• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.54-60
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• 2000

Purpose : The purpose of this study was to evaluate the gutter pathologies and the clinical results of arthroscopic treatment for ankle gutter syndrome. Materials and Methods : Seventy six patients(77 ankles) who had lesions in the ankle gutter were treated by arthroscopy. The gutter pathology could be divided into 3 categories; hypertrophic scar tissue, loose bodies and bone spurs. Fifty two patients were evaluated subjectively and functionally with authors' criteria. The follow-up period averaged 44 months(range, 2.9 year-8.5 year). Results : The incidence of the gutter lesion was $21\%$(77 ankles) among 366 ankles undergoing arthroscopy. The most common pathology was hypertrophic scar tissue. In 31 ankles$(40\%)$, the lesions were found only in gutter, and 46 ankles$(60\%)$ were associated with pathologies in other areas. All of parameters for subjective and functional evaluation were improved with statistical significance(p<0.001). Seventeen patients$(33\%)$ could returned to competitive or contact sports activity with same level of premorbid period. Conclusion : Ankle gutter is an important site of pathologies which cause chronic ankle pain, and should be explored in ankle arthroscopy. The ankle arthroscopy is a very effective treatment method fur the removal of pathologies in ankle gutter syndrome.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.189-195
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• 2003

Purpose : To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw Materials and Methods : 103 patients (104 cases) who were followed up at least more than 2 years after ACL reconstruction were included in this study. The average period of follow-up was 36 months. The clinical results such as physical examination and Lysholm knee score and instrumented anterior laxity test with Telos were evaluated. Results : The Lysholm knee score was 57.9 in average preoeratively and improved to 95.2 in average at follow up. On the Lachman test, there were mild (+) instability in 46 cases $(45\%)$, moderate (++) in 33 $(31\%)$, severe (+++) in 25 $(24\%)$ preoperatively. 90 cases $(87\%)$ were converted to negative and 14 $(13\%)$ to mild at follow up. On Pivot-shift test, there were negative (-) instability in 22 cases $(22\%)$, mild (+) in 62 $(59\%)$, moderate (++) in 12 $(11\%)$ and severe in 8 $(8\%)$ preoperatively. 87 cases $(84\%)$ were converted to negative and 17 $(16\%)$ to mild at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference on 20 lb was $13.4{\pm}5.6$ (7-25) mm in average preoperatively, and was decreased to $3.6{\pm}1.5$ (1-6) mm in average at follow-up. Complications were quadriceps muscle atrophy in 27 $(30.0\%)$, saphenous nerve paresthesia in 19 $(18.3\%)$, anterior knee crepitus in 13 $(12.5\%)$ and over-penetration of screw through lateral femoral cortex in 5 cases $(4.8\%)$. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of graft and fixatives in restoring knee stability and in improving clinical results with little complications such as anterior knee pain.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.148-153
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• 2005

Purpose: To analyze the clinical result of the arthroscopic reduction and fixation for the displaced tibial spine fractures in children and report the utility of the arthroscopic treatment with the review of the literature. Methods: Between December 2000 and July 2004, five patients (average age 9.1 years) received an arthroscopic reduction and fixation of displaced tibial spine fracture. A male-to-female ratio was 3:2 and mean follow-up was 38.2$(13{\sim}56)$ months. All five patients were classified type III by Movers and McKeever classification. The average period from injury to operation was 4.8 days $(3{\sim}8days)$, the avulsed fragment was reduced by operative arthroscopy and fixated by pull-out suture in 3 patients and by cannulated screw in 2 patients. Postoperatively long leg cast was applied for 2 weeks, and then gradual range-of-motion exercise was permitted. Full weight-bearing ambulation was permitted after 6 weeks. The clinical evaluation was performed by range of motion, Lachman and pivot shift test, KT-1000 arthrometer, Lysholm knee score and the modified Feagin score. Results: All five patients had no symptom and recovered full range of motion of the affected knees. Lachman test was positive finding of 1+ laxity in one patient, the others were negative, and all patients were negative findings for pivot shift test. The result of KT-1000 arthrometric assessment is mean maximum side-to-side differences 1.9 mm. Average Lysholm knee score was 99.4. All patients had excellent results in modified Feagin score. Conclusion: Arthroscopic reduction and fixation of displaced tibial spine fracture in children showed excellent result without complication. Both pull-out suture fixation and cannulated fixation provide an effective treatment option for fixation of the displaced anterior tibial spine fracture.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.138-142
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• 2009

Purpose: The purpose of this study was to evaluate the result of anterior cruciate ligament (ACL) reconstruction using a fourstrand single semitendinous tendon to decrease the donor site morbidity due to harvest both semitendinosus and gracilis tendon. Materials and Methods: Thirty seven consecutive patients who had underwent ACL reconstruction using four-strand single semitendinosus tendon were evaluated. Mean age was 28.6 years old. Male was 34, female 3 patients. Time from injury to surgery was 5.4 months. Combined injuries were 10 meniscus injuries, 3 medial collateral ligament injuries and 1 osteochondral injury. Mean follow-up period was 16 months(12~18 months). Clinical evaluation was done using range of motion, Lachman test, pivot-shift test, Lysholm score & KT-2000 arthrometer. Results: All patients showed the normal range of motion of mean 150..at follow-up. Lachman test and pivot-shift test was negative in 35 cases. Lysholm score was improve from 84 to 92. Two cases had residual laxity due to poor compliance. Mean anterior translation compared to contralateral side by KT-2000 arthrometer improved from 6.7 mm preoperatively to 2.1 mm at follow-up. Conclusion: Reconstruction of the anterior cruciate ligament with use of a four-strand single semitendinosus tendon autograft showed good clinical results.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.32-35
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• 2001

Purpose : To evaluate the efficacy of arthroscopic management of the triangular fibrocartilage complex(TFCC). Materials and Methods : Thirteen patients(14 wrists) with acute or chronic traumatic triangular fibrocartilage complex lesions were included in the study. The mean patients' age was 28.3 years, with a range of 21 to 45 years. All patients were diagnosed by physical examination, arthrographic or magnetic resonance imaging studies. Eight of the 14 wrists had central TFCC tear while 6 wrists had peripheral tear. Under arthroscopic control, injuries to the central portions were treated by debridement and excision of unstable tissue fragment while peripheral tears were repaired. The follow-up period averaged 28 months. The results were analyzed clinically using the Mayo modification of the Green and O' Brien wrist scoring system. Results : Nine of the 14 wrists were rated excellent,3 good and 2 fair Overall, 12 of the 14 patients rated as satisfactory and returned to sports or work activities. Conclusion : Arthroscopic treatment of TFCC resulted in a high degree of patient satisfaction and an increase in the ability to perform at workshop.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.276-279
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• 2009

Fibroma of tendon sheath is an uncommon benign soft tissue tumor with a predilection for the hand or upper extremities with extremely rare intra-articular involvement. It is mostly comprised of slow-growing fibrous lobules made up of scattered fibroblasts in a dense stroma with slit-like vascular channels. An unique case in a 54-year-old male patient involving the glenohumeral joint arising from postersuperior joint capsule is reported. Magnetic Resonance Imaging (MRI) reveals a focal nodular mass with decreased signal intensity on all pulse sequences and pathology confirmation was made with arthroscopic excision. Intra-articular fibroma of tendon sheath should be considered in the differential diagnosis of intra-articular soft tissue masses during shoulder arthroscopy.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.85-90
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• 1999

Purpose : The purpose of this study is to evaluate the clinical and histological results of the osteoarthritic patients who had second look arthroscopy after microfracture surgery. Materials and Methods : From Oct. 1997 to Dec. 1998, 46 patients, 48 knees were treated by microfracture technique. In the 22 patients, 24 knees, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. Three patients were men and 19 patients were women. Average age of the patients were 58 years (range, 40-75 years). The average follow up period was 12 months(7-20 months). We analysed clinical results according to the nine-point scale. Also we observed type II collagen formation with immunohistochemical staining. Results : Clinical results were excellent in 83% and good in 17%. Among the 24 knees, more than 80% areas of chondral defect were covered with regenerated cartilage in 21 knees. Histologically, the regenerated tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Regenerated cartilage contains variable amount of type II collagen with immunohistochemical staining. Conclusion : Most of the patients had significant improvement clinically. 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Microfracture in the full thickness chondral defect provides and enriched environment for cartilaginous tissue regeneration.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.440-444
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• 2021

In advanced gout, monosodium urate crystals are deposited in the joints and surrounding tissues, resulting in gouty tophi. A 45-year-old man was admitted to hospital due to pain and a limited range of motion in his right knee. Magnetic resonance imaging revealed a mass, and arthroscopic surgery and biopsy were then performed. Gouty tophi invading the anterior horns of the medial and lateral menisci were identified and surgically removed. To the best of the author's knowledge, there is no case report of intrameniscal gouty tophi invading both the medial and lateral menisci. This paper presents this case along with a review of the relevant literature.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.161-164
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• 2006

Purpose: Meniscal injuries are very common sports problems and indications for knee surgery. We analyzed the effectiveness of joint line tenderness retrospectively. Materials and Methods: From May 2005 to June 2006, 76 knees which were diagnosed meniscal injury and performed arthroscopic surgery by same surgeon at military hospital were included. We analyzed sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of joint line tenderness in meniscal diagnosis. Results: The joint line tenderness gave such results (78.8%, 32.6%, 52.6%, 47.3%, 66.7% for sensitivity, specificity, accuracy, positive predictive value, negative predictive value respectively). We got similar results in analyses with medial meniscal lesion, lateral meniscal lesion, and combined instability patients. Conclusion: The joint line tenderness is a easy and comfortable maneuver but, it's effectiveness is low when it is used lonely The composite examinations including MRI and diagnostic arthroscopy for meniscal injuries of the knee perform much better than joint line tenderness alone.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.13-19
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• 2007

Purpose: We investigated the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. Materials and Methods: Between February 1999 and October 2006, we evaluated retrospectively the results of acute, isolated posterior cruciate ligament injuries treated conservatively. The subjects consisted of 21 patients. At initial and follow up visits physical examination, $KT-2000^{TM}$ arthrometer and MRI were performed to assess improvement on the knee stability and continuity of the posterior cruciate ligament. IKDC (International Knee Documentation Committee) knee scoring and quadriceps muscle strength were also checked in all population. Comparing the results of initial and follow up examinations we assessed the natural history of acute, isolated posterior cruciate ligament injuries treated conservatively. The mean follow up period was 22.7 months. Results: The posterior drawer test showed 14 cases of Grade I, 6 cases of Grade II and 1 case of Grade III progressing 18 cases of Grade I and 3 cases of Grade II. The mean difference of 5.7mm by $KT-2000^{TM}$ arthrometer was changed Into 2.7mm and the continuity of posterior cruciate ligament initially checked by 48.1% on MRI increased to 69.7%. The mean quadriceps muscle strength was grade 'Good' and mean IKDC knee score was nearly grade 'A'. Conclusion: Our study suggests that patients with acute, isolated posterior cruciate ligament injuries treated conservatively may get good clinical outcomes on clinical situation and MRI.