• Title/Summary/Keyword: 반월상연골 손상

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Arthroscopic Meniscectomy in Patients Aged Over 50 - More than 3 Years Follow-Up Result - (50세 이상 환자에서의 반월상 연골 절제술 - 최소 3년 이상 추시 결과 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Go, Sang-Hun;Jung, Kwang-Hwan;Cha, Jae-Ryong;Lee, Chae-Chil;Jeong, Ji-Young;Seo, Dong-Kyo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.107-111
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    • 2008
  • Purpose: To evaluate the clinical and radiographical results of arthroscopic meniscectomy in patients aged over 50 with minimum 3-year follow-up. Materials and Methods: Of the patients who had undergone arthroscopic meniscectomies between Dec. 1997 and Dec. 2003, 36 patients(36 knees) were available for retrospective evaluation. The average age at the time of surgery was 56.4 years and the mean follow-up period was 63 months. According to the Kellgren-Lawrence classification, grade I change were noted in 16 patients, II in 12, III in 6 and IV in 2. According to Outerbridge classification, grade I articular lesions were noted in 16 patients, II in 10, III in 7 and IV in 3. Postoperative Lysholm score, patient s subjective satisfaction and radiographic changes were evaluated retrospectively. Results: Twenty-four patients(66.7%) were good or excellent for the Lysholm score and 26 patients(72.2%) were satisfied at final follow-up. Tibiofemoral angle was changes from mean valgus 3.9 degrees to mean valgus 2.6 degrees and 22 patients(61.1%) showed the progression of osteoarthritic changes. Conclusion: The satisfactory results could be obtained in 72.2% of patients aged over 50 with a minimal follow-up of 3 years after arthroscopic meniscectomy. The results tended to be worse in patients with moderate or severe tibiofemoral osteoarthritic changes or with articular cartilage lesions.

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Clinical Analysis of the Results following Meniscal Suture (반월상 연골 파열환자에서 봉합술 후 결과 분석)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;Jeong, Ki-Woong;Kwon, Chang-Hyeok;Shin, Neung-Choel
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.19-24
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    • 2000
  • Purpose : To clinically analyze 62 patients who had meniscal repair and compare the results according to methods of repair. Materials and Methods : Between May 1997 and June 1998, we repaired 68 torn menisci in 68 patients. There were 52 male and 10 female with an average age of 26.9 years(ranging from 6 to 51 years). We used Linvatec suture in 46 knees(group A)and meniscal arrow in 16 knees(B group). In six knees we used Linvatec and meniscal arrow both. These 6 knees were excluded and 62 of 68 repaired meniscus were analyzed in this study. Average follow-up period was 18.5 months(ranging 12 to 26 months). We evaluated clinical results by Tapper and Hoover's grading system and subjective symptoms of the patients. Results : There were excellent in 47 cases$(76\%)$, good in 12$(19\%)$ and fair in 3$(5\%)$. In group A, there were excellent in 35 cases$(76\%)$, good in 9$(20\%)$ and fair in 2$(4\%)$. In group B, there were excellent in 12 cases$(75\%)$, good in 3$(19\%)$ and fair in 1$(6\%)$. There was no significant differences in clinical results between two groups. But mean operative time taken for meniscus repair was 40 minutes in group A and 25 minutes in group B. Conclusion : We can obtain good clinical results with short operation time in meniscal repair by proper selection of methods of repair according to the type, location, and size of meniscal tear and associated lesions.

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The Treatment of Tibial Condylar Fractures Using Arthroscopy (관절경을 이용한 경골 과부 골절의 치료)

  • Shin Dong-Min;Lee Sang-Hong;You Jae-Won;Lee Byoung-Ho;Ha Sang-Ho;Na Tae-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.32-37
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    • 2000
  • Purpose : We performed routinely arthroscopy to diagnose and treat intra-articular soft tissue pathology and tibial condylar fractures. The purpose of this study was to evaluate clinical value of arthroscopy in the tibial condylar fractures. Materials and Methods : The 31 tibial condylar fractures was examed by routine arthroscopy, 9 treated by conservative method and 22 treated by surgery at least follow up of 12 months. The authors analysed to the cause, classification, soft tissue injuries such as ligaments and menisci, treatment and results. Results : The most common type was Schatzker classification type I in 15 cases$(18\%)$ and intra-articular lesions and associated ligament injury were in 21 cases$(67\%)$. Most common lesion was meniscal tear in 16 cases and most common type of meniscal lesions was peripheral detachment in 7 cases$(44\%)$. Schatzker I, II fracture patterns were associated with the highest frequency of soft tissue injuries, especially medial collateral ligament and meniscal injuries. Conclusion : Arthroscopic examination is useful method to evaluate the intra-articular pathology and to treat the tibial condylar fractures.

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Operative Treatment of Tibial Plateau Fractures (경골과 골절의 수술적 치료 결과)

  • Shin, Duck-Seop;Seong, Byeong-Yeon;Kim, Dong-Won
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.187-198
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    • 2001
  • Background: The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. Materials and Methods: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. Results: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. Conclusion: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.

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Long-Term Outcome Of Arthroscopic Meniscectomy In Traumatic Patients (외상성 반월상 연골 파열의 관절경적 절제술 후 장기 추시 결과)

  • Seo, Jae-Seong;Min, Hak-Jin;Yoon, Ui-Seong;Kim, Hee-Seon;Kim, Yoon-Jong;Kim, Yoo-Mih
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.174-179
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    • 2005
  • Purpose: To study the long-term outcome of arthroscopic meniscectomy with regard to clinical symptoms and radiographic signs of osteoarthritic change. Materials and Methods: The materials for the investigation consisted of 79 individuals among 144 patients who underwent knee arthroscopy due to an isolated meniscal tear from October 1990 to September 1992 in our hospital. Those 79 individuals were followed up for $10{\sim}15$ years after the knee arthroscopy and were took clinical examination through the review of knee radiographies obtained with weight bearing. 52 of the 79 patients were men, and the mean age of the total materials was 34.6 years old (in the range $17{\sim}48$). Results: At follow-up, radiographic changes including Fairbank changes and joint space narrowing were seen from 45 of the 79 patients (56.2%). In other calculation, radiographic changes were seen in 23 out of 54 patients (42.6%) who had a partial meniscectomy, but were presented in 22 out of 25 patients (88.0%) who had a total meniscectomy. As a result, more radiographic changes were seen after total meniscectomy (p=0.03). In clinical results, 39 out of 54 patients (72.2%) after partial meniscectomy were satisfactory, and 14 out of 25 patients (56.0%) after total meniscectomy were satisfactory, therefore, more percentage of patients were satisfactory in partial meniscectomy group than in total meniscectomy group, but the statistical differences were absent (p=0.24). Conclusion: The frequency of radiographic changes in $10{\sim}15$ years after meniscectomy was related to the quantity of the meniscus removed, but the differences of these changes were low and had little influence on activity and knee function.

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Arthroscopic Treatment of Tibial Spine Fracture using Suture Hook and pull-out PDS (Suture Hook과 pull-out PDS를 이용한 경골극 골절의 관절경적 치료)

  • Lee, Young Kuk;Kim, Joon Seok;Sohn, Sung Won
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.132-137
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    • 1999
  • Displaced tibial spine fractures need the anatomical reduction of the displaced bone fragment to achieve normal range of motion and anterior stability of the knee joint. The purpose of this paper is to describe details of arthroscopic technique using suture hook and pull-out PDS and to evaluate the clinical results. We report 7 cases who underwent arthroscopic reduction and internal fixation using suture hook and pull-out PDS. All cases had fresh fractures generated within 3 weeks. The follow up period was at average 16.6 months. The fracture union was achieved at average 7.4 weeks. Knee exercise was started 2 weeks after the operation. One of the patients, who had combined injury of posterior cruciate ligament and lateral meniscus, showed limitation of knee movement. But he was underwent the arthroscopic fibrolysis at one year later, he returned to normal range of motion. Arthroscopic treatment of displaced tibial spine fracture using suture hook and pull-out PDS showed good results including rigid fixation and early mobilization. Therefore it is thought to be one of the effective operative techniques in treatment of the tibial spine fractures.

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Analysis of revision anterior cruciate ligament reconstruction (전방 십자인대 재재건술의 분석)

  • Park, Chan-Hee;Song, Eun-Kyoo;Seon, Jong-Keun;Yim, Ji-Heoun;Kang, Kyung-Do;Lee, Tae-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.47-53
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    • 2011
  • Purpose: As the number of the anterior cruciate ligament (ACL) reconstruction has increased, the incidence of revision of ACL reconstruction due to reconstruction failure has been also increased. Therefore, authors analyzed the reason of the failure of ACL reconstruction and the clinical result of the ACL revision. Materials and methods: From February 1998 to July 2010, we selected 36 cases which was followed at least 12months after the ACL reconstruction failure. Duration from reconstruction to revision, the average duration was 60 months (5~334) and on first reconstruction, we used allograft on 23 cases (63.9%) and autograft on 13 cases (36.1%). For the main symptom of ACL reconstruction failure, instability was the most common symptom, and 35 cases (97.5%) were undergone only one reconstruction and 1case (2.5%) was undergone two reconstruction. Clinical results were evaluated by Lysholm knee joint score, pivot shift test, and Telos device. Results: Average follow-up duration of the patients was 21 months (12~40), and the reason for the ACL reconstruction failure, trauma was most common by 19 cases (52.8%), malposition of the femoral tunnel was 13 cases (36.1%), malposition of the tibia tunnel was 1case (2.8%), and failure of osteointegration was 3 cases (8.4%). On performing the ACL revision, we used allograft on 34 cases (94%) and autograft on 2 cases (6%), and 21 cases accompanied injury of the meniscus (medial meniscus 14 cases, lateral meniscus 7 cases). Lysholm knee joint score was improved from 66.5 points, preoperatively to 92 points on last follow-up (p<0.01). In most cases, patients were satisfied (92%) with the operation results. Tegner activity score was also improved from 2.0 points preoperatively to 6.2 points on the last follow-up. On Lachman and pivot sift test, 33 cases and 30 cases were improved to grade I respectively, and on stability test using Telos device, the bilateral difference was improved from mean 15.5 mm preoperatively to 4.5 mm on the last follow-up. Conclusion: After 1 year follow-up, Revision of ACL had a little anterior instability but it showed satisfactory result on clinical result and patient's subjective satisfaction.

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Diagnostic Criteria to Differentiate Medial Meniscal Injury from Degenerative Changes on $^{99m}Tc-MDP$ Knee SPECT in Patients with Chronic Knee Pain (만성 무릎관절 통증환자에서 내측 반월상연골 손상과 관절 퇴행성 변화의 감별을 위한 $^{99m}Tc-MDP$ 무릎관절 SPECT의 진단기준)

  • Paeng, Jin-Chul;Chung, June-Key;Jeong, Hwan-Jeong;Yoo, Jae-Ho;Kang, Won-Jun;So, Young;Lee, Dong-Soo;Lee, Myung-Chul;Seong, Sang-Cheol;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.103-109
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    • 2003
  • Purpose: In patients with chronic knee pain, the diagnostic performance of $^{99m}Tc-MDP$ knee SPECT for internal derangement of knee is deteriorated due to degenerative changes. In this study, we tried to establish diagnostic criteria to differentiate medial meniscal injury (MMI) from degenerative change (DC) when the uptake is increased in medial compartment. Materials and Methods: A total of 49 knee SPECT of the patients with chronic (more than 3 months) knee pain, which showed increased $^{99m}Tc-MDP$ uptake in the medial compartment, were included in this study. The diagnosis was confirmed by arthroscopy. On knee SPECT, 3 diagnosic criteria for MMI were investigated. In Criterion I, MMI was diagnosed when crescentic uptake was observed in the medial tibial plateau. In Criterion II, crescentic uptake was further classified into anterior, mid, posterior, and diffuse patterns, according to the location of maximal uptake; and only crescentic mid, posterior, and diffuse patterns were diagnosed as MMI. In Criterion III, MMI was diagnosed when medial tibial plateau showed higher activity then medial femoral condyle. The diagnostic performance of the 3 criteria was compared. Results: The sensitivity and specificity were 93% and 14% in Criterion I, 89% and 38% in Criterion II, and 75% and 67% in Criterion III, respectively. Criterion III had significantly improved diagnostic performance, especially, specificity. Conclusion: In this study, we established a practical diagnostic criterion to differentiate MMI from DC on knee SPECT. The result is helpful to improve the diagnostic value of knee SPECT as a screening test for chronic knee pain.

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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The Effect of Intra-articular Bee Venom Injection on Meniscal Injury : Four Cases Report (반월상 연골 손상에 대한 관절강내 봉약침 치료 증례보고 4례)

  • Kim, Dong-Eun;Yu, Deok-Seon;Yeom, Seung-Ryong;Kwon, Young-Dal;Song, Yung-Sun
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.1
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    • pp.219-230
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    • 2010
  • According to previous reports, intra-articular bee venom injection is very effective for synovitis, intra-articular lesions. In this article, we report 4 cases of well-treated meniscal tear with intra-articular bee venom injection. We used intra-articular bee venom injection on meniscal tear diagnosed by MR imaging and prescribed herbal medication, physiotherapy if necessary. Outcomes were measured by Visual Analogue Scale(VAS) and Lysholm Knee Scoring Scale. Patients who are treated by intra-articular bee venom injection had a significant effect on the pain reduction, improved range of motion and knee function. Further well-designed, controlled studies and more cases are needed to define the effect of intra-articular bee venom injection on knee.