Displaying publications 1 - 20 of 41 in total

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  1. Silva JF
    Int Orthop, 1980;4(2):79-81.
    PMID: 7429684 DOI: 10.1007/bf00271088
    Two hundred and nineteen patients with skeletal tuberculosis have been reviewed analysing the site of the lesion and the treatment given. Operative management is advocated since the results of this approach are encouraging.
    Matched MeSH terms: Knee Joint/surgery
  2. Ang LC
    Med J Malaysia, 1992 Sep;47(3):220-4.
    PMID: 1491648
    From 1988 to 1990, eighty operations on eighty knees of seventy-nine patients with a clinical diagnosis of meniscal tear was entered into a prospective study. The clinical diagnosis was correct in 76% of patients. Excellent or good results were achieved in 90% of knees which had only meniscal lesions but dropped to 70.5% when other intraarticular pathologies coexisted with the meniscal lesions. Excellent or good results were achieved in 71% of the knees in the presence of Anterior Cruciate Ligament (ACL) deficiency.
    Matched MeSH terms: Knee Joint/surgery*
  3. Yeow C, Chin CH, Ong PH
    Med J Malaysia, 1995 Dec;50(4):414-6.
    PMID: 8668066
    Giant cell tumour of bone occurring around the knee is fairly common and can be difficult to manage. We report a case of such tumour involving the distal femur which was successfully treated with complete excision followed by arthrodesis of the knee with a long interlocking intramedullary nail.
    Matched MeSH terms: Knee Joint/surgery*
  4. Ramanathan R
    Med J Malaysia, 1998 Sep;53 Suppl A:99-101.
    PMID: 10968190
    We studied 95 patients who underwent knee Arthroscopy under local anaesthesia between JANUARY 1995 till 1997. Materials used were 1% Xylocaine and 0.25% Bupivacaine of 20 mls each combined with midazolam 2 mg and IV pethidine 30 mgm for sedation. The patients were attached to monitors (pulse Oxymeter, ECG and BP and pulse recorders) and blood less field was created using a tornquet. The procedures lasted about 45 minutes. 90 out of 95 patients completed the procedures successfully without any complications. 2 developed respiratory embarrassments and were intubated and ventilated. 3 procedures abandoned and converted to general anaesthesia. The range of procedures done include meniscectomy, meniscal repair, synovial biopsy, debridement for osteoarthrosis, shaving of osteophytes, drilling of cartilage and bones and removal of loose bodies. This study is to show that knee arthroscopy under LA is a safe alternative in hospitals where GA time is limited.
    Matched MeSH terms: Knee Joint/surgery*
  5. Kwan MK, Penafort R, Saw A
    Med J Malaysia, 2004 Dec;59 Suppl F:39-41.
    PMID: 15941159
    Joint stiffness is one of the complications of limb procedure. It developes as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the affected joint. We are reporting four patients who developed fixed flexion contracture of their knees during bone lengthening procedure for the tibia with Ilizarov external fixator. Three of them were treated for congenital pseudoarthrosis and one was for fibular hemimelia. None of them were able to visit the physiotherapist even on a weekly basis. A splint was constructed from components of Ilizarov external fixator and applied on to the existing frame to passively extend the affected knee. Patients and their family members were taught to perform this exercise regularly and eventually near complete correction were achieved. With this result, we would like to recommend the use of this "Passive Knee Extension Splint" to avoid knee flexion Contracture during limb lengthening procedures with Ilizarov external fixators.
    Matched MeSH terms: Knee Joint/surgery
  6. Arif M, Makundala V, Choon DSK
    Med J Malaysia, 2005 Jul;60 Suppl C:99-103.
    PMID: 16381292 MyJurnal
    We report on our early experiences with the Press Fit Condylar Rotating Platform (PFC-RP) total knee replacement prosthesis at University Malaya Medical Centre. This new prosthesis was introduced to Malaysia in 2001. It combines the rotating platform technology of Low Contact Stress (LCS) and the modularity of Press Fit Condylar (PFC) system. We performed 18 knee replacements using cruciate retaining prosthesis without patellar resurfacing in 10 patients and followed them up over a period of 16-month. A new operative strategy was developed to match the flexion and extension gaps. The pre- and post-operative assessments were made according to the American Knee Society Scores (AKSS). Post-operative pain relief, range of motion, knee score and functional score showed promising early results. The average knee rating improved from 28 to 91 (range 75-94). Average functional assessment improved from 26 to 82 (range 75-90). The radiographic assessments show correction of an average pre-operative varus of 140 to post-operative valgus of 50 (range 4-70). Early infection occurred in two knees. Both responded to aggressive debridement and antibiotics. Stiffness was encountered in one patient. There were no spinouts of the insert. We are satisfied that the implants are performing well at the one-year mark and will continue monitor this cohort.
    Matched MeSH terms: Knee Joint/surgery*
  7. Kwan MK, Ng ES, Penafort R, Saw A, Sengupta S
    Med J Malaysia, 2005 Jul;60 Suppl C:66-71.
    PMID: 16381287 MyJurnal
    Bone defect following en bloc resection of primary bone tumor around the knee can be reconstructed by allograft or prothesis or combination of both. Resection-arthrodesis is an alternative option for young vigorous patients facing circumstances of financial constrain or limited supply of allograft. This study was undertaken to determine the outcome and complications associated with resection-arthrodesis of 22 primary bone tumors (13 giant cell tumors and 9 osteosarcomas) around the knee treated between 1990 and 2003 at the University Malaya Medical Center. The mean follow-up was 6 years (range 1-13 years). hree patients with osteosarcoma died of lung metastasis, 3 required above knee amputation and 2 defaulted follow-up. Local complications of the procedure include infection in 8 cases (36.4%), non-union 7 (31.8%) and mal-union. Of 14 patients who returned for final evaluation, 79.8% had satisfactory outcomes according to the Musculoskeletal Tumor Society grading system. In conclusion, resection-arthrodesis of the knee is a viable treatment option for selected patients with primary bone tumor around the knee, and good functional outcome can be expected in the presence of short-term local complications.
    Matched MeSH terms: Knee Joint/surgery*
  8. Ng WM, Chan KY, Lim ABK, Gan EC
    Med J Malaysia, 2005 Jul;60 Suppl C:14-6.
    PMID: 16381276
    A prospective cohort study was undertaken at two centers to look for the incidence of deep vein thrombosis (DVT) following knee arthroscopic surgery. Eighty-four patients who had 90 arthroscopic procedures were reviewed. The relevant risk factors: past or family history of DVT, smoking, oral contraceptives, body weight, haemoglobin level, platelet count, tourniquet time and type of anaesthesia were documented. All patients were subjected to preoperative and post-operative duplex ultrasound. Only one patient (1.2 %) was noted to have DVT involving the peroneal vein. We concluded that the incidence of DVT after knee arthroscopy was very low in this study population.
    Matched MeSH terms: Knee Joint/surgery*
  9. Rao SK, Rao PS
    Med J Malaysia, 2005 Dec;60(5):560-2.
    PMID: 16515105
    Post Arthroscopic intra-articular analgesia is a better method to avoid post-operative pain after arthroscopic surgery, thus avoiding the adverse effects of systemic analgesics. In this prospective randomized double blind study conducted on 90 patients, 30 patients in group A received 20 ml of intra-articular saline, 30 patients in Group B received 10 ml of intra-articular saline and 10 ml of 0.25% bupivacaine and 30 patients in Group C received 10 ml of 0.25% bupivacaine, 1 ml (30 mg) of ketorolac and 9 ml of saline intra-articularly. Ambulatory status, duration of analgesia and requirement for supplemented analgesia were compared in these three groups. Patients receiving this intra-articular analgesic combination of bupivacaine and ketorolac required significantly less supplemental postoperative analgesics. This combination significantly prolonged the duration of analgesia. Patients receiving this combination of drugs for intra-articular analgesia ambulated earlier.
    Matched MeSH terms: Knee Joint/surgery
  10. Tai CC, Cross MJ
    J Bone Joint Surg Br, 2006 Sep;88(9):1158-63.
    PMID: 16943464
    We carried out a prospective study of 118 hydroxyapatite-coated, cementless total knee replacements in patients who were = 55 years of age and who had primary (92; 78%) or post-traumatic (26; 22%) osteoarthritis. The mean period of follow-up was 7.9 years (5 to 12.5). The Knee Society clinical scores improved from a pre-operative mean of 98 (0 to 137) to a mean of 185 (135 to 200) at five years, and 173 (137 to 200) at ten years. There were two revisions of the tibial component because of aseptic loosening, and one case of polyethylene wear requiring further surgery. There was no osteolysis or progressive radiological loosening of any other component. At 12 years, the overall rate of implant survival was 97.5% (excluding exchange of spacer) and 92.1% (including exchange of spacer). Cementless total knee replacement can achieve excellent long-term results in young, active patients with osteoarthritis. In contrast to total hip replacement, polyethylene wear, osteolysis and loosening of the prosthesis were not major problems for these patients, although it is possible that this observation could change with longer periods of follow-up.
    Matched MeSH terms: Knee Joint/surgery
  11. Kamarul T, Selvaratnam L, Masjuddin T, Ab-Rahim S, Ng C, Chan KY, et al.
    J Orthop Surg (Hong Kong), 2008 Aug;16(2):230-6.
    PMID: 18725678
    To compare the efficacy of autologous chondrocyte transplantation (ACT) versus non-operative measures for cartilage repair in rabbits.
    Matched MeSH terms: Knee Joint/surgery*
  12. Kamarul T, Ab-Rahim S, Tumin M, Selvaratnam L, Ahmad TS
    Eur Cell Mater, 2011 Mar 15;21:259-71; discussion 270-1.
    PMID: 21409755
    The effects of Glucosamine Sulphate (GS) and Chondroitin Sulphate (CS) on the healing of damaged and repaired articular cartilage were investigated. This study was conducted using 18 New Zealand white rabbits as experimental models. Focal cartilage defects, surgically created in the medial femoral condyle, were either treated by means of autologous chondrocyte implantation (ACI) or left untreated as controls. Rabbits were then divided into groups which received either GS+/-CS or no pharmacotherapy. Three rabbits from each group were sacrificed at 12 and 24 weeks post-surgery. Knees dissected from rabbits were then evaluated using gross quantification of repair tissue, glycosaminoglycan (GAG) assays, immunoassays and histological assessments. It was observed that, in contrast to untreated sites, surfaces of the ACI-repaired sites appeared smooth and continuous with the surrounding native cartilage. Histological examination demonstrated a typical hyaline cartilage structure; with proteoglycans, type II collagen and GAGs being highly expressed in repair areas. The improved regeneration of these repair sites was also noted to be significant over time (6 months vs. 3 months) and in GS and GS+CS groups compared to the untreated (without pharmacotherapy) group. Combination of ACI and pharmacotherapy (with glucosamine sulphate alone/ or with chondroitin sulphate) may prove beneficial for healing of damaged cartilage, particularly in relation to focal cartilage defects.
    Matched MeSH terms: Knee Joint/surgery
  13. Saw KY, Anz A, Merican S, Tay YG, Ragavanaidu K, Jee CS, et al.
    Arthroscopy, 2011 Apr;27(4):493-506.
    PMID: 21334844 DOI: 10.1016/j.arthro.2010.11.054
    PURPOSE: The purpose of this study was to evaluate the quality of articular cartilage regeneration after arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous peripheral blood progenitor cells (PBPCs) in combination with hyaluronic acid (HA).
    METHODS: Five patients underwent second-look arthroscopy with chondral core biopsy. These 5 patients are part of a larger pilot study in which 180 patients with International Cartilage Repair Society grade III and IV lesions of the knee joint underwent arthroscopic subchondral drilling followed by postoperative intra-articular injections. Continuous passive motion was used on the operated knee 2 hours per day for 4 weeks. Partial weight bearing was observed for the first 6 to 8 weeks. Autologous PBPCs were harvested 1 week after surgery. One week after surgery, 8 mL of the harvested PBPCs in combination with 2 mL of HA was injected intra-articularly into the operated knee. The remaining PBPCs were divided into vials and cryopreserved. A total of 5 weekly intra-articular injections were given.
    RESULTS: Second-look arthroscopy confirmed articular cartilage regeneration, and histologic sections showed features of hyaline cartilage. Apart from the minimal discomfort of PBPC harvesting and localized pain associated with the intra-articular injections, there were no other notable adverse reactions.
    CONCLUSIONS: Articular hyaline cartilage regeneration is possible with arthroscopic subchondral drilling followed by postoperative intraarticular injections of autologous PBPCs in combination with HA.
    LEVEL OF EVIDENCE: Level IV, therapeutic case series.
    Matched MeSH terms: Knee Joint/surgery*
  14. Raja Izaham RM, Abdul Kadir MR, Abdul Rashid AH, Hossain MG, Kamarul T
    Injury, 2012 Jun;43(6):898-902.
    PMID: 22204773 DOI: 10.1016/j.injury.2011.12.006
    The use of open wedge high tibial osteotomy (HTO) to correct varus deformity of the knee is well established. However, the stability of the various implants used in this procedure has not been previously demonstrated. In this study, the two most common types of plates were analysed (1) the Puddu plates that use the dynamic compression plate (DCP) concept, and (2) the Tomofix plate that uses the locking compression plate (LCP) concept. Three dimensional model of the tibia was reconstructed from computed tomography images obtained from the Medical Implant Technology Group datasets. Osteotomy and fixation models were simulated through computational processing. Simulated loading was applied at 60:40 ratios on the medial:lateral aspect during single limb stance. The model was fixed distally in all degrees of freedom. Simulated data generated from the micromotions, displacement and, implant stress were captured. At the prescribed loads, a higher displacement of 3.25 mm was observed for the Puddu plate model (p<0.001). Coincidentally the amount of stresses subjected to this plate, 24.7 MPa, was also significantly lower (p<0.001). There was significant negative correlation (p<0.001) between implant stresses to that of the amount of fracture displacement which signifies a less stable fixation using Puddu plates. In conclusion, this study demonstrates that the Tomofix plate produces superior stability for bony fixation in HTO procedures.
    Matched MeSH terms: Knee Joint/surgery*
  15. Ali S, Osman NA, Mortaza N, Eshraghi A, Gholizadeh H, Wan Abas WA
    Clin Biomech (Bristol, Avon), 2012 Nov;27(9):943-8.
    PMID: 22795863 DOI: 10.1016/j.clinbiomech.2012.06.004
    The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee's satisfaction and comfort. Liners provide a comfortable interface by adding a soft cushion between the residual limb and the socket. The Dermo and the Seal-In X5 liner are two new interface systems and, due to their relative infancy, very little are known about their effect on patient satisfaction. The aim of this study was to compare the interface pressure with these two liners and their effect on patient satisfaction.
    Matched MeSH terms: Knee Joint/surgery*
  16. Siow WM, Chin PL, Chia SL, Lo NN, Yeo SJ
    Clin Orthop Relat Res, 2013 May;471(5):1451-7.
    PMID: 23299954 DOI: 10.1007/s11999-012-2776-7
    There is marked racial disparity in TKA use rates, demographics, and outcomes between white and Afro-Caribbean Americans. Comparative studies of ethnicity in patients undergoing TKAs have been mostly in American populations with an underrepresentation of Asian groups. It is unclear whether these disparities exist in Chinese, Malays, and Indians.
    Matched MeSH terms: Knee Joint/surgery*
  17. Wong KA, Singh VA, Pailoor J
    Singapore Med J, 2013 Nov;54(11):e228-9.
    PMID: 24276110
    Intra-articular haemangioma is a rare and uncommon condition that sometimes presents in infants. The lesion can be a diagnostic challenge, with misdiagnosis often leading to delayed diagnosis and treatment. It is essential to establish and treat the condition early, as intra-articular haemangioma can lead to destruction of the joint and secondary arthrosis. Herein, we report the case of a five-year-old boy who presented with intra-articular haemangioma and discuss the management of his condition.
    Matched MeSH terms: Knee Joint/surgery*
  18. Jiang L, Bin Abd Razak HR, Chong HC, Tan A
    J Arthroplasty, 2014 Feb;29(2):304-7.
    PMID: 23891052 DOI: 10.1016/j.arth.2013.06.002
    We aim to compare the patient profile and outcomes after TKA between the different racial groups in Singapore. Prospective data were collected from 364 patients who underwent TKA in Singapore General Hospital from January 2006 to May 2010. Patients were stratified according to ethnicity and we compared their preoperative demographic data, Short-Form 36 (SF-36), Oxford Knee (OKS) as well as Knee Society Scores (KSS). Malays were younger (62.0 ± 5.3) at time of surgery (p=0.05) and the body mass index of Chinese (27.9 ± 4.7) was lower than Malay (30.4 ± 5.0) and Indian (31.5 ± 4.5) patients (P<0.005). Malay (40.3 ± 11.0) and Indian (39.2 ± 9.3) patients had less favourable preoperative OKS than Chinese (35.9 ± 7.8) patients (P<0.05). All 3 ethnic groups achieved statistically significant improvements in outcome measures but did not differ significantly between the ethnicities.
    Matched MeSH terms: Knee Joint/surgery*
  19. Cartwright-Terry M, Yates J, Tan CK, Pengas IP, Banks JV, McNicholas MJ
    Arthroscopy, 2014 Jul;30(7):811-7.
    PMID: 24794571 DOI: 10.1016/j.arthro.2014.02.039
    To present a 5-year comparison of the functional outcomes of combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) reconstruction with those of isolated ACL reconstruction.
    Matched MeSH terms: Knee Joint/surgery
  20. Ahmad S, Mahidon R, Shukur MH, Hamdan A, Kasmin M
    J Orthop Surg (Hong Kong), 2014 Dec;22(3):325-8.
    PMID: 25550011
    To evaluate the outcome of reconstruction for chronic grade-II posterior cruciate ligament (PCL) deficiency in Malaysian military personnel.
    Matched MeSH terms: Knee Joint/surgery*
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