• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.71-75
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• 2000

Purpose : To introduce arthroscopic partial meniscectomy fur bucket handle tear of medial meniscus using posteromedial portal, which is superior to arthroscopic partial meniscectomy using standard anterior portals commonly used. Method : After arthroscopic examination of the knee, we reduce the torn meniscus, advance the arthroscope into posteromedial compartment under arthroscopic visualization, we make posteromedial portal with reexamination of the compartment and perform arthroscopic partial meniscectomy. Conclusion : With the technique of arthroscopic partial meniscectomy using standard anterior portals, accurate partial meniscectomy can not be done because of inadequate visual field, associated meniscal injuries of posterior horn and cartilage lesion of posterior aspect of the medial femoral condyle can be missed, commonly posterior cruciate ligament can be injured and artificial damage to weight bearing surface of medial femoral condyle is possible. An arthroscopic partial meniscectomy using posteromedial portal is an excellent method fur bucket handle tear of medial meniscus.

• 대한관절경학회:학술대회논문집
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• 2008.04a
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• pp.126-126
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• 2008

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.135-139
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• 2001

Purpose : Repair of the posterior capsule tear at the time of the operation for the chronic postero-lateral or postero-medial rotary instability has not been reported. We describe the arthroscopic repair of the posterior capsule tear using the posterior trans-septal portal. Method : After conducting basic arthroscopic examination of the knee, postero-medial and postero-lateral portals are secure to make the posterior trans-septal portal, through which the postero-medial and postero-lateral capsule tears are repaired using the suture hook under the arthroscopic guidance. Conclusion : When arthroscopic reconstruction of PCL insufficiency or postero-lateral rotaty instability that accompanies postero-medial or postero-lateral capsular tears. rising the posterior traits-septal portal could ensure better visualization of the capsule and a subsequent more accurate repair of the capsule. Since it significantly lessened instability, it could contribute to an achievement of successful clinical results.

• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.56-59
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• 2005

Trans-posterior septal posterior arthroscopic portals are useful in performing arthroscopic diagnosis and treatment of the lesions located in posterior aspect of knee joints. Except inferior surface of posterior horn of lateral meniscus, we easily observed entire lateral compartment, especially inferior surface of anterior horn and lateral tibial condyle by figure of 4 position through posteromedial trans-posterior septal arthroscopic portal. And it was possible to obtain visual field from posterior aspect and we could use anteromedial and anterolateral portals for instrumentation without clouding. So, this procedure may be useful in performing surgery of lateral compartment especially, anterior aspect in the knee joints.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.67-75
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• 2009

Purpose: This study evaluated the clinical outcomes of debridement arthroplasty using the posteromedial approach in elbow joints with pain and bony limitation of motion. Materials and Methods: This study involved 16 elbows in 16 patients with pain and bony limitation of motion, which were treated by debridement arthroplasty using the posteromedial approach from March 2005 to March 2008. The mean follow up period was 27.6 (13~52) months. The clinical outcomes were analyzed using the Visual Analogue Scale(VAS) for pain scale, the preoperative and postoperative range of motion and the Mayo Elbow Performance Scores(MEPS). Results: The VAS was decreased significantly from a preoperative mean of 4.5 to a postoperative mean 1.1 (p<0.001). The average arc of motion improved significantly from $61.6 (0~90)^{\circ}$ preoperatively to $109.4 (80-120)^{\circ}$ postoperatively (p<0.001). The MEPS also improved significantly from 59.4 to 85.6 postoperatively (p<0.001). There were no complications, such as hematoma and elbow instability. Conclusion: Debridement arthroplasty using the posteromedial approach is a useful surgical procedure in the elbow joint with pain and bony limitation of motion, where all compartments can be debrided, the ulnar nerve can be manipulated easily and damage to the medial collateral ligament can be minimized.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.232-237
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• 2005

Purpose: To evaluate the effectiveness of arthroscopic direct cystic removal of popliteal cyst using 70 degree arthroscopy and posteromedial portal. Materials and Methods: From January 2003 to January 2004, 21 patients(23 cases) with popliteal cyst have been treated by direct cystic decompression with arthroscopy. The average age of the 21 patients was 54 years(range 35 to 78 years). There were 5 males and 16 females. Of the 23 cases,8 cases were occured in right side and 11 cases were occured in left side. 4 cases were both sides. In all cases, preoperative MRI were performed to detect combined intraarticular pathology. At 6 months and 1 year postoperatively, follow-up ultrasonography were performed to detect recurrence of cyst. We used Rauschning and Lindgren criteria for clinical evaluation. Results: All cases had no recurrence and no complaints of pain, swelling, or functional impairment at 1 year after surgery. At ultrasonography, no recurrence were founded. One complication was occurred. Postoperatively, Rauschning and Lindgren criteria were more than grade 1. Conclusion: Arthroscopic direct cystic removal using arthroscopy and posteromedial portal is an effective method in popliteal cyst surgery.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.153-158
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• 2006

Purpose: We evaluated the effectiveness of arthroscopic shaving cystectomy by using posteromedial portal for popliteal cyst with the correction of valvular mechanism. Materials and Methods: We had treated 15 cases of popliteal cyst with arthroscopic shaving cystectomy by using posteromedial portal from April 2004 to June 2005. The mean duration of follow up was 15 months (range: $12{\sim}28$). Functional results were based on the Rauschning and Lindgren criteria. We estimated operative time, time for regaining pain-free full range of motion and checked sonography for recurrence of the cyst at 12 months after the surgery. Results: The functional results by Rauschning and Lindgren criteria were rated Grade 0 or Grade 1 in all cases at last follow up. The average operation time was 45 minutes (range: $35{\sim}70$). All cases regained pain-free full range of motion within five days after surgery and range of motion was also normal at last follow up. There were no recurrence and no walking disturbance in all cases. Conclusion: Arthroscopic shaving cystectomy by using posteromedial portal is one of the effective alternative method of the treatment for popliteal cyst and it is also useful to correct the valvular mechanism.

• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.70-76
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• 2005

Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.33-39
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• 2017

Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.109-114
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• 1999

Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.