Biomedical subjects

Tomihisa Koshino

Publications and source records attributed to Tomihisa Koshino.

At least 19 recordsLinked to original sources

PubMed2006

Histopathological abnormalities in painful bipartite patellae in adolescents.

The purpose of this study was to clarify the etiology of painful bipartite patella in adolescents by histopathological examination of excised specimens. We performed excision of a fragment of painful bipartite or tripartite patella from six patients (six knees). The articular cartilage, interposed tissue, bone, and bone marrow of the excised specimens were histologically examined. The articular cartilage was intact in all but two patellae. The predominant composition of the interposed tissue was fibrous tissue in one patient; fibrous tissue and fibrocartilage in four patients; and fibrous tissue, fibrocartilage, and hyaline cartilage in one patient. In the interposed tissue, diffuse degenerative and necrotic fibrocartilage was observed in four patients and focal necrotic fibrocartilage was seen in two patients. In all patients, the central region of the interposed tissue almost completely lacked blood vessels. Other histological features of the interposed tissue included necrosis of the trabecular bone in three patients, irregularly shaped spicules of immature bone in three patients, and fragments of hyaline cartilage in two patients. In all patients the bone marrow adjacent to the interposed tissue showed numerous small blood vessels, and trabecular bone surfaces and the fibrocartilage surface adjacent to this bone marrow was scalloped and lined with numerous osteoclasts. The striking histopathological features of the interposed tissue were fibrous tissue and necrosis of the fibrocartilage. These abnormalities may ultimately lead to the failure of an accessory ossification center to unite with the main portion of the patella.

Adolescent↗

PubMed2005

Repair of articular cartilage defect by autologous transplantation of basic fibroblast growth factor gene-transduced chondrocytes with adeno-associated virus vector.

OBJECTIVE: To examine the effects of basic fibroblast growth factor (bFGF) gene-transduced chondrocytes on the repair of articular cartilage defects. METHODS: LacZ gene or bFGF gene was transduced into primary isolated rabbit chondrocytes with the use of a recombinant adeno-associated virus (AAV) vector. These gene-transduced chondrocytes were embedded in collagen gel and transplanted into a full-thickness defect in the articular cartilage of the patellar groove of a rabbit. The efficiency of gene transduction was assessed according to the percentage of LacZ-positive cells among the total number of living cells. The concentration of bFGF in the culture supernatant was measured by enzyme-linked immunosorbent assay to confirm the production by bFGF gene-transduced chondrocytes. At 4, 8, and 12 weeks after transplantation, cartilage repair was evaluated histologically and graded semiquantitatively using a histologic scoring system ranging from 0 (complete regeneration) to 14 (no regeneration) points. RESULTS: LacZ gene expression by chondrocytes was maintained until 8 weeks in >85% of the in vitro population. LacZ-positive cells were found at the transplant sites for at least 4 weeks after surgery. The mean concentration of bFGF was significantly increased in bFGF gene-transduced cells compared with control cells (P < 0.01). Semiquantitative histologic scoring indicated that the total score was significantly lower in the bFGF-transduced group than in the control group throughout the observation period. CONCLUSION: These results demonstrated that gene transfer to chondrocytes by an ex vivo method was established with the AAV vector, and transplantation of bFGF gene-transduced chondrocytes had a clear beneficial effect on the repair of rabbit articular cartilage defects.

Animals↗

PubMed2004

Transepicondylar line and condylar line as parameters for axial alignment in knee arthroplasty.

In order to investigate the reliability of the transepicondylar line and the condylar line as indicators for lower limb alignment in knee arthroplasty, the femorotibial angle (FTA), and the angle between the transepicondylar line and the tangential line of tibial plateau (angle epsilon) and condylar-plateau angle (CPA) were measured in 107 (78 patients) full-length standing X-ray films of lower limbs. The mean FTA was measured to be 178.0+/-9.3 degrees, the CPA 1.5+/-8.5 degrees and angle epsilon -0.8+/-8.5 degrees. The correlation between FTA and the CPA was analyzed to be significant with a correlation coefficient of 0.63, while another correlation between FTA and angle epsilon was calculated to be significant with a correlation coefficient of 0.81 at the same time. As a result, the correlation of the latter one was highly significant, having a R2 value of 0.648 (P<0.001), while the R2 of the former was only 0.397 (P<0.001). In conclusion, the transepicondylar line could be considered as a more reliable indicator for lower limb alignment, which may play an important role in ligament balancing and improvement of the guiding system in knee arthroplasty.

Arthritis, Rheumatoid↗

PubMed2004

Fifteen to twenty-eight years' follow-up results of high tibial valgus osteotomy for osteoarthritic knee.

A long-term follow-up study was performed on 75 knees of 53 patients after high tibial valgus osteotomy. The earlier results have previously been reported. There were 15 knees in 11 men and 60 knees in 42 women. The follow-up period ranged from 15 to 28 years with a mean of 19 +/- 3 years. The age at osteotomy ranged from 46 to 73 years with a mean of 59.6 +/- 6.7 years. The diagnosis was medial compartmental osteoarthritis (OA) in 68 knees (46 patients) and spontaneous osteonecrosis of the medial femoral condyle in 7 knees (7 patients). Valgus osteotomy was performed above the tibial tuberosity, with removal of a laterally based wedge in all cases, aiming for anatomical valgus angulation of 10 degrees . The American Knee Society Score showed a Knee Score of 37 +/- 20 and a Function Score of 38 +/- 16 preoperatively and 87 +/- 13 and 80 +/- 19 at the final 15 to 28 years' follow-up. The femoro-tibial angle in standing was 186 +/- 6.5 degrees (6 degrees of anatomical varus angulation) before and 171 +/- 7.5 degrees (9 degrees of anatomical valgus angulation) at final follow-up (p < 0.0001), with no apparent loss of limb alignment.

Aged↗

PubMed2003

Articular cartilage repair of rabbit chondral defect: promoted by creation of periarticular bony defect.

This study investigated the stimulatory effect of bone healing on cartilage regeneration. Full-thickness osteochondral defects, 5 mm wide x 3 mm deep, were created in the patellar groove of the right distal end of the femur in 60 mature Japanese white rabbits. The bone defect was made in the medial condyle of the ipsilateral tibia in the experimental group. The control group had only a chondral defect in the patellar groove. At 4, 8, and 12 weeks after surgery, cartilage repair was evaluated macroscopically and histologically using a semiquantitative grading scale. The mean scores of the gross and histological evaluation grade in the experimental group were significantly superior to those in the control group at 8 and 12 weeks ( P << 0.05). These findings suggested that regeneration of articular cartilage defects might be promoted by creation of a periarticular bony defect.

Animals↗

PubMed2003

Fibroblast growth factor 2 in synovial fluid from an osteoarthritic knee with cartilage regeneration.

The levels of fibroblast growth factor 2 (FGF2) in synovial fluid of osteoarthritic knees were measured. The correlation between FGF2 and the severity of cartilage degeneration in varus-deformed knees with medial compartmental osteoarthritis or the articular cartilage regeneration that occurs after high tibial osteotomy (HTO) were investigated. Knees that underwent total knee arthroplasty (TKA) were categorized as either mildly or severely degenerated according to a modified Outerbridge's grading system for degeneration of articular cartilage. Regeneration of articular cartilage was observed in a biopsy specimen from the medial femoral condyle removed with the patient's consent during hardware removal approximately 2 years after HTO. The joint fluid FGF2 level was measured at that time using an enzyme-linked immunosorbent assay. Cartilage regeneration was classified as immature or mature according to the staging for regeneration of articular cartilage. The histological findings were analyzed using Pineda's evaluation method for cartilage regeneration. The mean concentration of FGF2 was 57.4 +/- 17.6 pg/ml in the joint fluid from knees with severely degenerated cartilage. This was higher than the FGF2 concentration found in the mildly degenerated group. Approximately 2 years after HTO the FGF2 level in synovial fluid was lower in knees with mature regenerated cartilage than in those with immature regeneration. Osteoarthritic knees at a more mature regeneration stage had a lower Pineda's histological score. This result suggested that the FGF2 concentration in knees with osteoarthritis was influenced by articular cartilage degeneration and regeneration, and it correlated with the histological evaluation.

Aged↗

PubMed2003

Radiologic evaluation of the rheumatoid hand after synovectomy and extensor carpi radialis longus transfer to extensor carpi ulnaris.

PURPOSE: In this study we radiologically evaluated the effects of extensor carpi radialis longus (ECRL) tendon transfer on the stability and deformity of joints of rheumatoid hands in cases with a postoperative period of more than 5 years. METHODS: Synovectomy concomitant with tendon transfer of the ECRL to the extensor carpi ulnaris (Clayton's procedure) was performed in 28 wrists of 23 patients with rheumatoid arthritis. The follow-up period was 8.8 +/- 2.8 years. Pre- and postoperative x-rays were reviewed and measured. Follow-up evaluation included Steinbrocker's classification of the radiocarpal joints, Larsen's grade of the third metacarpophalangeal (MCP) joint, radial angulation of the wrist, ulnar translocation of the carpus, and ulnar drift of the fingers. RESULTS: Nineteen of 28 wrists (68%) were ankylosed (radius-proximal carpal row fusion or radiolunate limited fusion). Radial angulation of the wrist was reduced from 131 degrees +/- 8.8 degrees before surgery to 121 degrees +/- 7.9 degrees after surgery. Dislocation and ulnar translocation of the carpus (UTC) were prevented by surgery (UTC: 1.05 +/- 0.10 before and 1.07 +/- 0.09 after surgery). The mean ulnar drift of the fingers was maintained at the preoperative level (UDF: 14 degrees +/- 5.7 degrees before and 14 degrees +/- 12.9 degrees after surgery). The incidence of alteration (increase and decrease) of UDF of more than 5 degrees between pre- and postoperative evaluation was significantly higher in the group with worsening of Larsen grade of MCP joints than in the group without worsening (with worsening: 7 of 8 MCP joints, without worsening: 8 of 20 MCP joints). CONCLUSIONS: ECRL tendon transfer (Clayton's procedure) provided effective stabilization at more than 5 years (mean, 8.8 y) after surgery. In addition, this method may help to prevent ulnar drift of the fingers if combined with correction of local factors at the MCP joints.

Adult↗

PubMed2003

15-year follow-up study of total knee arthroplasty in patients with rheumatoid arthritis.

In 25 patients with rheumatoid arthritis, 36 cases of cemented Kinematic total knee arthroplasty were reviewed clinically and radiographically at 13 to 19 years after surgery. The mean age at the time of surgery was 51.6 +/- 8.9 years. According to the follow-up results evaluated with the Hospital for Special Surgery knee scoring system, 28 knees (77.7%) were classified as good or excellent. The mean flexion angle at follow-up evaluation was 99 degrees +/- 24 degrees (10 degrees -140 degrees ). At the tibial or femoral bone-cement interfaces, a radiolucent line was seen in 10 of 36 knees (27.8%) at follow-up evaluation. The survival rate of prostheses with revision as the endpoint was estimated to be 93.7% at 15 years. Kinematic total knee arthroplasty in rheumatoid arthritis patients provided a good long-term outcome.

Adult↗

PubMed2003

Regeneration of degenerated articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis of the knee.

The aim of the current study was to document regeneration of the articular cartilage after correction of varus deformity for osteoarthritis of the knee. The repair of articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis was observed in 146 knees of 115 patients. The mean age of the patients at osteotomy was 65+/-7 years (range 47-80). Observations were made through an arthrotomy at the time of removal of the blade plate, an average of 2 years after the initial osteotomy. Regeneration of the degenerated cartilage was classified into three stages. There were no regenerative findings (Stage A) in 13 knees; partial regeneration with fibrocartilaginous tissue (Stage B) in the previous degenerated area (Stage B) in 86 knees; and total coverage by new regenerated fibrocartilage or hyaline-like cartilage (Stage C) in 47 knees. Mature regeneration (Stage C) was observed more frequently in the knees with increased width of the medial joint space after high tibial osteotomy than in those with unchanged width (P<0.01), and in the knees with more than 5 degrees of anatomical valgus angulation after osteotomy than in those with less than 5 degrees (P=0.05). Even the knees with eburnation of subchondral bone in the weight-bearing portion showed Stage C regeneration in 26 out of 80, in contrast with no regeneration in two knees with degenerated cartilage remaining. O'Driscoll's histological and histochemical grading score was higher in the Stage C group (P<0.02). The weight-bearing portion of the medial femoral condyle with exposed bone was concluded to be partially or entirely covered by newly regenerated cartilage after 1 year after adequate correction of varus deformity by high tibial osteotomy without antologous chondrocyte implantation.

Aged↗

PubMed2003

Provoked anterior knee pain in medial osteoarthritis of the knee.

The incidence and the causes of provoked anterior knee pain in medial osteoarthritis (OA) of the knee were investigated clinically and radiographically. A retrospective study was performed in 179 primary osteoarthritic knees of 129 patients. Provocative tests were conducted on the patellofemoral (PF) joint to induce retropatellar crepitation, grating pain, tenderness around the patella, and pain on deviating the patella. The femorotibial angle (FTA) was measured on standing anteroposterior radiographs as a parameter of limb alignment. The widths of the medial and lateral joint space of the PF joint were measured on skyline views of standing or 30, 60 or 90 degrees knee flexion. The angle of flexion contracture was measured on lateral radiographs of knees with maximum extension. The lateral shift and tilt of the patella were measured on standing skyline views. Retropatellar crepitation was found in 70% of knees, while provoked anterior knee pain was observed in 35-45% of knees with medial OA of the knee. Standing FTA was significantly greater in knees with tenderness around the patella and pain on deviating the patella than in those without these symptoms (P<0.05). The angle of flexion contracture was significantly greater in knees with provoked symptoms in the PF joint than in those without symptoms (P<0.05). The degree of lateral shift was greater in knees with provoked symptoms (P<0.05). Flexion contracture and varus deformity of the knee with lateralization of the patella may be factors aggravating provoked PF symptoms in medial OA of the knee. The radiographic assessment in this series failed to show a significant relationship between the width of the PF joint space and the incidence of provoked PF symptoms.

Aged↗

PubMed2003

Medial opening-wedge high tibial osteotomy with use of porous hydroxyapatite to treat medial compartment osteoarthritis of the knee.

BACKGROUND: The aims of this study were to investigate the results of opening-wedge high tibial valgus osteotomy in patients with medial compartment osteoarthritis of the knee and to examine the usefulness of hydroxyapatite wedges as the supporting material. METHODS: Medial opening-wedge osteotomy was performed in twenty-one osteoarthritic knees in eighteen patients who had a mean age of 66.6 years. The mean duration of follow-up was 78.6 months. A medial transverse osteotomy was performed proximal to the tibial tuberosity, with the most lateral 10% of the tibia left intact. The medial side of the osteotomy site was opened to the desired angle of correction. Two hydroxyapatite wedges of the same size (5.0, 7.5, or 10.0 mm) were inserted into the opened osteotomy site along with bone grafts, and the fragments were fixed with two plates. The angle of correction could be adjusted by altering the direction of wedge insertion. The goal was to achieve a final standing alignment of 10 degrees of anatomical valgus angulation. RESULTS: All patients had pain relief and improvement in walking ability after the osteotomy. The mean knee and function scores of the American Knee Society were 60.2 +/- 5.3 and 48.1 +/- 10.4 points, respectively, before the osteotomy and 94.3 +/- 7.3 and 93.1 +/- 9.8 points, respectively, at the time of the final follow-up. Limb alignment, expressed as the standing femorotibial angle, was corrected from 180 degrees +/- 2.9 degrees preoperatively to 169.7 degrees +/- 3.7 degrees (10.3 degrees of anatomical valgus angulation) at the time of the latest follow-up. There were no cases of recurrence of varus deformity or collapse of the hydroxyapatite wedges. CONCLUSIONS: After a mean duration of follow-up of 6.6 years, we found that the medial opening-wedge osteotomy of the proximal part of the tibia provided satisfactory clinical results for patients with osteoarthritis of the knee. Use of the porous hydroxyapatite wedges resulted in no collapse or subsidence at the osteotomy site. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series [no, or historical, control group]). See p. 2 for complete description of levels of evidence.

Aged↗

PubMed2002

Inhibition of lung metastasis of osteosarcoma cell line POS-1 transplanted into mice by thigh ligation.

Using a model with external ligation of the thigh, the effect of ischemia-reperfusion injury on tumor growth and the activity of lung metastasis was investigated in mice inoculated a spontaneous murine osteosarcoma cell line (POS-1) in vivo. POS-1 cell suspension was inoculated into the right hind footpad of 70 mice. Four weeks after inoculation, the ipsilateral thigh was ligated for 3 h in 15 mice and the contralateral thigh in 15 mice. Another ten mice were inoculated with POS-1 without ligating the thigh. The number of metastatic foci on the lung surface 6 weeks after inoculation was 2.29+/-0.98 (mean+/-SE) foci/lungs in mice with ipsilateral ligation and 6.25+/-2.41 in mice with contralateral ligation, which were significantly lower than control (13.40+/-1.42 in mice no ligation) (P<0.01). The number of metastatic foci on the lung surface in mice with intraperitoneal injection of superoxide dismutase (SOD) and catalase was 3.25+/-0.65 (mean+/-SE) foci/lungs in mice with ligation which was significantly greater than that in mice without SOD and catalase injection 1.29+/-0.97 (P=0.04). Cell viability was 9.12+/-4.07% with 100 microM H(2)O(2) in 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay. It revealed that at concentrations of 100 microM H(2)O(2) or higher was cytotoxic to POS-1. In cell invasion assay, the number of invading cells with 10 microM H(2)O(2) was 2.80+/-0.53 cells/field, which was significantly lower than control (5.93+/-0.18) (mean+/-SE), indicating that low-dose H(2)O(2) suppressed invasion of POS-1. These results suggested that reperfusion injury had selective cytotoxicity to POS-1 through producing reactive oxygen species. Activated oxygen was considered to inhibit the regional growth and the ability of lung metastasis of POS-1 cells.

Animals↗

PubMed2002

Use of joint fluid analysis for determining cartilage damage in osteonecrosis of the knee.

OBJECTIVE: To assess the value of joint fluid analysis for determining cartilage degradation and prognosis in spontaneous osteonecrosis (ON) of the knee. METHODS: Synovial fluid was obtained from 30 knees with spontaneous ON (26 medial femoral condyles, 4 medial tibial plateaus) as well as from 50 knees with medial compartmental osteoarthritis (OA) as a control. Levels of chondroitin 6-sulfate (C6S), C4S, and hyaluronic acid were measured with high-performance liquid chromatography. The lesion size, appearance of the articular cartilage, and results of magnetic resonance imaging (MRI) were compared with the results of joint fluid analysis. RESULTS: The mean +/- SD level of C6S was 82.2 +/- 36.6 nmoles/ml in joint fluid from ON knees, which was significantly higher than the levels in knees with grade 2 (47.2 +/- 20.0 nmoles/ml) and grade 3 (55.8 +/- 29.2 nmoles/ml) OA. The C6S:C4S ratio was highest in lesions with mild articular changes and reflected the macroscopic alteration of cartilage overlying the ON lesion. The concentration of C6S in the 9 knees with lesions that covered > or = 40% of the condyle (99.0 +/- 32.9 nmoles/ml) was higher than that in the 17 knees with lesions that covered <40% of the condyle (67.2 +/- 31.7 nmoles/ml). Knees with bone marrow edema on MRI had a higher level of C6S than did knees with a fibrous-like appearance. CONCLUSION: While radiologic staging was useful for indicating the size of the ON lesion, it was less valuable for determining articular cartilage damage. Joint fluid analysis may provide more precise information about articular cartilage degradation in ON, and the findings may also be of prognostic significance.

Aged↗

PubMed2002

Slow-releasing potential of vancomycin-loaded porous hydroxyapatite blocks implanted into MRSA osteomyelitis.

Although antibiotic-loaded hydroxyapatite blocks have been used for the treatment of chronic osteomyelitis, their long-term potential for releasing antibiotic into human bones is not well known. Five patients with chronic osteomyelitis due to methicillin-resistant Staphylococcus aureus (MRSA) infection were effectively treated with local implantation of vancomycin-loaded hydroxyapatite blocks. Blocks were removed during the following reconstructive surgeries when the releasing capability of the blocks, and the bacteriocidal activity of the remaining vancomycin in these blocks could be evaluated. Vancomycin was rapidly released within 1 month after implantation, and by 3 months 90% of vancomycin had leaked from the blocks. At 18 months vancomycin still remained in a bacteriocidal form in the hydroxyapatite blocks, though the blocks had no releasing potential or the eluted vancomycin had been changed to a different form. Vancomycin-loaded porous hydroxyapatite blocks would be useful for the treatment of chronic osteomyelitis or implant-associated osteomyelitis due to MRSA.

Adult↗

PubMed2002

Merkel cell carcinoma with bone metastasis: a case report.

A case of Merkel cell carcinoma with bone metastasis is described. The patient, who had a history of Merkel cell carcinoma of the skin in the right cheek, had spontaneous pain in the right thigh. At the initial visit, the right hip range of motion was slightly limited, but there was no gait disturbance or abnormality in the radiographs of the right hip. However, the pain gradually increased and caused gait disturbance. The patient underwent surgical treatment. A bipolar type of femoral prosthesis was implanted into the femur, and sampling of cancellous bone was performed at the time of osteotomy. Pathological examination showed the findings of Merkel cell carcinoma. Merkel cell carcinoma is a rare malignant tumor of the skin, which usually occurs on the head, neck, or extremities and metastasizes to the lymph nodes. Although osseous involvement often occurs in the adjacent facial bones through direct invasion, distant osseous metastasis appears to be extremely rare.

Aged↗

PubMed2002

Effect of femoral nerve resection on progression of cartilage degeneration induced by anterior cruciate ligament transection in rabbits.

The purpose of this study was to evaluate the effect of femoral nerve resection on the progression of cartilage degeneration in an anterior cruciate ligament transection (ACLT) and partial meniscectomy (PM) model in rabbits. To induce degeneration of articular cartilage, PM and ACLT were performed on the bilateral knees of 24 rabbits, and femoral sensory nerve selective resection (FNR) was additionally performed on the left knee. Six rabbits each were killed 6 and 10 weeks after surgery to observe early cartilage degeneration and 17 and 24 weeks after surgery to evaluate the late phase. Mankin's histological score at 10 weeks (7.5 +/- 2.7 points; mean +/- SD) after surgery in the FNR group was higher than that at 6 weeks (3.0 +/- 0.6 points) ( P < 0.05). In the control group the score at 17 weeks (7.8 +/- 2.0 points) was higher than that at 6 weeks (2.7 +/- 0.5 points) ( P < 0.05). The concentration of chondroitin sulfate in the joint fluid was quantified by high-performance liquid chromatography. The concentration of chondroitin 6-sulfate in the FNR group at 10 weeks (11.6 +/- 4.1 nmol/ml) was higher than that at the other times and that of the control group at 10 weeks (5.4 +/- 3.2 nmol/ml) after surgery ( P < 0.05). These results indicate that FNR may promote the progression of cartilage degeneration in knees with PM and ACLT.

Analysis of Variance↗

PubMed2002

Osteogenic response of hydroxyapatite cement implanted into the femur of rats with experimentally induced osteoporosis.

Hydroxyapatite (HAP) cement was implanted in the femur of rats with experimentally induced osteoporosis, and the osteogenic response was studied histomorphologically. Osteoporosis was induced with ovariectomy with either a normal diet or a low-calcium diet. The rats fed a low-calcium diet after ovariectomy showed a decrease in both cumulative photodensity and the cortical thickness index. There was significant bone conduction in the femur of these rats, but the development of new bone was late, and the affinity index was small. The change in the affinity index with time was similar between the ovariectomy group and the ovariectomy/low calcium-group, suggesting the possibility that estrogen plays a major role in bone conduction.

Animals↗

PubMed2002

High tibial osteotomy with anterior advancement of distal fragment for medial and patellofemoral compartmental osteoarthritis of the knee.

High tibial osteotomy was performed in 73 knees of 50 patients with medial and patellofemoral compartmental osteoarthritis of the knee, which was combined with anterior advancement of the distal fragment. At the operation, parapatellar release of the retinaculum and subperiosteal elevation of contracted medial soft tissue were also adjoined. The average age of the patients at the time of surgery was 64 years. The follow-up period was an average of 58 months. On overall clinical results assessed with the Knee Society score, the average total knee score was improved from preoperative 50 points to postoperative 94, and the preoperative average functional score of 47 points increased to 92 postoperatively. At follow-up, pain from a grinding patella was not found in 68 of 73 knees and pain from grinding and deviating of the patella was relieved in more than 96% of all cases. The mean femorotibial angle was reduced from preoperative 185 degrees to postoperative 167 degrees. On skyline view, the width of the lateral facet joint space was widely opened postoperatively, particularly on the flexion angle of 90 degrees. This operative procedure successfully relieved patellofemoral symptoms of the patients with medial and patellofemoral compartmental osteoarthritis of the knee.

Aged↗