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Biomedical subjects

Chia-Chen Hsu

Publications and source records attributed to Chia-Chen Hsu.

12 recordsLinked to original sources
PubMed2006

Medial plicae and degeneration of the medial femoral condyle.

PURPOSE: The purpose of this study was to evaluate and analyze the chronological changes of the pathologic medial plica and the chondral lesions on the medial femoral condyle. The relationship between the severity of the pathologic medial plica and that of the chondral lesions on the medial femoral condyle was also investigated. TYPE OF STUDY: Retrospective case series study of consecutive patients who underwent arthroscopic surgery. METHODS: A retrospective case series study was conducted to review the findings of 1,587 knees of 1,263 patients who had received arthroscopic surgery between 1989 and 2001. The medial plica was classified by its size and the severity of its gross pathologic change. The location and severity of the cartilaginous degeneration on the surface of the medial femoral condyle of these patients were also investigated. The correlation of patient age with the gross pathologic change of their medial plica and the severity of the cartilaginous degeneration on the surface of the medial femoral condyle was analyzed. RESULTS: We found that 472 knees (29.7%) of 378 patients (29.9%) had the structure of the medial plica. The incidence was significantly higher (66.9%) in patients with osteoarthritic knees. The severity of the gross pathologic change of the medial plica was positively correlated with patients' age. The size of the plica was found to be smaller in older patients. Two distinct areas of degenerative cartilaginous lesion related to the medial plica were found on the surface of the medial femoral condyle in 97% of the knees with the structure of the medial plica. The severity of the degeneration was positively correlated with patients' age and the severity of the pathologic change of the medial plica. CONCLUSIONS: According to our observation, medial plica was more commonly found in patients with osteoarthritic knees. Cartilaginous degeneration on the surface of the medial femoral condyle could be found in most of the knees with a medial plica. The severity of the degeneration was positively correlated with the severity of the medial plica and patients' age. LEVEL OF EVIDENCE: Level III.

Age Factors↗
PubMed2006

Distal femoral varus osteotomy for osteoarthritis of the knee. Surgical technique.

BACKGROUND: Distal femoral varus osteotomy is a procedure that is performed for the treatment of lateralcompartment osteoarthritis of the knee as well as for correction of the associated valgus deformity. However, its role remains controversial and its efficacy in the treatment of associated patellofemoral arthritis has not been well studied. The purpose of the present study was to evaluate the outcome after distal femoral osteotomy performed for the treatment of painful genu valgum and to assess the influence of patellofemoral arthritis on the results. METHODS: Thirty patients (thirty knees) were managed with distal femoral varus osteotomy for the treatment of noninflammatory lateralcompartment arthritis of the knee associated with a valgus deformity. Twelve knees had isolated lateral-compartment arthritis, ten had mild-to-moderate degenerative changes in the other two compartments, and eight knees had severe patellofemoral arthritis in addition to lateral-compartment disease. The osteotomy site was fixed with a 90 degrees blade-plate. After a mean duration of follow-up of ninety-nine months, all patients were evaluated with use of the Hospital for Special Surgery knee-rating system and a physical examination. RESULTS: At the time of the most recent follow-up, twenty-five patients (83%) had a satisfactory result and two had a fair result according to the Hospital for Special Surgery rating system. The remaining three patients had had a conversion to a total knee arthroplasty. With conversion to total knee arthroplasty as the end point, the cumulative ten-year survival rate for all patients was 87% (95% confidence interval, 69% to 100%). Improvement in patellar tracking, which persisted at the time of the latest follow-up, was observed in seven of the eight knees with associated severe patellofemoral arthritis. CONCLUSIONS: Distal femoral varus osteotomy with blade-plate fixation can be a reliable procedure for the treatment of lateral-compartment osteoarthritis of the knee associated with valgus deformity. The result of the osteotomy does not appear to be affected by the presence of severe patellofemoral arthritis.

Bone Plates↗
PubMed2005

Distal femoral varus osteotomy for osteoarthritis of the knee.

BACKGROUND: Distal femoral varus osteotomy is a procedure that is performed for the treatment of lateral-compartment osteoarthritis of the knee as well as for correction of the associated valgus deformity. However, its role remains controversial and its efficacy in the treatment of associated patellofemoral arthritis has not been well studied. The purpose of the present study was to evaluate the outcome after distal femoral osteotomy performed for the treatment of painful genu valgum and to assess the influence of patellofemoral arthritis on the results. METHODS: Thirty patients (thirty knees) were managed with distal femoral varus osteotomy for the treatment of noninflammatory lateral-compartment arthritis of the knee associated with a valgus deformity. Twelve knees had isolated lateral-compartment arthritis, ten had mild-to-moderate degenerative changes in the other two compartments, and eight knees had severe patellofemoral arthritis in addition to lateral-compartment disease. The osteotomy site was fixed with a 90 degrees blade-plate. After a mean duration of follow-up of ninety-nine months, all patients were evaluated with use of the Hospital for Special Surgery knee-rating system and a physical examination. RESULTS: At the time of the most recent follow-up, twenty-five patients (83%) had a satisfactory result and two had a fair result according to the Hospital for Special Surgery rating system. The remaining three patients had had a conversion to a total knee arthroplasty. With conversion to total knee arthroplasty as the end point, the cumulative ten-year survival rate for all patients was 87% (95% confidence interval, 69% to 100%). Improvement in patellar tracking, which persisted at the time of the latest follow-up, was observed in seven of the eight knees with associated severe patellofemoral arthritis. CONCLUSIONS: Distal femoral varus osteotomy with blade-plate fixation can be a reliable procedure for the treatment of lateral-compartment osteoarthritis of the knee associated with valgus deformity. The result of the osteotomy does not appear to be affected by the presence of severe patellofemoral arthritis.

Arthroplasty, Replacement, Knee↗
PubMed2004

Shock wave treatment shows dose-dependent enhancement of bone mass and bone strength after fracture of the femur.

Shock wave treatment is believed to improve bone healing after fracture. The purpose of this study was to evaluate the effect of shock wave treatment on bone mass and bone strength after fracture of the femur in a rabbit model. A standardized closed fracture of the right femur was created with a three-point bending method in 24 New Zealand white rabbits. Animals were randomly divided into three groups: (1) control (no shock wave treatment), (2) low-energy (shock wave treatment at 0.18 mJ/mm2 energy flux density with 2000 impulses), and (3) high-energy (shock wave treatment at 0.47 mJ/mm2 energy flux density with 4000 impulses). Bone mass (bone mineral density (BMD), callus formation, ash and calcium contents) and bone strength (peak load, peak stress and modulus of elasticity) were assessed at 12 and 24 weeks after shock wave treatment. While the BMD values of the high-energy group were significantly higher than the control group (P = 0.021), the BMD values between the low-energy and control groups were not statistically significant (P = 0.358). The high-energy group showed significantly more callus formation (P < 0.001), higher ash content (P < 0.001) and calcium content (P = 0.003) than the control and low-energy groups. With regard to bone strength, the high-energy group showed significantly higher peak load (P = 0.012), peak stress (P = 0.015) and modulus of elasticity (P = 0.011) than the low-energy and control groups. Overall, the effect of shock wave treatment on bone mass and bone strength appears to be dose dependent in acute fracture healing in rabbits.

Animals↗
PubMed2004

Arthroscopic single- versus double-bundle posterior cruciate ligament reconstructions using hamstring autograft.

This prospective study compared the clinical results of single- and double-bundle posterior cruciate ligament (PCL) reconstruction with a minimum follow-up of 2 years. There were 35 patients including 19 single- and 16 double-bundle posterior cruciate ligament reconstructions using hamstring autograft. The average age was 29.4 +/- 13.6 years versus 28.2 +/- 10.4 years; and the average follow-up was 41.0 +/- 13.1 months versus 28.1 +/- 4.2 months for single- and double-bundle reconstruction, respectively. The indication for surgery was functional disability of the knee due to pain and instability as the result of high-energy PCL injury. The evaluation parameters included functional assessment, ligament laxity, functional score and radiographs of the knee. The results showed no significant difference in functional assessment, ligament laxity, functional score and radiographic changes of the knee between the two techniques. The rate of overall satisfaction with the operation was comparable from patient and surgeon perspectives. Contrary to many recent reports, the results of this study showed that single- and double-bundle PCL reconstruction using hamstring autograft produced comparable clinical results in medium-term follow-up. The difference between single- and double-bundle PCL reconstruction, if any, can be concluded only with long-term results and larger number of patients.

Adolescent↗
PubMed2004

Prevention of deep-vein thrombosis after total knee arthroplasty in Asian patients. Comparison of low-molecular-weight heparin and indomethacin.

BACKGROUND: A prospective clinical study was performed to compare the efficacy of low-molecular-weight heparin and indomethacin for the prevention of deep-vein thrombosis after total knee arthroplasty in Asian patients. METHODS: One hundred and fifty patients undergoing total knee arthroplasty were randomly divided into three groups. One group consisted of fifty-one patients who received no prophylaxis with an anticoagulant (the control group), one consisted of fifty patients who received the low-molecular-weight heparin Fraxiparine (the Fraxiparine group), and the third consisted of forty-nine patients who received indomethacin (the indomethacin group). Bilateral ascending venography was performed preoperatively and at five, six, or seven days postoperatively. A third venogram was made at three months for patients who had had a deep-vein thrombosis. RESULTS: The prevalence of deep-vein thrombosis was 71% in the control group, 50% in the Fraxiparine group (p = 0.042), and 45% in the indomethacin group (p = 0.011). Only 28% of the deep-vein thromboses were symptomatic, and there were no pulmonary emboli. CONCLUSIONS: Compared with no prophylaxis, Fraxiparine and indomethacin significantly lowered the prevalence of deep-vein thrombosis after total knee arthroplasty. Prophylaxis against deep-vein thrombosis in the Asian population appears to be warranted. LEVEL OF EVIDENCE: Therapeutic study, Level I-1a (randomized controlled trial [significant difference]). See Instructions to Authors for a complete description of levels of evidence.

Adult↗
PubMed2003

Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits.

Despite the success in clinical application, the exact mechanism of shock wave therapy remains unknown. We hypothesized that shock wave therapy induces the ingrowth of neovascularization and improves blood supply to the tissues. The purpose of this study was to investigate the effect of shock wave therapy on neovascularization at the tendon-bone junction. Fifty New Zealand white rabbits with body weight ranging from 2.5 to 3.5 kg were used in this study. The right limb (the study side) received shock wave therapy to the Achilles tendon near the insertion to bone. The left limb (the control side) received no shock wave therapy. Biopsies of the tendon-bone junction were performed in 0, 1, 4, 8 and 12 weeks. The number of neo-vessels was examined microscopically with hematoxylin-eosin stain. Neovascularization was confirmed by the angiogenic markers including vessel endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS) expressions and endothelial cell proliferation determined by proliferating cell nuclear antigen (PCNA) expression examined microscopically with immunohistochemical stains. The results showed that shock wave therapy produced a significantly higher number of neo-vessels and angiogenesis-related markers including eNOS, VEGF and PCNA than the control without shock wave treatment. The eNOS and VEGF began to rise in as early as one week and remained high for 8 weeks, then declined at 12 weeks; whereas the increases of PCNA and neo-vessels began at 4 weeks and persisted for 12 weeks. In conclusion, shock wave therapy induces the ingrowth of neovascularization associated with early release of angiogenesis-related markers at the Achilles tendon-bone junction in rabbits. The neovascularization may play a role to improve blood supply and tissue regeneration at the tendon-bone junction.

Achilles Tendon↗
PubMed2003

Acute popliteal artery occlusion after arthroscopic posterior cruciate ligament reconstruction.

Arthroscopic posterior cruciate ligament reconstruction may carry certain risks of complications, including injury to the neurovascular structures in the popliteal region. Acute occlusion of the popliteal artery, a limb-threatening complication, was reported after total knee arthroplasty. We report a case of acute popliteal artery occlusion after arthroscopic posterior cruciate ligament reconstruction. The possible causes included underlying artherosclerosis, the use of pneumatic tourniquet, surgical manipulation, and arterial spasm. Early diagnosis and prompt surgical treatment are the keys to success in the treatment of this limb-threatening complication. Spontaneous resolution of the thrombus such as is reported in this case is exceptional.

Anticoagulants↗
PubMed2003

The effect of alendronate on bone mineral density in the distal part of the femur and proximal part of the tibia after total knee arthroplasty.

BACKGROUND: Bone mineral density around the knee is related to the mechanical properties of bone. Alendronate has been shown to be effective for the treatment of osteoporosis and for reducing the rate of osteoporotic fractures. The purpose of the present study was to investigate the effect of alendronate on bone mineral density in the distal part of the femur and proximal part of the tibia after total knee arthroplasty in women. METHODS: Ninety-six women with an average age of seventy years who were undergoing total knee arthroplasty were randomly divided into two groups. Patients in the study group received oral alendronate at a dose of 10 mg/day for six months, whereas patients in the control group did not. The bone mineral density in the distal part of the femur and proximal part of the tibia was determined preoperatively and at six and twelve months postoperatively. RESULTS: In the control group, the bone mineral density showed significant decreases of 13.8% (p < 0.001) and 7.8% (p = 0.003) in the distal part of the femur and of 6.5% (p = 0.002) and 3.6% (p = 0.141) in the proximal part of the tibia at six and twelve months, respectively. In the study group, however, the bone mineral density showed significant increases of 10.0% (p = 0.010) and 1.9% (p = 0.049) in the distal part of the femur and of 9.4% (p < 0.001) and 5.4% (p = 0.032) in the proximal part of the tibia at six and twelve months, respectively. The overall differences in bone mineral density between the study and control groups were significant (p = 0.011 for the proximal part of the tibia, and p = 0.033 for the distal part of the femur). CONCLUSIONS: We found significant postoperative decreases in bone mineral density in the distal part of the femur and proximal part of the tibia in women who had undergone total knee arthroplasty. Oral administration of alendronate for six months postoperatively significantly improved the bone mineral density. While the clinical benefits of alendronate after total knee arthroplasty remain unproven and the duration of follow-up in the present study was quite short, the improvement in bone mineral density may have a clinically important effect on prosthetic fixation and the rate of periprosthetic fractures after total knee arthroplasty.

Absorptiometry, Photon↗
PubMed2003

Results of curettage and high-speed burring for chondroblastoma of the bone.

BACKGROUND: Chondroblastomas of the bone are rare lesions. Most of these lesions can be successfully treated by curettage and bone grafting. However, a considerable rate of recurrence has been reported, especially in aggressive lesions. The purpose of this study was to report the results of 10 cases of chondroblastomas of the bone treated with curettage and high-speed burring. METHODS: Ten patients with histologically confirmed chondroblastoma of the bone were treated with curettage and high-speed burring between October 1991 and August 2000. There were 7 men and 3 women with an average age of 18.9 (range, 12 to 30) years. Radiographically, 3 were classified as having aggressive lesions, and 7 were classified as having non-aggressive ones. For treatment, 8 of them had defects packed with either bone grafts or bone substitutes; 1 defect was packed with bone cement; and the other was left alone because the lesion was small. RESULTS: At an average follow-up period of 62 (range, 8 to 112) months, all patients had painless, normal function of the affected limb without local recurrence or distant metastasis. Complete healing of the lesion was seen in 8 patients including the one without a bone graft. The lesion in 1 patient who had received bone cement remained unchanged radiographically. One patient experienced incomplete healing of the lesion, which was caused by inadequate packing of the bone substitute. CONCLUSION: Curettage and high-speed burring represent an effective method for the treatment of chondroblastoma of the bone whether in the non-aggressive or aggressive stage.

Adolescent↗