• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.779-797
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• 1996

The present study investigated the effects of variations in decalcification time of demineralized freeze-dried bone on the osteogenic potential of DFDB. Sixteen 3-wall intrabony defects with 4mm depth were surgically created in the mesial aspect of upper and lower anterior teeth of 4 dogs. Following the flap procedure, three test groups with 4 defects each received either freeze-dried bone graft (Group I), demineralized freeze-dried bone graft decalcified for 12hours (Group II), or demineralized freeze-dried bone graft decalcified for 24hours(Group III). The rest of the four defects received the flap procedure-only as the control group. The healing was histologically analyzed after 14 weeks on the length of connective tissue adhesion, new bone formation and new cementum formation. The results were as follows: 1. The length of connective tissue adhesion showed no statistically significant difference in all groups with $0.62{\pm}0.14mm$ for Control, $0.42{\pm}0.11mm$ for Group I, $0.63{\pm}0.43mm$ for Group II and $0.52{\pm}0.11mm$ for Group III. 2. The new bone formation showed no statistically significant difference in all groups with $3.17{\pm}0.24mm$ for Control. $3.15{\pm}0.56mm$ for Group I. $3.22{\pm}0.36mm$ for Group II, and $3.28{\pm}0.74mm$ for Group III. 3. The new cementum formation showed no statistically significant difference in all groups with $4.19{\pm}0.46mm$ for Control, $3.23{\pm}0.64mm$ for Group I, $4.13{\pm}1.82mm$ for Group II. and $3.13{\pm}0.62mm$ for Group III.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.19-25
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• 2009

Purpose: We report mid to long - term results of meniscal transplantation and evaluate the important factors for successful outcomes. Materials and Methods: Between December 1999 and September 2002, 25 meniscal transplantations were performed using fresh frozen allograft. The lateral meniscus was transplanted in 19 cases and medial meniscus in 6 cases. The mean age was 34 years (range, 17~50 years) and the mean follow up was 54.8 months (range, 6~85 months). Preoperative measurements were made using a ruler graded in millimeters. Lateral meniscus was fixed by keyhole technique and medial meniscus was fixed by double bone plug technique with suturing the periphery of the meniscal transplant. All patients were evaluated with Knee Assessment Scoring System (KASS), Lysholm knee score, and Tegner activity scale for daily activity. Results: Symptoms improved in all cases. The average KASS score increased from 61.7 preoperatively to 83.8 postoperatively. The average Lysholm knee score increased from 77.7 preoperatively to 87.7 postoperatively (excellent in 3 cases, good in 17 cases, fair 4 cases, poor 1 case). But painful swellings were 3 cases, numbness in 1 case, and granuloma due to non-absorbable suture material in 1 case. Peroneal nerve palsy in 1 case was recovered after 6 weeks postoperatively. Conclusion: Meniscal allograft transplantation after subtotal or total menisectomy can significantly relieve pain and improve function of the knee joint. The exact preoperative sizing and secure fixation are essential for successful outcomes.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.100-104
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• 2005

Osteosarcoma is the most common tumor in malignant bone tumors. The peak age incidence in osteosarcoma is between 10 to 14 years of age. This tumor rarely develops under 6 years of age and the youngest patient in the previous literature was a 13 months old girl who had an osteosarcoma involving the second metacarpal bone. We report a case of an 8 month old male infant, who had an osteosarcoma involving the right proximal tibia. This patient was treated by wide excision with transepiphyseal resection and reconstruction with allograft. At 20 months after operation, the varus deformity was developed at the proximal junctional site of allograft. Thereafter, the revision was performed with correction of deformity and augmentation with the proximal fibula transfer. At 51 months after operation, he has been remained as free of disease, and he has recovered the knee motion ranged from 15 degree to 75 degree. The osteosarcoma in infant is very rare but it should be considered the osteosarcoma in the differential diagnosis of any bone lesion. Instead of amputation, the limb sparing operation and the solutions for limb length inequility in growing period should be carefully considered in the infantile osteosarcoma.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.128-133
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• 2000

Purpose : To compare the changes of the patellar height, patellofemoral alignment and subjective symptom and to compare the effects of patellar tendon harvest after anterior cruciate ligament(ACL) reconstruction using autograft and allograft. Materials and Method : ACL reconstruction was performed on 87 patients who were followed up for minimum 1 year. The group I was 52 patients who were operated with bone-patellar tendon-bone autograft and the group II was 35 patients who were operated with bone-patellar tendon-bone allograft and achilles tendon allograft. At the time of follow-up, the authors evaluated the patellar height by Blackburne-Peel method, Merchant congruence angle, Lateral patellofemoral angle and subjective symptoms were assessed. Results : The patellar heights were significantly decreased from 0.86 preoperatively to 0.80 postoperatively in the group I and from 0.87 preoperatively to 0.83 postoperatively in the group II. There were no significant differences in the lateral patellofemoral angles between the both groups but in the Merchant congruence angle, significant differences were observed in the both groups, from$-1.43^{\circ}$ preoperatively to-$5.43^{\circ}$ postoperalively in the group I and from$-1.53^{\circ}$ preoperatively to$-3.65^{\circ}$ postoperatively in the group II. Conclusion : After ACL reconstruction, the patellofemoral alignment was changed and this kind of changes may be caused by multiple factorials such as harvest of autografts, ACL reconstruction itself, and quadriceps muscle atrophy.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.127-134
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• 2020

Purpose: The aims of this study were (1) to investigate the relationship between the characteristics of allogenic bone block and the compressive strength of an allogenic bone block measured by biomechanical experiments, and (2) to compare the maximum pressure load of allogenic bone block with the gap pressure measured at the high tibial opening osteotomy. Materials and Methods: Ten patients who provided informed consent for gap pressure measurements during opening wedge high tibial osteotomy (OWHTO) were included. The gap pressures were measured at 1 mm intervals while opening the osteotomy site from 8 mm to 14 mm. Seventeen U-shaped allogenous wedge bone blocks were made from the femur, tibia, and humerus. The height, width, cross-sectional area, and cortex thickness of the bone blocks were measured, along with the maximum compressive load just before breakage. The relationship between these characteristics and the maximum pressure load of the bone blocks was evaluated. The gap pressures measured in OWHTO were compared with the maximum pressure loads of the allogenous wedge bone blocks to evaluate the possibility of inserting allogenous wedge bone blocks into the osteotomy site without a distractor in OWHTO. Results: The OWHTO gap pressure increased with increasing osteotomy site opening. The mean gap pressure, which occurred at a 14-mm opening, was 282±93 N; the maximum pressure was 427 N. The maximum pressure load of the allografts was 13,379±6,469 N (minimum, 5,868; maximum, 29,130 N) and was correlated significantly with the cortical bone thickness (correlation coefficient=0.693, p=0.002) and cross-sectional area (correlation coefficient=0.826, p<0.001). Depending on the sterilization method, the maximum pressure loads for the bone blocks were 13,406±5,928 N for freeze-dried and 13,348±7,449 N for fresh frozen. The maximum compressive load of the allogenous wedge bone blocks was 13.7-times greater than that in OWHTO opened to 14 mm (5,868 N vs. 427 N). Conclusion: The compressive strength of allogenous wedge bone blocks was sufficiently greater than the gap pressure in OWHTO. Therefore, allogenous wedge bone blocks can be inserted safely into the osteotomy site without a distractor.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.92-99
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• 2003

The prevalence of anterior cruciate ligament (ACL) injury is continuously increased due to sports activities and traffic accident. Simultaneously ACL reconstruction operations are on the increase. Several kinds of autografts and allografts are used in ACL reconstruction. Although ACL reconstruction using an autogenous bone-patellar tendon-bone graft is the good standard, it might have potential morbidity, anterior knee pain and minimal extension loss. To minimize the complications and disadvantages on each graft and to select appropriate graft for each patient, it is necessary to understand the unique characteristics of each graft for biomechanical aspect, morbidity and disadvantage. Selecting the appropriate graft depends on numerous factors including surgeon's preference and experience, patient's activity level and age, extent of ligament injury, tissue availability, and patient's selection for graft .

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.7-12
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• 2000

Purpose : The purpose of this study is to evaluate the clinical outcomes and radiological changes after reconstruction of anterior cruciate ligament with human allograft. Material and Method : Authors analyzed 22 cases of anterior cruciate ligament allograft reconstruction which were done from January, 1995 to December, 1998 and could be followed up for a year or more. All cases were followed and reviewed in terms of anterior drawer test, Lachman test, Pivot shift test, radiographic examination, knee range of motion, and side-to-side difference of anteroior tibial translation using CA-4000 knee motion analyzer, and Lysholm knee scoring system. Result : The mean Lysholm knee score was 54 preoperatively and improved to 81 postoperatively by average of 27. The side-to-side difference of anterior tibial translation using CA-4000 knee motion analyser was less than 3 mm in 16 cases$(73\%)$, between 3 and 5 mm in 4 cases$(18\%)$, and greater than 6 min in 2 cases$(9\%)$. Average tibial tunnel enlargement was 1.5 mm, but there were not any osteoiysis or cystic formation along the tunnel and no relationship between tunnel enlargement and clinical outcome. Conclusion : Although this study had limited cases, clinical results of anterior cruciate allograft reconstruction were similar to those of reconstruction with autograft reported in the literatures. We think that allograft is an acceptable substitute fer autograft in anterior cruciate ligament reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.14-18
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• 2004

Purpose: To compare the mid-term follow-up results of anterior cruciate ligament(ACL) reconstruction with the bone-patellar tendon- bone(BTB) autograft to those with the BTB allograft. Materials and Methods: Retrospective study was performed in 59 cases with BTB autograft and 42 cases with BTB allograft. Evaluations include Lysholm score, 2000 IKDC subjective knee score, Shelbourne patello-femoral pain score , Lachman test, pivot shift test, KT-1000 arthrometer test and 2000 IKDC knee examination. Results: There were no significant statistic differences between two groups in Lysholm score and 2000 IKDC subjective knee score of more than 70 (p<0.05). Five cases(8.5%) showed the patello-femoral pain score less than 80 according to Shelboume with autograft group and two cases(4.8%) with allograft group (p<0.05). Lachman test, pivot shift test and KT-1000 arthrometer test showed no significant statistic differences between two groups(P<0.05). Fifty-four cases(91.5%) were normal or nearly normal according to the 2000 IKDC knee examination with autograft group and thirty-eight cases(90.4%) with allograft group(p<0.05).Conclusion: BTB allograft as well as BTB autograft is considered to be an acceptable choice for ACL reconstruction.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.157-162
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• 2008

Nowadays, most of the malignant bone tumor patient underwent limb salvage operation, however, reconstructive options for skeletally immature group are still controversial. There are three necessary conditions of most ideal reconstructive method in treating the skeletally immature children. As the epiphyseal plate sacrification is usually inevitable in malignant bone tumor around knee joint, ideal reconstructive technique would be as follows; 1)minimal or no damage to theadjacent epiphyseal plate, 2) maintaining mobile joint, 3) index procedure does not disturb subsequent operation such as lengthening. Segmental resection and reconstruction using autogenous pasteurized graft was done for 4 years old meta-diaphyseal osteosarcoma of femur. At 6 months from index operation, plain radiograph showed pasteurized bone resorption and loosening of fixation devise. To overcome the complication, we used allograft reconstruction by impacting the proximal host bone to the fluted portion of allobone. Three months later, proximal bone union was observed and patient showed good functional outcome.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.