Two caces of severely deformed rheumatic knee were replaced by the kinematic rotating hinge knee prosthesis. Clinical results were satisfactory and there were no complications. Compared to early hinged prostheses, the kinematic rotating hinge has some good innovations. Axial rotation and distraction are allowed, and flexion and extension take place between metal and polyethylene surfaces. These changes should lead to the reduction of the complications very often seen in early hinged prostheses. Kinematic rotating hinge knee is considered to be one of useful prosthesis in severe ligamentous instability, massive loss of bone and revision of a failed total knee replacement.

View full abstract

Twenty-four cases with Grade III injuries of the lateral ligaments of the ankle were treated between 1985 and 1990. There were 8 male patients and 16 female patients. The age of these patients ranged from 13 to 57 years old (average age, 24.6 years). The period of follow-up study ranged from 6 months to 10 year (average time, 16.5 months).
Of 14 cases with fresh injuries, 7 cases were treated operatively and 7 cases conservatively. Reconstructive surgery was performed in 3 cases with old injury.
The clinical results, which were evaluated in accordance with Furuya's criteria, were better in the fresh group than in the old group. The improvement of instability on stress X-ray was better in the operation group than in the conservative group.

View full abstract

We report here a case of Stickler syndrome associated with pes planovalgus deformity. At the age of 8 years the patient had corrective surgery for deformities of the feet, and the present symptoms at 15 years old are both gonalgia and pedalgia after moderate exercise. His myopia has not led to retinal detachment.
This syndrome, an autosomal dominant connective tissue disorder with some variable expressivity, is a relatively rare multiple congenital anomaly. The major symptoms are skeletal joint changes including epiphyseal dysplasia, and severe congenital myopia. Without treatment, the latter may easily lead to total blindness. Therefore, it is important that the orthopedic surgeon proceeds a complete physical examination; and if this syndrome is suspected, consultation with other specialists should be necessary as soon as possible.

View full abstract

Because advancements in oncology have extended the life expectancies of patients who suffer from metastatic spinal tumors, it has become necessary to prevent paralysis and neural encroachment and relieve the pain. We have studied five patients (Three female, two male) who underwent reconstructive surgery for cervical spinal metastasis through more than two vertebrae. Primary lesions were thyroid, parotid, breast, and lung. All patients demonstrated evidence of myelopathy. Surgical procedures include decompression and stabilization anteriorly and posteriorly. The postoperative follow-up period was 3-150 months (mean 24 months). Pain was diminished or reduced markedly, and ambulation was preserved by an average of 28 months. We conclude that surgical reconstruction is beneficial in treating spinal metastasis of slow progressive malignant tumors.

View full abstract