• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.199-206
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• 2009

Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.249-253
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• 2009

Purpose: We evaluated the clinical and radiographic results of arthroscopic ankle arthrodesis using 3 cannulated screws for the treatment of arthritis of ankle. Materials and Methods: From May 2006 to February 2009, 17 cases of arthritis of ankle were treated by ankle arthrodesis using 3 cannulated screws under arthroscopy. There were 8 male and 7 female and the average age was 62.2 years. We evaluated them clinically using AOFAS ankle-hindfoot functional scale, VAS pain score and patient’s satisfaction. For the radiographic evaluation, we checked them by simple AP, lateral and mortise view. The average follow-up period was 24.2 months. Results: The ankle-hindfoot functional scale was improved from an average of 47.4 points preoperatively to an average of 82.5 points at the last follow-up. The visual analogue scale pain score was decreased from an average of 8.6 to 2.4. Patient's satisfaction had favorable results with excellent in 7 cases(41.2%), good in 8 cases(47.0%), fair in 1 case(5.9%) and poor in1 case(5.9%). All ankles were successfully fused and the mean period of fusion was 9.1 weeks. Conclusion: Arthroscopic ankle arthrodesis using 3 cannulated screws was good modality of ankle arthrodesis with good clinical results and high union rate in the case of advanced ankle arthritis.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.116-119
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• 2001

Purpose : To describe long-term clinical results and serial changes in the postoperative range of motion(ROM) after arthroscopic treatment for a limitation of motion(LOM) of the elbow. Materials and Methods : The subjects who visited chosun university hospital from December, 1996 to January 2000 were twenty-one patients ranging from 37 to 54 years of age, and the average age was 43.2 years. The chief complaints were painful limitation of motion of the elbow and average ROM showed that flexion contracture were 17 degrees and further flexion were 87 degrees. Results : The total ROM was $70^{\circ}$ preoperatively. 2 months after postoperatively the mean flexion contracute improved from $17^{\circ}\;to\;3^{\circ}$ with further flexion from $87^{\circ}\;to\;122^{\circ}$ degrees. One year after postoperatively the mean flexion contracture were $5^{\circ}$ and further flexion were $113^{\circ}$. All patients reported a decresement in pain level as well as improvement in motion. There was no complication in this series. Conclusion : Arthroscopic surgery appear to be satisfactory management modality for degenerative elbow contractures.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.172-176
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• 2008

Purpose: The proper surgical methods for treating acromioclavicular joint dislocation is still controversial. New methods should provide better early motion with sufficient strength. Materials and Methods: We performed arthroscopic stabilization using TightRope$^{(R)}$ (Arthrex, Inc, Naples, FL) in 10 cases of acromioclavicular joint dislocation between April, 2007, and December, 2007, and followup for a minimum of 10 months. We performed radiologic evaluation by comparing the clavicle anteroposterior radiograph with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Imatani's methods. Results: In clinical evaluation, 6 cases were excellent, 3 cases were good, and 1 case was poor. In radiologic evaluation, 9 cases were excellent and 1 case was poor. Redislocation occurred in 1 case. Conclusion: During short-term followup, 9 of 10 patients who underwent arthroscopic stabilization using TightRope$^{(R)}$ had excellent results in Imatini tests and radiologic evaluation, except 1 patient with redislocation.

• 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.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.2
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• pp.45-52
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• 2013

Purpose: We wanted to compare the accuracy between the blind anterior approach and ultrasound guided posterior approach, which are preferred in the present clinical practice for the glenohumeral joint injection. Materials and Methods: The consecutive 95 cases were included in that the glenohumeral joint injection was done in the university hospital and the medical record and ultrasonography were available. There were 52 cases which were injected by blind anterior approach (group I) and 43 cases who were injected by ultrasound guided posterior approach (group II). The injection was decided as accurate if the fluid was visualized in the posterior joint under the ultrasound. We evaluated the range of motion before and after 2 weeks of injection. A subjective satisfaction of the patients was interviewed at the 2 weeks after injection. Results: The accuracy of the glenohumeral joint injections of the group I and group II was 80.8% and 90.7%, respectively. The range of motion was improved for the all cases regardless of the approaches. At the 2 weeks after injection, the subjective satisfaction (better than good) was achieved in 73.7%. Conclusion: The accuracy of the blind anterior approach for the glenohumeral joint injection was 80.8%. The accuracy of the ultrasound guided posterior approach was 90.7%. In this comparative study by the one physician, the ultrasound guided posterior approach showed the better accuracy.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.40-46
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• 2010

Purpose: The aim of this study was to evaluate the usefulness of arthroscopic Bony Bankart repair using a One Anchor Double Fixation Technique. Materials and Method: Seventeen patients with a Bony Bankart lesion were treated using the One Anchor Double Fixation Technique (OADF Technique). There were 13 males and 4 females. The average age was 24 years (range 17-42). The average follow-up period was 22.3 months. One 3.0 mm suture anchor with doubly loaded sutures was inserted into the glenoid rim. One suture strand was passed the around the small bony fragment and tied first. Another suture strand was passed through the capsule and tied over the bony fragment. The result was measured using Rowe's evaluation index & KSS score. The glenoid defect & bony fragment were measured by 3D-CT scan. Results: Rowe's evaluation index on the final follow-up showed an overall improvement from an average of 54 (range, 23-71) to 83.4 (range 71-90). Of the 17 cases, 13 were excellent, 3 were good, and 1 was fair. KSS scores showed improvement from an average of 71 (range 49-82) to 92.5 (range 82-94). There were no cases where pain continued to the final follow-up, and no cases being re-dislocated during the follow-up period. For six cases, we confirmed the bony healing of the bony Bankart lesion by CT. Conclusion: Bony Bankart lesion repair using this new method achieves excellent clinical results with low recurrence rates and is considered another choice for bony Bankart lesions.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.253-260
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• 2020

Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm² and the mean size of the donor sites was 51.9 cm². The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.227-236
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• 2019

Purpose: To evaluate the results of tibial lateral plateau fractures using arthroscopic-assisted reduction and internal fixation without cortical window or bone grafts. Materials and Methods: From March 2009 to March 2017, 27 patients with Schatzker type II tibial plateau fractures with articular depression and displacement over 5 mm on a computed tomography (CT) scan, who were treated with arthroscopic reduction and internal fixation and followed-up for at least 18 months, were enrolled in this study. Under arthroscopic guidance, the depressed fracture fragment was reduced using a freer and fixed with 5.0 or 6.5 mm cannulated screws through the inframeniscal portal without a cortical window or bone graft. The clinical and radiological results were evaluated using a Rasmussen system. Second look arthroscopy was performed in thirteen patients during the implant removal operation. Results: All fractures healed completely with a mean union time of 8.7 weeks (range from 8 to 12 weeks). Twenty four patients had good to excellent clinical results and 25 patients had good to excellent radiological results according to the Rasmussen classification. A well-healed articular surface with fibrocartilage was also found in 13 cases with second look arthroscopy. The 8 cases on CT scan at outpatient department follow-up showed bone union without bone grafting. Conclusion: Arthroscopic-assisted fixation of tibial lateral plateau fractures is a useful method without a cortical window or bone graft that produces good clinical results.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.2
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• pp.54-58
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• 2010

Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.