• Title/Summary/Keyword: 관절강직

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Outcome in Impingement Syndrome of the Shoulder According to Presence of Stiffness (견관절 충돌 증후군 환자에서 강직 여부에 따른 치료 결과)

  • Moon, Gi-Hyuk;Lee, Jae-Wook;Yoo, Moon-Jib;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.45-50
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    • 2004
  • Purpose: The purpose of this study is to compare the outcome of operative results in the impingement syndrome of the shoulder with and without the stiffness. Material and Method: Seventy-six patients who had the impingement syndrome without stiffness were evaluated, and treated with the subacromial decompression and 24 patients who had the impingement syndrome with stiffness, were treated with the subacromial decompression and the manipulation. The average follow-up period was 32 months. Result: The impingement syndrome of the shoulder with stiffness was more severe in the preoperative pain and worse in ASES score than without stiffness. The postoperative pain and ASES score improved in the both group. The satisfactory groups were 67% in the group with stiffness and 80% without stiffness. The satisfactory rate was 83% in the group with stiffness and 93% without stiffness. The satisfactory groups with diabetes were 47% in the group with stiffness and 81% without stiffness. Forward elevation, exeternal rotation at the side and internal rotation improved in both groups postoperatively and there were no statistically significant differences postoperatively External rotation was restricted statistically in the group with stiffness. Conclusion: Although patients may not regain the full range of motion, the technique of manipulation followed by arthroscopic subacromial decompression offers good pain relief and satisfactory functional recovery for the impingement syndrome with stiffness. However preoperative counseling is necessary for the impingement syndrome combined with diabetes and stiffness due to poor out come.

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Arthroscopic Treatment of Stiff Elbow (주관절 강직의 관절경적 치료)

  • Moon, Young-Lae;Nam, Ki-Young
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.299-303
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    • 2010
  • Purpose: Management of the stiff elbow by arthroscopic procedure is an effective but technically demanding. Our purpose was to review the specific arthroscopic maneuver which can be useful for the stiff elbow. Materials and Methods: A stiff elbow that is refractory to conservative treatment can be treated surgically to remove soft tissue or bony blocks to motion. The olecranon or coronoid osteophyte and loose bodies have been removed arthroscopically with good results and rare complications. Results and Conclusion: For the successful arthroscopic management of elbow stiffness, it need to knowledge and skills for debride contracted tissue and preserve vital anatomic structure.

Arthroscopic Adhesiolysis for Postoperative Arthrofibrosis of the Knee (수술후 발생한 슬관절 강직의 관절경적 유리술)

  • Kim Sung-Jae;Shin Sang-Jin;Lee Won-Yong;Kim Jin-Yong;Kim Sang-Gon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.42-48
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    • 2000
  • We retrospectively reviewed the results of arthroscopic adhesiolysis on postoperative knee stiffness in order to observe the clinical improvement and to evaluate the prognostic factors. Arthroscopic adhesiolysis without extraarticular procedure was performed in 31 knees displaying persistent flexion or extension loss. The causes of arthrofobrosis were previous ligament surgeries in 17 knees, surgery for a fracture involving the articular surface of the knee in 10 cases and other causes in four cases. The average range of motion was $60^{\circ}(range,\;14^{\circ}-74^{\circ})$ preoperatively, and improved by $120^{\circ}(range,\;7^{\circ}-127^{\circ})$ immediately following the procedure. The range of motion at the final follow-up (average 34 months) was $129^{\circ}(range,\;3^{\circ}-132^{\circ})$. In the 17 patients with arthrofibrosis fellowing ligament surgery, the range of motion was improved from $65^{\circ}$ preoperatively to $135^{\circ}$ at final follow-up. The improvement in function and motion was achieved during the first postoperative year. In the 10 patients with arthrofibosis following intraarticular fractures, the range of motion was improved from $60^{\circ}$ preoperatively to $125^{\circ}$ at the final follow-up, and most of the increase in motion was achieved within the first 6 months. Patients who suffered from a limitation of motion for less than 7 months gained an average $70^{\circ}$ improvement in total range of motion following arthroscopic surgery. However, the total range of motion in patients with a duration of symptoms greater than 7 months improved by an average $49^{\circ}$ postoperatively. In conclusion, arthroscopic adhesiolysis without incisional procedure is an effective therapeutic modality in arthrofibrosis of intraarticular origin. Improved outcomes can be expected in stiffness after ligament surgery and a symptom duration of arthrofibrosis less than 7 months.

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A Case of Chronic Ankylosing Spondylitis with Total Hip Replacement - A Case Report - (고관절 전치환술을 시행 후 내원한 만성 강직성 척추염 환자 치험 1례)

  • Cho, Yoon-Chul;Ra, Kyoung-Won;Lim, Se-Young;Yoo, Sang-Min;Kim, Sang-Deok
    • The Journal of Korea CHUNA Manual Medicine
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    • v.5 no.1
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    • pp.141-150
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    • 2004
  • Objectives : The objective of this study is to evaluate the treatment effect of Oriental therapy including exercise therapy in chronic ankylosing spondylitis with total hip replacement. Methods : Oriental therapy and exercise therapy were performed for 64days admission in a patient who had chronic ankylosing spondylitis with total hip replacement and physical tests were examined. Result : Pain and ROM of cervical. lumbar spine, and left hip joint has improved with this treatment. And Anorexia, dyspepsia, and fatigue were also decreased. Conclusions: In this case, oriental therapy was proved to be effective in improving chronic symptoms and general prostration of Ankylosing Spondylitis. And It is necessary to carry out exercise therapy regulary.

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Pathophysiology of Stiff Elbow (주관절 강직의 병태 생리)

  • Song, Hyun-Seok;Yoon, Hyung-Moon
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.286-292
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    • 2010
  • Purpose: Stability of joints and maintenance of range of motion are needed for optimum function. The most common complaint about the elbow joint is joint stiffness. Recent articles have reported good outcomes in the treatment of stiff elbow joints. However, deciding which procedure to use is always difficult. Materials and Methods: Morrey et al. reported that the functional range of motion of the elbow joint is $30-130^{\circ}$ of flexion-extension and $50^{\circ}C$ of supination and pronation. About 90% of daily activities are done using this range of motion. Stiff elbow joints can be classified according to the traumatic events that caused the problem or the location of the main pathology. Intraarticular pathology includes severe articular mismatch, intraarticular adhesions, loss of articular cartilage, mechanical blockade by osteophytes, loose bodies, and hypertrophied synovium. Extraarticular pathology includes severe capsular adhesion due to the trauma or to dislocation, contracture of the collateral ligaments or muscles, bony bridge. Results and Conclusions: The main pathology underlying the loss of extension is the fibrous contracture of the anterior capsule. In this pathology, an anterior capsulectomy would be helpful. The main pathology underlying the loss of flexion is the contracture of the posterior band of medial collateral ligament.

Clinical Result of Arthroscopic Capsular Release and Repair for SLAP II Lesion with Stiffness (강직을 동반한 제 2형 SLAP 병변의 관절경적 관절막 유리술과 봉합술의 임상적 결과)

  • Ahn, Gil-Yeong;Nam, Il-Hyun;Lee, Yeong-Hyun;Lee, Jung-Ick;Moon, Gi-Hyuk
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.118-122
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    • 2008
  • Purpose: We assessed the clinical results after the operative treatment of type 2 SLAP lesion with stiffness. Materials and Methods: 13 patients who had SLAP lesion with stiffness were treated with arthroscopic capsular release, SLAP repair and treatment of the associated lesion. The average follow-up period was above 12 months. Results: The postoperative mean VAS was scored 1.5 and the postoperative ROWE score was 92.3, which showed a significant improvement after the operation (P<0.001). The mean range of motion was a significantly improved after the operation (P<0.001). The ROWE score was excellent for all the cases. Conclusion: Arthroscopic capsular release and SLAP repair and treatment of the associated lesion in patients with type 2 SLAP lesion with stiffness are effective treatments for the increasing the range of motion and decreasing the pain.

Arthroscopic Treatment for Degenerative Elbow Contractures (주관절 퇴행성 강직의 관절경적 처치)

  • Moon, Young-Lae;You, Jae-Won;Kim, Dong-Whee
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.116-119
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    • 2001
  • Purpose : To describe long-term clinical results and serial changes in the postoperative range of motion(ROM) after arthroscopic treatment for a limitation of motion(LOM) of the elbow. Materials and Methods : The subjects who visited chosun university hospital from December, 1996 to January 2000 were twenty-one patients ranging from 37 to 54 years of age, and the average age was 43.2 years. The chief complaints were painful limitation of motion of the elbow and average ROM showed that flexion contracture were 17 degrees and further flexion were 87 degrees. Results : The total ROM was $70^{\circ}$ preoperatively. 2 months after postoperatively the mean flexion contracute improved from $17^{\circ}\;to\;3^{\circ}$ with further flexion from $87^{\circ}\;to\;122^{\circ}$ degrees. One year after postoperatively the mean flexion contracture were $5^{\circ}$ and further flexion were $113^{\circ}$. All patients reported a decresement in pain level as well as improvement in motion. There was no complication in this series. Conclusion : Arthroscopic surgery appear to be satisfactory management modality for degenerative elbow contractures.

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