• Title/Summary/Keyword: 인대 봉합술

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Arthroscopic Treatment of an Anterior Cruciate Ligament Avulsion Fracture: Physeal-Sparing, All-Inside Suture Bridge Repair (전방십자인대 견열 골절의 관절경적 치료: 성장판을 보존한 All-Inside 교량형 봉합술)

  • Park, Byeong-Mun;Lee, Seung-Hwan;Yang, Bong-Seok;Kim, Ji-Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.444-449
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    • 2020
  • An anterior cruciate ligament (ACL) avulsion fracture is an uncommon injury that occurs predominantly in the pediatric and adolescent population. Accurate reduction and fixation of an avulsed fragment are necessary to restore and maintain the length of the ACL and normal knee biomechanics. Several techniques are available to repair an ACL avulsion fracture. On the other hand, treatment is controversial in skeletally immature patients due to risk of physeal injury. This paper reports a case of an ACL avulsed fracture in a skeletally immature patient treated with arthroscopic all-inside suture bridge repair, in which an excellent result and firm stability were obtained without physeal injury.

Arthroscopic Medial Plication using Pull-out Suture for the Treatment of Acute or Recurrent Patellar Dislocation - Technical Note - (급성 또는 재발성 슬개골 탈구의 치료에 있어서 견인 봉합술을 이용한 관절경적 내측 관절막 중첩술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Kim, Jae-Hoon;Ha, Hae-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.214-218
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    • 2006
  • Purpose: We describe a new technique of arthroscopic medial plication using pull-out suture with consideration of anatomical location of medial patellofemoral ligament for the treatment of acute or recurrent patellar dislocation. Operative technique: Under arthroscopic examination, sutures are passed through the medial capsule, at which medial patellofemoral ligament is located, from outside to inside of knee joint. Three guide wires are inserted from anterior surface of the patella to upper half of its medial border. Intraarticular portions of sutures are pulled out toward anterior surface of the patella through bony tunnels. Under appropriate tension, the sutures are tied after performing lateral retinacular release. Conclusion: As suturing medial patellofemoral ligament, this technique can maximize the effect of medial plication and can correct subluxation and tilt of the patella. It seems to be a minimally invasive, easy and effective method for the treatment of acute or recurrent patellar dislocation.

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Arthroscopic Posterior Cruciate Ligament Repair (관절경적 후방 십자 인대 봉합술)

  • Kim, Kyung-Taek;Sohn, Sung-Keun;Kim, Chul-Hong;Kang, Min-Soo;Lee, Chul-Won
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.117-121
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    • 2007
  • Purpose: The purpose of this study is to evaluate the results of arthroscopic primary repair of a posterior cruciate ligament(PCL) avulsion injury without bony fragment at the femoral attach site. Materials and Methods: From Jan. 1993 to Dec. 2002, we performed 10 cases of PCL repair by arthroscopic suture technique. The mean follow-up period was $38.7{\pm}11$ months and the mean age of the patients was $28.2{\pm}6$ years old. 8 cases were men. 2 cases were women. At last follow-up, all cases were evaluated with the Lysholm and Gillquist knee rating system and International Knee Documentation Committee criteria. Posterior tibial displacement on stress lateral radiograph and posterior instability with posterior drawer test were measured also in all cases. Results: The mean Lysholm and Gillquist score was $94.5{\pm}2.6$. 4 cases were IKDC A(normal) and the other 6 cases were IKDC B(nearly normal). Posterior instabilities by posterior drawer test were grade I in 5 cases and grade II in 5 cases. A mean posterior translation of tibia was $3{\pm}2.3$ mm on stress lateral radiographs. Conclusion: Arthroscopic primary repair of PCL avulsion without bony fragment at the femoral attach site is one of the useful methods that reduce the posterior instability and improve the functional outcomes.

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Arthroscopic Anterior Talofibular Ligament Repair for Grade II Chronic Ankle Instability - Two Cases Report - (족관절 중등도 불안정성의 관절경적 전거비인대 봉합 - 증례 보고 -)

  • Song, Baek-Yong;Young, Ki-Won;Kim, Jin-Su;Park, Young-UK;Kim, Tae-Won;Lee, Kyung-Tai
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.22-27
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    • 2011
  • The modified Brostrom procedure is first considered for the treatment of chronic ankle instability (CAI). Recently, ankle arthroscopy is also recommended for the treatment of concomitant intra-articular lesions during the open repair of the lateral ligaments. We arthroscopically repaired the anterior talofibular ligament with a use of bio suture anchor for CAI as well as performing the multiple drilling procedure for combined osteochondral lesion of talus. We report the cases with a review of the literature.

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Meniscus Repair using Meniscus Arrow with Anterior Cruciate Ligament Reconstruction (전방 십자 인대 재건술시 동반된 반월상 연골 파열에 대한 meniscus arrow를 이용한 봉합)

  • Cho Sung-Do;Park Tae-Woo;Hwang Su-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.156-160
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    • 2002
  • Purpose : To evaluate the results and usefulness of meniscal repair using meniscal arrows with ACL reconstruction. Material and Methods : Among cases of the simultaneous meniscal arrow fixation and ACL recontruction performed between May, 1997 and September, 2000, 17 cases could be evaluated. The average follow-up were 18.5 months. Twelve cases were medial meniscus, 5 cases, lateral meniscus. All cases were longitudinal tear. Meniscal tear were seen at red-red zone in 13 cases, red-white zone in 5 cases. The results were analyzed by pain, joint line tenderness, locking, McMurray test, the Marshall knee scoring scale and complications. Results : Postoperatively two patients had mild joint line tenderness without pain on joint motion or weight bearing. No patient had locking or positive McMurray test. At last follow-up, 15 cases $(88\%)$ were 'excellent' or 'good' according to the Marshall knee score scale. There were two complications which are soft tissue irritation sign on active knee motion and a femoral chondral injury due to protruded T-shaped head of meniscus arrow. Conclusion : Meniscus arrow can be one of the options in repairing the associated meniscus tear, especially the posterior horn of medial meniscus, during ACL reconstruction. However, surgeons using meniscus arrow should be aware of its potential complications such as pain due to soft tissue irritation and chondral damage of the femoral condyle.

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Management of Multiple Ligament Injured Knee (슬관절 다발성 인대 손상의 치료)

  • Sim, Jae-Ang;Lee, Beom-Koo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.16-23
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    • 2013
  • Multiple ligament knee injury is defined as rupture to at least two of the four major knee ligament structures. Three or four knee ligament injury results in knee dislocation as complete disruption of the integrity of the tibiofemoral articulation. In multiple ligament knee injury, vascular and neurologic assessment should be performed meticulously and systematically. Emergency surgery should be needed if arterial injury is suspected. Surgical treatment rather than conservative management should be done and early surgery might be better than delayed surgery. Reconstruction of ACL and PCL, repair or reconstruction of MCL, and reconstruction of posterolateral corner are recommended, although many debates have occurred. Multiple ligament knee injury requires more aggressive management than single ligament knee injury.

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Osteolysis-Related Bioabsorbable Suture Anchor Fixation in a Medial Collateral Ligament Avulsion Fracture during Total Knee Arthroplasty (슬관절 인공관절 치환술 중 발생한 내측 측부 인대 견열 골절에 대해 생흡수성 봉합 나사못을 이용한 고정 후 발생한 골용해)

  • Huh, Jung-Wook;Park, Man-Jun;Hong, Seong-Hwak;Park, Joon-Hyung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.545-549
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    • 2020
  • Although rare, the treatment options for a medial collateral avulsion fracture during total knee arthroplasty (TKA) range from conservative management using a cast and orthosis to internal fixation using metal screws. Bioabsorbable suture anchors have been used to replace metal fixators with distinct advantages, such as biocompatibility, radiolucency, and unnecessary second removal surgery, but complications, such as osteolysis, have been reported. This paper reports a potential risk of an extensive osteolysis-related suture anchor fixation of a medial collateral ligament (MCL) avulsion fracture during TKA in conjunction with a literature review.

Arthroscopic Meniscal Repair with Bioabsorbable Devices (생체 흡수성 기구를 이용한 반월상 연골 봉합술)

  • Kim Jong Soon;Shin Kyoo Seog;Lee Dong Hwa;Sok Jin Ho;Park Sang Hwan;Heo Jeong Kuk
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.150-155
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    • 2002
  • Purpose : The purpose of this study was to evaluate the clinical results of meniscal repair using the bioabsorbable devices. Materials and Methods : From 1998, 21 meniscal repairs were underwent using the bioabsorbable devices and followed more than 1 year. The Meniscus $Arrow^{\circledR}$(Bionx) and the Meniscal $Fastener^{\circledR}$(Mitek) had been applied. The indication for meniscus refixation was an unstable longitudinal tear in the posterior horn of the medial or lateral meniscus. Concurrent ACL reconstruction with meniscal repair was performed on 9 knees. The clinical result was evaluated using Lysholm knee score. Result : The average Lysholm knee scores for all patients improved from 56 preoperatively, to 89 postoperatively. The type of the device were not significantly related to clinical outcome or Lysholm knee score. But the concurrent ACL reconstruction group and the patients treated within 8 weeks had better clinical result than the others. Conclusion : The all-inside meniscal repair technique using bioabsorbable devices can be considered to be an useful method in the well selected patients and concurrent ACL reconstruction surgery.

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Arthroscopic Repair of Meniscus Tears - Comparison of torn location and combined injury - (파열된 반월상 연골판의 관절경적 봉합술 - 파열 위치와 동반 손상 여부에 따른 비교 -)

  • Jung, Young-Bok;Tae, Suk-Kee;Jin, Whui-Jae;Chung, Jai-Won;Park, Cheol-Kyoung
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.85-91
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    • 2001
  • Purpose : The purpose of this study was to determine the clinical outcome of meniscal repairs according to tern location and combined injury. Materials and Methods : From 1994, 73 meniscal repairs were underwent by arthroscopy and followed more than 1 year. The locations of torn meniscus were 29 red-red Bone, 36 red-white zone, 8 white-white zone. Twenty-six patients also had combined lesion including ACL injury 17 cases and treated simultaneously. Clinical result was evaluated by OAK system. Result : Healing rates(above good) were $94\%$ in isolated injury and $88\%$ in combined injury, especially $94\%$ in ACL injury. The result according to tern location were $90\%$ in red-red zone, $91\%$ in red-white zone, all in white-white zone. Conclusion : Meniscus tear with ACL injury should be repaired by arthroscopy, simultaneously. The meniscal tear of white-white zone could be healed by arthroscopic meniscal suture.

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Factors Affecting Clinical Results of the Meniscal Repair (반월상 연골 손상의 봉합치료 결과에 영향을 미치는 인자)

  • Song, Eun-Kyoo;Rowe, Sung-Man;Chung, Jae-Yoon;Kim, Jong-Seok;Bae, Bong-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.63-69
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    • 2003
  • Purpose : Clinical outcome of meniscal repair fur meniscal injury was examined and the factors affecting the outcome were determined. Materials and Methods : We examined 55 patients with meniscal injury who underwent arthroscopic meniscal repair and could be followed-up for more than 1 year. Clinical outcome according to Tapper & Hoover classification was examined in relation with age, gender, injury site, the presence of bucket-handle tear, method of repair, the period between injury to repair, and the concomitant reconstruction of anterior cruciate ligament. Results : According to Tapper & Hoover classification, the outcome was excellent in 29 cases, good in 23 cases and fair in 3 cases. Age and method of repair have significant relationships with clinical results according to Tapper & Hoover classification, but gender, injury site, the presence of bucket-handle tear, the period between injury to suture, and the concomitant reconstruction of anterior cruciate ligament have no significant relationships. Conclusion : A satisfactory results was obtained in $95\%$ of the patients with meniscal injury with meniscal repair. Age at injury and method of repair have significant relationships with clinical result statistically.

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