• Title/Summary/Keyword: 관절경적 분류

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Comparison of Arthroscopic Debridement and Multiple Drilling for Osteochondritis Dissecans of the Talus (거골 박리성 골연골염의 관절경적 변연 절제술과 다발성 천공술의 비교)

  • Kim, Kyung-Tae;Kim, Jin-Hak;Lee, Song;Choi, Dae-Jung;Cho, Kun-Ho;Jeon, Young-Won
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.206-213
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    • 2005
  • Purpose: To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling. Materials and Methods: Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5 years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups. Results: There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved $53.1{\pm}2.7$ points preoperatively to $85.1{\pm}8.5$ points postoperatively in group I and $54.6{\pm}6.8\;to\;80.7{\pm}8.5$ points group II. Subjective and functional scores was also improved $49.6{\pm}10.5$ points preoperatively to $84.6{\pm}7.7$ points postoperatively in group I and $50.7{\pm}9.2\;to\;83.0{\pm}9.6$ points in group II. But there were no statistical significance between them. Conclusion: Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.

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Arthroscopic Meniscal Repair with Rapid Loc Device (Rapid Loc 기기를 이용한 관절경적 반월상 연골판 봉합술)

  • Kwon, Duck-Joo;Lee, Kee-Byung;Joeng, Woong-Kyo;Lee, Byung-Taek;Park, Sang-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.180-185
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    • 2005
  • Purpose: To purpose of this study is to evaluate the clinical and radiological results of arthroscopic meniscus repair using Rapid Loc device. Materials and Methods: A retrospective study was performed on 44 cases which had been turned out longitudinal tear without degeneration. We repaired all cases with Rapid Loc device. Patients were evaluated using clinical examination, Orthopaedische Arbeitsgemeinschaft Knie (OAK) scheme, and MRI. We regarded patients with joint line tenderness, swelling or McMurray positive test as clinical failure. Results: A mean age was 33.3 years and follow-up period was average 15 months. Clinical results were excellent 15 cases(34.1%), good 20 cases(45.5%), fair 7 cases(15.9%), poor 2 cases(4.5%). MRI showed grade 115 cases(33.3%), grade II 22 cases(50%), grade III 7 cases(16.7%). Clinical failures were 8 cases and only one complication was developed. Conclusion: Rapid Loc device showed the excellent results in meniscus repair. We regard it has a lot of advantages in safety, softness, ease, ability to control tension at repair site.

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Differences in Associated Shoulder lesions Regarding Ages and Gender Among Patients with Complete Rotator Cuff Tear (회전근 개 완전파열 환자에서의 나이 및 성별에 따른 견관절 동반 병소의 차이)

  • Kim, Jae-Hwa;Dan, Jin-Myoung;Yoon, Byung-Ho;Kim, Young-Woong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.180-184
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    • 2008
  • Purpose: This study evaluated the differences in associated shoulder lesions on complete rotator cuff tear patients regarding ages and gender. Materials and Methods: Between June 2003 and March 2006, 109 patients (59 males, 50 females) who received arthroscopic shoulder surgery for their complete rotator cuff tear were selected and their associated shoulder lesions were analyzed. Ages were between 24 years, the youngest, and 75 years, the oldest. Groups by age were under 59 years group and over 60 years group, and associated lesions of patients to be analyzed were Acromioclavicular arthritis, SLAP(shoulder labrum anterior and posterior) lesion, and biceps tendinitis, and statistic analysis were performed by Khai-square method. Results: For acromioclavicular joint arthritis, over 60 years old group showed higher association rate compared to under 59 years young group, and for SLAP lesions, under 59 years young group showed higher association rate compared to over 60 years old group only in men. Conclusion: For diagnosis and treatment of complete rotator cuff tear patient, associated shoulder lesions in different ages should be considered, especially associations of SLAP lesions in young male patients, and acromioclavicular joint arthritis in old age patients should be verified.

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Arthroscopic Findings of Biceps pulley in Shoulder Pathology (견관절 병변과 관련된 이두박건 활차의 관절경적 소견)

  • Choi Chang-Hyuk;Kim Shin-Kun;Jang Woo-Chang;Lee Sung-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.136-141
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    • 2002
  • Purpose : The role of biceps pulley is stabilizing sling for the long head of the biceps tendon against anterior shearing stress in the rotator interval. The purpose of this study was to classify arthroscopic findings of biceps pulley and to evaluate the relationship with shoulder pathology. Materials and Methods : From January 2002 through July 2002, we observed biceps pulley in 49 cases of shoulder pathology treated with arthroscopically. There were 22 cases of anterior instability, 12 cases of rotator cuff tear, 5 of impingement syndrome, 6 of frozen shoulder, 2 of superior labral injury and 1 of each scapulothoracic bursitis and biceps dislocation. We classified biceps pulley as four types according to the arthroscopic appearance. Type I its stretched type. type II as sling type, type III at detached sling type, and type IV as concealed type. Results : We observed stretched type in 24 cases $(49\%)$, sling type in 5 cases $(10\%)$, detached sling type in 2 cases, concealed type in 1 case, and unidentified cases in 17 cases $(35\%)$. Conclusion : Development and variation of biceps pulley may have symptomatic correlation according to the degree of shoulder motion or pathologic status.

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Autogenous Osteochondral Grafts for the Osteochondritis dissecans of the Knee (슬관절 박리성 골연골염에 대한 자가 골연골 이식술)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chun Shun-Wook;Seo Ji-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.142-148
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    • 2003
  • Purpose: This study was performed to evaluate the operative results of osteochondritis dissecans treated with autogenous osteochondral grafts. Materials and Methods: From May 1990 to May 2000, this study included 13 patients, 17 cases treated with autogenous osteochondral grafts. The mean age of patients at operation was 23.4 years (range,20 to 32 years), all cases were men, and the mean follow-up was for 24.2 months (range, 12 to 110 months). Treatment was done by open or arthroscopic method using with Osteochondral Autograft Transfer System (OATS, Arthrex, USA). Results: Trauma history existed in all cases, and major trauma history in 7 cases, and minor repetitive in 10 cases. The involved sites of lesion were medial femoral condyle in 11 cases, in which extended classic site was 9 cases, inferocentral site was 2 cases, and lateral femoral condyle in 6 cases, in which all cases were inferocentral site. Magnetic resonance imaging (MRI) staging was stage II in 1 case, stage III in 11 cases, stage IV in 5 cases, and arthroscopic staging was stage III in 12 cases, stage IV in 5 cases. The mean lesion size was 3.19$cm^2$ (range, 1 to 8$cm^2$). Clinical results evaluated with grading system by Aichroth, were excellent in 3 cases (18$\%$), good in 11 cases (65$\%$), moderate in 2 cases (12V), poor in 1 case (5$\%$), which revealed satisfactory results in 83$\%$. Congruent articular surface, satisfactory articular thickness, and no loosening or subsidence was evidenced by follow-up MRI or arthroscopic finding. Conclusion: Autogenous osteochondral grafts can be an alternative treatment in lesions larger than 1$cm^2$ in size, unstable lesion, and involvement of weight-bearing articular surface. Long term follow-up will be needed for the final efficacy of autogenous osteochondral grafts.

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Acetabular Labral Tear in Sports Injury (스포츠 손상에서의 비구순 파열)

  • Hwang Deuk-Soo;Rhee Kwang-Jin;Kwon Youk-Sang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.15-20
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    • 2002
  • Purpose: The purpose of this study is to evaluate diagnosis and treatment of acetabular labral tears in sports injuries. Materials and Methods: From March 1995 to January 2000, We treated 15 patients with acetabular labral tear by sports injuries. There were 6 men and 9 women. Mean age was 41 years old. Running injuries are 5 cases, fighting 3, aerobic exercise 3, swimming 2, climbing 1, bicycle 1. For conservative treatment, we performed medication and observation at least for 1 year. For the patients with arthroscopic surgery, we performed Harris Hip Score (pain and function) preoperatively and postoperatively at 6, 12 months, and evaluated patient’s pain by JOA pain scoring system and postoperative subjective satisfaction. Results: The mean score of HHS improved 15 points with conservative treatments and 32 points with hip arthroscopy. In 4 cases of conservative treatment, there was 1 scale improvement of JOA pain scoring system. In arthroscopic partial labrectomy, all cases were improved to more than 2 scale. Conclusion: We considered that acetabular labral tears occurred associated with sports injuries. So it is important to be interested in enthusiastic diagnosis and appropriate treatment for hip pain caused by sports injuries, especially about acetabular labral tears.

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Frequency and Pattern of Partial Thickness Rotator Cuff Tear in SLAP Lesions (SLAP 병변에서 회전근 개 부분층 파열의 빈도와 양상)

  • Cho, Duck-Yun;Yoon, Hyung-Ku;Kim, Hyoung-Jun;Rhee, Seung-Young;Kim, Jae-Hwa
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.119-123
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    • 2004
  • Purpose: The purpose of this study is to check the range of motion of shoulder and inverstigate the frequencies and patterns of partial thickness rotator cuff tear in SLAP lesions. Materials and Methods: Forty-six patients, forty-seven cases who had SLAP lesions at shoulder arthroscopy were analyzed spectively using the medical records, intra-operative arthroscopic photo & video for SLAP lesions and rotator cuff articular side partial tear. Under the interscalene anesthesia, the range of notion of foreward elevation, internal rotation and external rotation was measured on fixed scapula and 90 degree abduction of the shoulder. Results: The rang of Motion are 150 degree on foreward elevation, 65.5 degree on external rotation, 61.7 degree on internal rotation. By Snyder's classification, type ll SLAP lesion is noted in 24 cases (five cases in type 1, one case in type IV). Rotator cuff articular side partial tear is noted in 24 cases ( one case in type I, 22 cases in type II, one case in type IV SLAP). All the rotator cuff articular side partial thickness tear were located in the anterior part of the supraspinatus. Conclusion: The rotator cuff partial thickness tear is mostly noted on the articular side and frequently found in the relatively more unstable type of SLAP lesions. So we consider that SLAP lesion may be a one of the causes for partial tear of the rotator cuff articular side.

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The Open Surgical Treatment for Stiff Elbow (주관절 구축의 관혈적 치료)

  • Lee, Ji-Ho;Ra, In-Hoo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.293-298
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    • 2010
  • Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

Arthroscopic Treatment for the Pigmented Villonodular Synovitis in the Knee (슬관절에 발생한 색소 융모 결절성 활액막염의 관절경적 치료)

  • Bae, Dae-Kyung;Cho, Nam-Su
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.22-26
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    • 2001
  • Purpose : To confirm the efficacy of arthroscopic synovectomy fur the pigmented villonodular synovitis in the knee. Materials and Methods : Between October 1996 and February 2000, the arthroscopic synovectomy had been performed in six patients(six knee joints), whose diagnoses were confirmed by pathologist. All patients complained of painful swelling in involved knee and four of the six patients had trauma history. There were three male and three female patients. Average age was 35.8 years ranging from 16 to 67 years. Follow up period was average 22.7 months(range, $13\~53$ months). Results : According to arthroscopic findings, there were three localized forms and three diffuse forms. At their last follow-up examinations, all patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : Complete arthroscopic excision is the definitive treatment for localized pigmented villonodular synovitis and meticulous arthroscopic excision through all portals including posterior portal can be considered as a valid alternative to traditional open synovectomy for the patients with diffuse pigmented villonodular synovitis.

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Comparison the Preoperative MRI Findings with Postoperative Arthroscopic Findings on Meniscus Injury with Anterior Cruciate Ligament Rupture (전방십자인대 파열에 동반된 반월상 연골판 손상의 관절경 수술 소견과 수술 전 자기공명영상 검사와의 비교)

  • Sohn, Hong Moon;Lee, Gwang Chul;Kim, Dong Hwi;Park, Sang Soo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.147-152
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    • 2012
  • Purpose: The purpose of this study was to compare the preoperative magnetic resonance image (MRI) findings with postoperative arthroscopic findings on meniscus injury with anterior cruciate ligament (ACL) rupture. Materials and Methods: We reviewed MRI images and arthroscopic findings of 225 patients treated by ACL reconstruction due to rupture, from February 2001 to November 2010. There were 154 cases of meniscus tear in arthroscopic findings. We examined the sensitivity for detecting meniscal tears varied with the presence of a rupture of the ACL, with the location of the tear within the meniscus, and among configurations of meniscal tears. Results: In the presence of a rupture of the ACL, the sensitivity of MRI was 0.88 for medial meniscal tears and 0.69 for lateral meniscal tears. And sensitivity of MRI was lowest in posterior horn and peripheral portion tears in lateral meniscus injury accompanying ACL rupture, sensitivity was low in anterior horn and flap shape tears in medial meniscus injury accompanying ACL rupture. Conclusion: In Meniscus injury with ACL rupture, a special attention shoulder given to the posterior horn and peripheral portion injury in lateral meniscus during arthroscopic surgery due to difficulty in detecting on MRI.

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