obstacles to the procedure. We recommend that another approach for patients with a thigh girth greater than 55 cm be used.
The Journal of Arthroplasty 06/2007; 22(4):569-73. · 2.11 Impact Factor
[show abstract][hide abstract] ABSTRACT: The treatment of supracondylar or intercondylar femoral fractures in elderly patients with gonarthrosis is a difficult problem. Primary total knee arthroplasty (TKA) can be considered as a treatment modality for these patients, and several authors have reported acceptable results with this option. They have performed TKA using custom-made, hinged, or constrained components with long stem for fracture reduction and stabilization. But use of hinged or constrained total knee arthroplasties for dealing with supracondylar and intercondylar fractures may be unnecessary, and an alternative is to use a cruciate-retaining stemmed TKA. We report 3 elderly female patients who had supracondylar or intercondylar femoral fractures and coexisting gonarthrosis treated by primary TKA with use of a cruciate-retaining augmentable femoral component with stem extension. All patients improved their ambulatory status and showed good knee function. We believe that use of a cruciate-retaining type of component is a reasonable alternative to the use of a more constrained prosthesis in the treatment for this group of patients.
The Journal of Arthroplasty 11/2006; 21(7):1074-9. · 2.11 Impact Factor