• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.8-17
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• 1996

The purpose of this study is a comparative evaluation of range motion, especially extension deficit between the group of total patellectomy and that of intact patella, after reconstruction of the patellar tendon in the prosthetic replacement of a proximal tibia. Between 1990 and 1994, 15 patients who had a primary malignancy on proximal tibia were operated on. All patients were evaluated clinically and radiographically. Two patients were excluded because one had a deep infection treated with arthrodesis of the knee and the other was a composite allograft. The mean follow-up of the 13 patients was 27 months(15-47), including 10 osteosarcomas, 1 chondrosarcoma, 1 malignant fibrous histiocytoma and 1 malignant giant cell tumor. Eleven patients had a resection of the proximal tibia and 2 had an extracapsular total knee resection with distal femur. Reconstruction of the defect was done in 8 cases with a custom-made Link Endo-Model Total Rotation Knee Joint Prosthesis, and in 5 with How Medica Modular Resection System (HMRS). We used two methods to reconstruct the ligamentum patellae. Fixation of the patellar tendon to the prosthesis only with suturing and/or stapling(group SS) was done in 7. Transposition of gastrocnemius muscle to enhance fixation and to cover the prosthesis(group TG) was done in 6. Regardless of fixation methods, total patellectomy was done in 5 either to lengthen the patellar tendon or to make primary skin closure easier or for both. In 8 cases, patella was left intact or resurfaced with polyethylene prosthesis. Active extension was measured while the patient was in a sitting position. There is no statistically meaningful difference in terms of extension deficit (Wilcoxon rank test, p=0.8800) between patellectomy group and intact patella group, and between group of fixation only with suturing and that of gastrocnemius transposition. Two cases of extension deficit over 30 degree were seen in group SS and in the group of intact patella. Conclusively, total patellectomy could be an option without increasing the risk of extension deficit when primary skin closure is difficult or patellar tendon is a little bit short to be fixed. There is no rating in the Enneking system of functional evaluation that this finding into consideration.

• The Journal of Korean Physical Therapy
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• v.15 no.2
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• pp.131-145
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• 2003

The purpose of this study was to evaluate effects of artificial balenotherapy on the with degenerative osteoarthritis were selected as the subject do this study among the patients with degenerative osteoarthritis having pains in their knees by the criteria of America Rheumatoid Association. And the randomly selected ten patients out of the twenty were classified as an artificial balenotherapy group and the other the Patients were in a control group. Ten individuals with degenerative osteoarthritis patients in the artificial balenotherapy group Participated in artificial balenotherapy Program four weeks from March 1st, 2003 to March 31st, 2003 in Daegu 00 hospital. Ten individuals with degenerative osteoarthritis in the control group did not receive Artificial Balenotherapy. The conclusions were as follows: 1. After 4 weeks of therapy, the score of WBC(p < 0.01), RBC(p < 0.01), HTC(p < 0.01) in the artificial blalenotherapy group were significantly decreased, compared with their scores in pre-intervention. 2.In the balenotherapy group, significantly increase $Na^{+}$ ion(P < 0.05), decrease K ion(p < 0.01), unchanged Cl ion scores were found, compared with their scores in pro-intervention. 3. The result of the substudy about the effects of artificial balenotherapy on the substances that have relations with the function of liver were following that artificial balenotherapy group, increased total bilirubin(P < 0.01), unchanged total Protein, Albumin, total cholesterol, GOT, GPT, ALP were found, compared with their score in pre-intervention. 4. The result of the substudy about the effects of artificial balenotherapy on the substances that have relations with the function of kidney were following that in the artificial balenotherapy group, reduced BUN(P < 0.05), and increased creatine were found. 5. The result of the substudy about effects of artificial balenotherapy on the knee pain visual analog score, knee's functional score, ADL score were following that in the artificial balenotherapy group, decreased VAS score(P < 0.05), increased ADL score(p < 0.01), unchanged knee's functional score were founf, compared with their scores of the pre-intervention. In conclusion, the result of this study suggest that artificial balenotherapy improved ADL score and reduced knee pain visual analog score of the patients with degenerative osteoarthritis. The result proposed that appropriate use of artificial balenotherapy improves the degenerative osteoarthritis