• Title/Summary/Keyword: 관절경적 재건술

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Arthroscopic Reconstruction of Bony Defect in Shoulder Instability (골 결손을 동반한 견관절 불안정성의 관절경적 재건술)

  • Kim, Yang-Soo;Ok, Ji-Hoon
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.117-124
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    • 2011
  • Purpose: We reviewed arthroscopic reconstruction among the several treatment options for anterior shoulder instability with a bony Bankart lesion. Materials and Methods: Although open Bankart repair has long been considered the optimal surgical management of anterior shoulder instability, advancements in arthroscopic techniques have led to a recent shift to arthroscopic Bankart repair. However, for cases of a glenoid bony defect, several authors have reported various methods to accurately measure the amount of bony defect. Results: The arthroscopic technique of bony Bankart reconstruction continues to evolve and various methods have followed. To overcome the limitations of single fixation of a Bankart lesion, arthroscopic dual fixation (2 point fixation) has recently been tried to anatomically repair and restore the rigid fixation of a bony fragment. The concept of performing the Bristow-Latarjet transfer procedure under arthroscopy has also recently emerged. However, a large series of cases and long term follow up are required to prove the better results. Conclusion: To obtain a successful outcome for patients with anterior instability with a glenoid bony defect, it is imperative that the surgeon be aware of the accurate status of the bony defect and the intraoperative, postoperative factors associated with the proper treatment of this unstable pathology.

Arthroscopic Repair of the Postero-medial or Postero-lateral Capsule Tear in the Knee Joint - Technical Note - (슬관절 후내측 혹은 후외측 관절막 파열의 관절경적 봉합술 - 수술 수기 -)

  • Ahn Jin-Hwan;Cho Yang-Bum;Lee Yong-Seuk
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.135-139
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    • 2001
  • Purpose : Repair of the posterior capsule tear at the time of the operation for the chronic postero-lateral or postero-medial rotary instability has not been reported. We describe the arthroscopic repair of the posterior capsule tear using the posterior trans-septal portal. Method : After conducting basic arthroscopic examination of the knee, postero-medial and postero-lateral portals are secure to make the posterior trans-septal portal, through which the postero-medial and postero-lateral capsule tears are repaired using the suture hook under the arthroscopic guidance. Conclusion : When arthroscopic reconstruction of PCL insufficiency or postero-lateral rotaty instability that accompanies postero-medial or postero-lateral capsular tears. rising the posterior traits-septal portal could ensure better visualization of the capsule and a subsequent more accurate repair of the capsule. Since it significantly lessened instability, it could contribute to an achievement of successful clinical results.

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Removal of a Femoral Interference Screw that Migrated Posteriorly after ACL Reconstruction, Using Posterior Trans-septal Portal - A Case Report - (전방 십자 인대 재건술 후 후방으로 전위된 대퇴 간섭 나사의 후방 경격막 도달법을 이용한 제거 - 증례 보고 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Ha, Hae-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.187-191
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    • 2006
  • Few cases have been reported in which the femoral interference screw has migrated into the posterior compartment after an ACL reconstruction. It usually requires removal, because it leads usually to mechanical symptom. However, the arthroscopic removal of a screw is a technically demanding procedure, especially in the case of an intact integrated ACL graft or one that is encapsulated around the screw. We present a case in which a displaced femoral interference screw migrated within the posterior compartment 11 years postoperatively, after the graft had been successfully incorporated at the femoral site and showed good continuity on MRI and arthroscopic examination. Although it is often technically challenging, through the use of a posterior trans-septal portal, we can successfully remove a displaced femoral interference screw even in the most difficult locations in the posterior compartment without damage to ACL graft.

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Gait Analysis After Posterior Cruciate Ligament Reconstruction Using Fresh-Frozen Achilles Allograft (신선 동결 아킬레스 동종건을 이용한 후방십자인대 재건술 후 보행분석)

  • Chun, Churl-Hong;Cho, Jae-Deuk;Chun, Keun-Churl
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.76-82
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    • 2009
  • Purpose: The purpose of this study was to analyze the clinical result and the gait patterns for patients who had undergone the arthroscopic posterior cruciate ligament (PCL) reconstruction using Achilles allograft. Materials and Methods: Among the patient who had undergone the arthroscopic PCL reconstruction using fresh-frozen Achilles allograft between March 2004 to March 2005, we selected 12 patients who compliance to our rehabilitation program. Clinical result and gait analysis were carried out at 36 months postoperatively. There were measured by using range of motion (ROM), Lysholm knee score, Tegner activity score, IKDC score, posterior stress test, and posterior translation measured by using Telos stress arthrometer. Kinematic gait analysis was carried out using 3-dimensional gait analysis system. Results: The PCL reconstruction surgery yielded statistacally significant results in all of clinical evaluation. In gait analysis, the average knee flexion angle increased during stance phase and decreased during the swing phase, but was not statistically significant and there were no significant difference between both sides of their knees overall. Conclusion: Since there was no statistically significant difference between the injured and uninjured sides as a result of the gait evaluation of the patients who had arthroscopic reconstruction surgery on their PCL injured knee and conformed to the rehabilitation program, systemic and strict rehabilitation ought to be important in the reconstruction surgery.

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Functional Evaluation after Arthroscopic Reconstruction in Isolated and Combined Injury of Posterior Cruciate Ligament (후방십자인대의 단독 및 동반 손상에서 관절경적 재건술 후 기능적 평가)

  • Lee Kwang-Won;Lee Seung-Hun;Park Jae-Guk;Kim Ha-Yong;Kim Byung-Sung;Choy Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.115-120
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    • 2002
  • Purpose : To compare the functional evaluation with the posterior translation after arthroscopic PCL reconstruction in isolated and combined PCL-deficient knees. Materials and Methods : We retrospectively evaluated 45 patients with PCL-deficient knees who were treated by arthroscopic PCL reconstruction using Achilles tendon allograft from June 1994 to June 2000. The differences of posterior translation were measured with posterior stress lateral radiographs and KT-2000 arthrometer. The functional results were evaluated using the Lysholm knee score and IKDC evaluation form. Results : Preoperative mean side to side differences of the posterior translation were 11.83 mm in isolated PCL-deficient knees and 12.7 mm in combined PCL-deficient knees respectively. At the last follow-up in isolated and combined PCL-deficient knees, the mean radiographic side to side differences of the posterior translation were 6.38 mm and 6.7 mm, the average corrected 20 Ib posterior displacements using KT-2000 arthrometer were 3.5 mm and 4.1 mm, the mean Lysholm score were 87.4 and 81.2, the grade A and B of IKDC evaluation form were 16 cases $(88.9\%)$ and 23 cases $(85.2\%)$, respectively. Conclusion : The functional results had no relationship with the degree of posterior translation after arthroscopic PCL reconstruction. Tendency of posterior translation may be influenced by associated injury of the knee.

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Arthroscopic Double-Bundle Posterior Cruciate Ligament Reconstruction (관절경적 이중다발 후방십자인대 재건술)

  • Chun, Churl Hong;Kim, S.H.
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.140-145
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    • 2011
  • 후방십자인대 손상의 이상적 치료는 아직까지도 확립되지 않았다. 과거 몇 십 년간 후방십자인대에 대한 지식과 슬관절 안정성에 대한 후방십자인대의 생역학에 대한 지식이 증가하였다. 특히 이중 다발에 대한 지식이 증가하고 이러한 모든 노력들은 후방십자인대의 해부학적인 특징을 최대한 복원하기 위해 이루어졌다. 재건술의 수술 방법은 특정 손상 양상에 따라 그에 맞게 이루어지는데 만성 손상의 경우나 remnant가 거의 존재하지 않는 경우에는 이중 다발을 재건하는 것이 만족스러운 결과를 보인다. 아직까지 이중 다발 후방십자인대 재건술의 결과에 대해서는 논란이 많은 것은 사실이나 장기 추시가 가능해지면 이중 다발 후방십자인대 재건술이 해부학적으로나 생역학적으로 더욱 정상에 가깝기 때문에 더 나은 장기적 결과를 보여줄 것으로 예상된다.

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