• Title/Summary/Keyword: 환자의 추시

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The Results of Arthroscopic Double-Row Rotator Cuff Repairs with Combined Knot-tying and Knotless Suture Anchors (매듭 결속과 비매듭 봉합나사를 이용한 관절경적 이열 회전근개 봉합술의 결과)

  • Ku, Jung-Hoei;Lee, Choon-Key;Cho, Hyung-Lae;Choi, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.172-179
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    • 2008
  • Purpose: To evaluate the functional and structural results of arthroscopic double-row repair using combined knot-tying and knotless suture anchors in rotator cuff tears. Materials and Methods: From March 2006 to June 2007, twenty-one patients (15 males, 6 females; mean age 55.6 years; range 48 to 67) were included who underwent arthroscopic double-row repair for full-thickness tears of the rotator cuff following conservative treatment for a mean of 6.5 months (range 3 to 11). The tear size was carefully inspected arthroscopically and we found 2 small, 13 medium and 6 large-sized rotator cuff tears, with a mean tear size of 2.5cm(range 1.8 to 3.2). The repair constructs were consisted of horizontal mattress sutures using conventional knot-tying suture anchors medially and simple suture at the same level of medial row stitch with Bioknotless RC anchors (DePuy Mitek, Norwood, MA) as lateral row. Clinical and functional evaluations were made according to the range of motion, the ASES, UCLA scale and the isokinetic strength testing. Postoperative cuff integrity was determined through magnetic resonance imaging. The mean follow-up was 15 months (range 13 to 24). Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up (p < 0.01). Nineteen patients (90%) were satisfied with the result of the treatment. In 17 of 21 patients (81%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 7 months postoperatively. There were no significant functional differences according to the preoperative tear size (p<0.01), but large-sized tear shows less favorable structural results in 3 out of 6 cases(50%). Conclusion: Our results document the usefulness and variability of arthroscopic double-row rotator cuff repairs comparable to the results of the other types of double-row repairs.

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Arthroscopic Treatment of Greater Tuberosity fracture - Preliminary Report - (상완골 대결절 골절 손상에 대한 관절경적 치료 -예비 보고-)

  • Ji, Jong-Hoon;Kim, Young-Yul;Park, Sang-Eun;Ra, Ki-Hang;Do, Jeong-Hun;Kim, Weon-Yoo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.57-65
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    • 2007
  • Purpose: The purpose of this study was to evaluate the clinical result of arthroscopic treatments by using suture anchors or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture. Materials and Methods: From March 2004 to March 2006 we have used suture anchor or suture anchors combined with cannulated screw for 6 cases of the greater tuberosity fracture which include displaced fractures, comminuted fractures and minimally displaced fractures with comcomittent lesions such as rotator cuff tears, stiffness and labral lesion. In this retrospective study, we analyzed the clinical outcomes by using the range of motion, University of California at Los Angeles shoulder rating scale (UCLA) and the ASES shoulder index score (ASES) in the average 6 months follow up. Results: At the last follow up, average range of motion was improved to 154.3 degree, 145.8 degree, 32.6 degree and L1 vertebrae in each forward flexion, abduction, external rotation and internal rotation. Clinically the UCLA rating scales improved to 31.5 and the ASES shoulder index score (ASES) improved to 93.6 in the last follow up. Conclusion: Arthroscopic treatments by using suture anchor or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture is an alternative treatment of the greater tuberosity fracture of the proximal humerus fracture.

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Comparison of Clinical Results and Second-Look Arthroscopy after Anterior Cruciate Ligament Reconstruction using Hamstring Tendon Autograft, Mixed graft and Tibialis Tendon Allograft (자가슬괵건, 혼합건 및 동종 경골건을 이용하여 실시한 전방십자인대 재건술후 임상결과 및 이차관절경 검사 비교)

  • Cho, Jin-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.18-26
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    • 2011
  • Purpose: This study is to compare the clinical results of ACL reconstruction between three groups using hamstring tendon autograft, mixed and tibialis tendon allograft. Materials and Methods: Between August 2003 and August 2008, we analyzed 169 cases of ACL reconstruction, 66 cases used hamstring tendon autograft, 42 cases used mixed graft and 61 cases used tibialis tendon allograft, with a minimum follow-up of 12 months. For the clinical evaluation, we evaluated the Lysholm score, Telos stress test device and IKDC score. Results: The average side to side difference in Telos stress test decreased from $7.5{\pm}1.0$ mm to $1.6{\pm}1.0$ mm in autograft group, from $7.6{\pm}1.1$ mm to $1.4{\pm}1.1$ mm in mixed graft group and from $7.4{\pm}1.3$ mm to $2.5{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from 58.6 to 92.3 in autograft group, from 60.6 to 92.6 in mixed graft group and from 55.3 to 91.5 in allograft group. There was no significant difference between three groups in clinical results. At second look arthroscopy, tension of ligament and synovial coverage were good result in autograft and mixed graft than allograft group. Conclusion: All hamstring tendon autograft, mixed graft and tibialis tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. Both hamstring tendon autograft and mixed graft showed good synovial coverage in second look arthroscopy. So mixed graft will be considered as good alternative in case of shorter or thin harvested hamstring tendon.

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Arthroscopic Subscapularis Tendon Repair - Preliminary Report of 8 cases study - (관절경하 견갑하건 봉합술 - 8 례에 대한 예비보고 -)

  • Yun, Ho-Hyun;Moon, Gi-Hyuk;Jang, Jong-Hoon;Yoo, Yon-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.124-131
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    • 2004
  • Purpose: To validate and introduce the technique of the arthroscopic repair for the treatment of the Subscapulris tendon tear. Materials and Methods: From April 2003 to April 2004, Arthroscopic repairs were performed in 8 patient with subscapularis tendon tear. The mean follow-up period was 11months. two cases involved only subscaplaris tendon tear. Four cases were associated small sized posterosuperir. rotator cuff tear and two cases were in large size. The type of subscapularis tendon showed upper portion full-thickness tear in 6 cases, partial-thickness tear localized at articular surface in 1 case, complete tear in 1 case. The results were analyzed by using subjective satisfaction, inferior movenent of superior displaced humeral head, Constant-Murley functional scoring Results: Constant-Murley scoring was improved from 55 point preoperatively to 75 point postoperatively following 11 months. Mean score was 71 point except 2 cases of large superoposterior rotator cuff tear, Most humeral heads were distaracted postoperatively. The subjective result for the 8 shoulders were very satisfying in 5 cases, satisfying in 1 case and dissatisfying in 2 cases. Therefore satisfactory results were noted in 6 cases (75%) of this overall treatment group. Conclusion: The arthroscopic repair for the subscapularis tendon tear is thought to be available method, which could reduce severe complications following the weakness of deltoid muscle and postoperative pain. Especially Partial Subscapularis tear not associated with superoposterior rotator cuff tear including PASTA lesion was the sutable indication of the Arthroscopic repair.

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Preliminary Result of Revision Fusion Surgery for Thoracolumbar Spine Using Revision Rod (Revision Rod를 이용한 흉요추 유합 재수술 예비 결과)

  • Youn, Yung-Hun;Cho, Kyu-Jung;Park, Ye-Su;Park, Jae-Woo;Park, Jin-Sung;Kwon, Won-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.520-526
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    • 2020
  • Purpose: The need for revision fusion surgery after spinal fusion has increased. A revision rod that connects to the previous rod was newly developed for revision surgery. The purpose of this study was to analyze the clinical and radiological results after spinal fusion revision surgery using revision rods. Materials and Methods: Twenty-one patients who underwent revision fusion surgery after spinal fusion in two university hospitals with minimum 1 year follow-up were reviewed. This study assessed 16 cases of adjacent-segment disease, four cases of thoracolumbar fracture, and one case of ossification of ligament flavum. The Oswestry Disability Index (ODI) and numerical rating scale (NRS) were evaluated as clinical outcomes, and the union rate, lordosis or kyphosis of the revision level, lumbar lordosis, T5-12 kyphosis, and proximal junctional kyphosis angle were evaluated as the radiological outcomes. Results: The average ODI was 54.6±12.5 before surgery and improved to 29.8±16.5 at the final follow-up. The NRS for back pain and leg pain was 5.0±1.7 and 6.4±2.0 before surgery, which changed to 2.9±1.6 and 2.9±2.2 at the final follow-up. Lumbar lordosis was 18.1°±11.9° before surgery and 21.1°±10.3° at the final follow-up. Proximal junctional kyphosis was 10.8°±10.1° before surgery, and 9.2°±10.5° at the final follow-up. These angles were not changed significantly after surgery. Bony union was successful in all cases except for one case who underwent posterolateral fusion. Conclusion: Revision surgery using a newly developed revision rod on the thoracolumbar spine achieved good clinical outcomes with successful bony union. No problems with the newly developed revision rod were encountered.

Clinical Results of Lateral-Posterior Internal Fixation for the Treatment of Scapular Body Fractures (견갑골 체부 골절에서 외측 후방 금속판 고정술의 치료 결과)

  • Lee, Yoon-Min;Yeo, Joo-Dong;Song, Seok-Whan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.46-53
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    • 2020
  • Purpose: Scapular body fractures have generally been treated with non-surgical methods. This study reports the clinical and radiological outcomes after lateral-posterior internal fixation for treating displaced scapular body fractures. Materials and Methods: From March 2007 to May 2017, out of 40 patients who underwent internal fixation for scapular fractures, 13 cases of lateral plate fixation of a scapular body fracture were reviewed retrospectively. Preoperative and postoperative displacement, angulation and glenopolar angle (GPA) were measured. The range of shoulder motion, visual analogue scale (VAS), and disabilities of the arm, shoulder, and hand (DASH), and Constant score were assessed at the last follow-up. Results: The mean follow-up period was 17.7 months (range, 6-45 months). The mean preoperative GPA was 23.3°±3.96° (range, 17.8°-28.1°) and the postoperative GPA was 31.1°±4.75° (range, 22.5°-40.1°). Injury to the suprascapular nerve, nonunion, fracture redisplacement, metallic failure, or infection did not occur. At the last follow-up, the mean range of motion was 150.5°±19.3° in forward flexion, 146.6°±2.34° in lateral abduction, 66.6°±19.1° in external rotation, and 61.6°±18.9° in internal rotation. The VAS, DASH, and Constant scores were 1.7±1.3, 6.2±2.4, and 86±7.9 points, respectively. Conclusion: A scapular body fracture with severe displacement, angulation and marked decreased GPA can be stabilized by lateralposterior plate fixation using the appropriate surgical technique with good functional and radiological results.

Treatment of Pyogenic Arthritis of the Knee Using Drainage Tube Insertion in the Posterior Compartment through the Posterior Transeptal Portal after an Arthroscopic Synovectomy (관절경적 활액막 절제술 후 후격막 삽입구를 통한 배액관의 후방 거치를 이용한 무릎의 화농성 관절염 치료)

  • Kim, Tae Ho;Yu, Chang Eon;Shin, Chung Shik
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.269-275
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    • 2019
  • Purpose: This study analyzed the treatment effects of drain insertion in the posteromedial portal after an arthroscopic synovectomy and posterior septum resection for pyogenic arthritis. Materials and Methods: From June 2005 to December 2016, 56 cases (55 patients, 1 case of bilateral knee) were diagnosed with pyogenic arthritis and arthroscopic treatment was performed. Fourteen patients (25.0%) were identified with causative organisms. The average follow-up period was 12.3 months, and the mean age was 67.8 years old. Twenty-four cases were males and 31 cases were females. Kellgrene-Lawrence grade (K-L grade) I was 6 patients, II was 20 patients, III was 11 patients, and IV was 18 patients. Surgery was performed through six portal. The posterior septum was removed and a drainage tube was inserted from the posterior medial side to the posterior side of the joint. The Lysholm score was used after surgery for a functional evaluation. The K-L grade at the time of admission and at the last follow-up were compared for a radiological evaluation. Results: The mean normalization period of the C-reactive protein was 59.8 days (6-164 days). Intravenous antibiotics were used for an average of 37.1 days. The results of the functional evaluation revealed a mean Lysholm score of 64.5 (30-98) in a total of 56 cases. Two reoperations was performed, but the treatment was completed with same method in all patients. The K-L grade was similar at the time of surgery and at the last follow-up (p>0.05). Conclusion: The method of drain insertion in the posteromedial portal after arthroscopic synovectomy and posterior septum resection for pyogenic arthritis is an effective technique that can obtain satisfactory results by inducing proper exudate discharge.

Principle of Rehabilitation after the Arthroscopic Anterior Cruciate Ligament Reconstruction (관절경적 전방 십자인대 재건술 후의 재활 치료 원칙)

  • Kyung Hee-Soo;Kim Hee-Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.6-14
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    • 2003
  • The goal of rehabilitation after ACL reconstruction are return the patient to a reinjury level of activity with stable joint, removing pivot shift phenomenon, preservation of meniscus, restoration of range of motion, and minimize patello-femoral complication. The ACL reconstruction should avoid immediate surgery. The preoperative phase emphasizes two important factors. (1) The patient should have a resolution of knee swelling, a return of full ROM, and a normal gait. (2) The patient should be mentally prepared for the operation and subsequent rehabilitation. The postoperative rehabilitation program emphasizes extension, closed kinetic chain function exercises. The regular follow-up is important.

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Snow-Man Shaped Nodular Tenosynovitis in the Knee - Case Report - (슬관절내에 발생한 눈사람 형태의 결절성 건활액막염 - 증례보고 -)

  • Lee, Geon-Woo;Lee, Kun-Su;Song, Sang-Ho;Kim, Myeong-Ku;Yun, Sang-Hyeon
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.44-47
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    • 1999
  • The authors describe one case of a 25-year-old male with nodular tenosynovitis in left knee joint who did not have a history of joint trauma. He had joint pain and restricted flexion of the left knee at 100 degrees. After arthroscopic excision of mass, symptom was relieved completely and the patient had gained full range of motion of the left knee. No recurrence of symptom and loss of motion of the left knee were noticed during follow up period for 12 months.

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Extraskeletal Osteosarcoma Around the Knee Joint - A Case Report - (슬관절 주위에 발생한 연부조직 골육종 - 증례 보고 -)

  • Lee, Bong-Jin;Kim, Tae-Ho;Ha, Chang-Won;Kim, Sung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.81-86
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    • 2009
  • An extraskeletal osteosarcoma is a rare malignancy. A small number of cases and studies have been reported in the world and only two cases have been reported in Korea. We experienced an extraskeletal osteosarcoma around the knee joint of 91-year-old male who was the oldest case in the literatures. It was developed without history of trauma, irradiation, myositis ossificans, and heterotopic ossification of dermatomyositis. This patient was treated with excision alone, however he was alive and there were no sign of local recurrence or distant metastasis and functional loss during 1-year follow-up.

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