• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.134-139
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• 2012

Purpose: To report the treatment results of arthroscopic osteochondroplasty in osteochondral lesion of the talus. Materials and Methods: This study included 32 patients who had osteochondral lesion of the talus treated with arthroscopic osteochondroplasty and were able to be followed up over 3 years from 1999 to 2007. The mean follow up period was 48 (38-108) months, and 22 male patients and 10 female patients with a mean age of 34 (20-56) years were included. Locations of lesion were evaluated with simple X-ray and magnetic resonance imaging (MRI), and severities of lesions were classified by Berndt and Harty classification. All cases were treated by arthroscopic debridement or microfracture. The treatment results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and subjective and functional score of Kailkkonen. The group treated by arthroscopic microfracture was compared with the group treated by arthroscopic debridement. Results: The mean AOFAS ankle-hindfoot scale was significantly improved 53 (${\pm}7$) points preoperatively to 84 (${\pm}8$) points postoperatively (P<0.001). The mean subjective and functional score was also improved 55 (${\pm}8$) points preoperatively to 88 (${\pm}8$) points postoperatively with statistical significant (P<0.001). There were no relations between the severity of lesions and the postoperative functional score of ankle (P>0.05). There were no significant differences in the clinical results between the group treated with arthroscopic microfracture and the group treated with arthroscopic debridement (P>0.05). Conclusion: Arthroscopic osteochondroplasty of osteochondral lesion of the talus shows excellent result in terms of patients' satisfaction. There were no significant differences in the clinical results between arthroscopic microfracture group and debridement group.

• Investigative Magnetic Resonance Imaging
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• v.11 no.1
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• pp.27-32
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• 2007

Purpose : To evaluate the mucoid degeneration (MD) of the anterior cruciate ligament (ACL) of the knee by correlation of MRI findings with pathology, in the patients with osteoarthritis (OA). Materials and Methods : This study included 17 patients (mean 68.8 years old) who underwent preoperative MRI. In proton density-weighted sagittal and coronal images ACLs were evaluated for the thickness and signal intensity (SI). Total knee replacement arthroplasty was performed and the pathologic findings of ACL were evaluated. MD was classified as 3 grades according to the degenerated amount in microscopy. Thickness and SI was evaluated as normal or increased on MRI. Results : All of the 4 patients who showed thickened ACL showed increased SI on MRI. All of the 8 patients with increased SI of the ACL on MRI had MD in the ACL. However, remained 9 patients also had MD, in spite of their normal thickness and SI on MRI. Calcification was seen in 5 patients. Conclusion : Eight cases who showed ACL thickening or increased SI on MRI were well correlated with MD, however, because the other nine cases who showed normal thickness and normal SI of ACL on MRI also showed MD in pathology, normal MRI finding should not exclude the possibility of MD of ACL.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.230-236
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• 2010

Purpose: We wanted to evaluate the result of percutaneous, mini-open reduction for the treatment of Mason II or III radial head and neck fractures. Materials and Methods: 13 patients (8 male, 5 female) with Mason II or III radial head and neck fractures were treated by 1 cm percutaneous mini-open reduction under fluoroscopy. The average age of our subjects was 29 years. Follow up duration was 18 months. Results: Union was noted in all cases. Mean radial neck angulation was decreased from 33.2 degrees to 7.8 degrees. The mean change in angulation between the immediate post-operative and last follow-up was 0.7 degrees. The mean range of motion at the elbow joint was at last follow up, 133.1 degrees in flexion, 7.3 degrees in extension, 80 degrees in pronation and 84.3 degrees in supination. Postoperatively, mean Mayo Elbow Performance Index, American Shoulder and Elbow Surgeons elbow score, and Disabilities of the Arm, Shoulder and Hand score were 96.2, 97 and 1.2. Temporary posterior interosseous nerve palsy (1 case) and minimal cubitus valgus deformity (1 case) were noted. Conclusion: Selected Mason II or III radial head and neck fractures can be treated satisfactorily with percutaneous mini-open reduction.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.206-212
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• 2007

Purpose: Heterotopic ossification is a well-known postoperative and post-traumatic complication of the elbow. We reviewed the treatment outcome for the use of low-dose radiation after surgical intervention of the elbow to prevent recurrence of heterotopic ossification (HO). Materials and Methods: Forty-five patients with HO underwent surgical intervention and postoperative radiotherapy of the elbow. The median age of the patients was 29 years ($16{\sim}75$ years), and 27 of the patients were men and 18 were women. The occurrence of HO was mainly due to surgery after fracture (24/45) and traumatic injury (21/45). Limitation of the range of motion (ROM) was the most common symptom of the patients. Thirty-four patients received postoperative radiotherapy with a dose of 8 Gy in 2 fractions; 5 patients received a dose of 10 Gy in 5 fractions and 6 patients received a dose of 7 Gy in 1 fraction. Postoperative radiotherapy was given on the first two postoperative days for most of the patients. Sixteen patients were not given anti-inflammatory medication and 29 patients were given NSAIDs for $1{\sim}8$ months. Results: After a median follow-up period of 18 months (range $6{\sim}72$ months), 41 patients showed clinical improvement and two patients did not show improvement. Assessment of the ROM showed a mean improvement from $0{\sim}135^{\circ}$ to $60{\sim}145^{\circ}$ (p=0.028), and assessment of the functional outcome according to MEPI was from ($15{\sim}95$) to ($80{\sim}100$) (p<0.0001). Two of the 34 patients that were followed-up with radiography had mild radiological recurrence of heterotopic ossification. No complications were observed after the radiotherapy. Conclusion: These results suggested that low-dose radiation administered after surgical intervention is safe and effective to prevent the recurrence of HO in the elbow.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.112-126
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• 2022

Purpose To determine the value of 3 Tesla (T) MRI texture analysis for predicting tumor margin infiltration in soft tissue sarcomas. Materials and Methods Thirty-one patients who underwent 3T MRI and had a pathologically confirmed diagnosis of soft tissue sarcoma were included in this study. Margin infiltration on pathology was used as the gold standard. Texture analysis of soft tissue sarcomas was performed on axial T1-weighted images (WI) and T2WI, fat-suppressed contrast-enhanced (CE) T1WI, diffusion-weighted images (DWI) with b-value of 800 s/mm², and apparent diffusion coefficient (ADC) was mapped. Quantitative parameters were compared between sarcomas with infiltrative margins and those with circumscribed margins. Results Among the 31 patients with soft tissue sarcomas, 23 showed tumor margin infiltration on pathology. There were significant differences in kurtosis with the spatial scaling factor (SSF) of 0 and 6 on T1WI, kurtosis (SSF, 0) on CE-T1WI, skewness (SSF, 0) on DWI, and skewness (SSF, 2, 4) on ADC between sarcomas with infiltrative margins and those with circumscribed margins (p ≤ 0.046). The area under the receiver operating characteristic curve based on MR texture features for identification of infiltrative tumor margins was 0.951 (p < 0.001). Conclusion MR texture analysis is reliable and accurate for the prediction of infiltrative margins of soft tissue sarcomas.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.485-495
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• 1998

Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.