• Title/Summary/Keyword: 후외방 불안정성

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Treatment of Posteolareral Rotatory Instability of the Knee (슬관절 후외방 불안정성의 치료)

  • Kim, Jin Goo
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.146-154
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    • 2011
  • Injury of posterolateral corner is unusual, but it can cause disability due to severe instability and cartilage damage. However, the anatomical structures, diagnosis and treatment have not defined clearly yet. Posterolateral corner injury is regarded as the one of main factor to the results of failure in cruciate ligament reconstcution if it was undiagnosed and untreated. Diagnosis of postetolateral corner injury is consists of physical exam, radiographic finding, MRI, and arthroscopic findings. The treatment method of of postetolateral corner injury depends on the time and severity of injury. Anatomical reconstruction of posterolateral corner shows the better clinical outcome than non anatomical reconstructions, but the clinical results of long term follow up is still needed. Therefore, the aim of this article is to review the recent literatures and to organize diagnosis and treatment of posterolateral corner injury.

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Reconstruction of Recurrent Posterolateral Rotatory Instability of the Elbow - A Case Report - (재발성 주관절 후외방 회전 불안정성의 재건술 - 증예보고 -)

  • Jeon In Ho;Kyung Hee Soo;Kim Poong Taek;Ihn Joo Chul
    • Clinics in Shoulder and Elbow
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    • v.4 no.2
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    • pp.191-195
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    • 2001
  • Posterolateral rotatory instability is the most common pattern of elbow instability especially which is recurrent, and is usually post-traumatic because of inadequate soft tissue healing. The lateral ulnar collateral ligament was reconstructed by using ipsilateral palmaris longus tendon. Functionally good result was obtained. This is a case report illustrating the posterolateral rotatory instability of the elbow and its reconstruction with palmaris longus.

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Arthroscopic Technique of Bone Defect in Anterior Shoulder Instability (골 결손이 동반된 전방 견관절 불안정성에서 관절경적인 수술 술기)

  • Ko, Sang-Hun;Park, Ki-Bong
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.102-108
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    • 2009
  • Purpose: The bone defects that are associated with shoulder anterior instability may be the causes of failure of arthroscopic surgery. For the treatment of traumatic shoulder instability, we tried to determine the arthroscopic techniques that can be used for the bone defect of the glenoid and the humeral head. The purpose of this study is to assess the surgical techniques for the arthroscopic reconstruction of the shoulder with anterior instability and bone defects. Materials and Methods: We analyzed the articles that have been recently published on anterior shoulder instability and we assessed the arthroscopic surgical techniques. We compared the articles and the methods of arthroscopic surgical techniques for treating bone defects of the anteroinferior glenoid and the posterolateral humeral head, which were considered as the causes of recurrence of shoulder instability. Results: There are the anteroinferior bone defects of the glenoid and Hill-Sachs lesions in the bone defects that appear in patients with anterior shoulder instability. These bone defects are currently the causes of failure of arthroscopic surgery. Conclusion: Open shoulder surgery may be the treatment of the choice for a shoulder with instability and significant bone defects of the glenoid and the humeral head. But efforts are being made to overcome the weaknesses of open surgery by the use of arthroscopy.

One Stage Revision Anterior Cruciate Ligament Reconstruction (일단계 전방 십자 인대 재 재건술)

  • Ra, Ho-Jong;Ha, Jeong-Ku;Kim, Sang-Bum;Sung, Jung-Hwan;Seo, Jeong-Gook;Kim, Jin-Goo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.143-148
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    • 2009
  • Purpose: To investigate the causes of failure on ACL reconstructions and evaluate the effectiveness of one stage revision ACL reconstructions. Materials and Methods: From November 2004 to July 2008, thirty three patients who had got revision ACL recontstructions after reruptures of ACL were evaluated. The causes of failure of ACL reruptures were 22 vertical femoral tunnels, 7 neglected PLRI, 3 severe traumas and 1 deep infection after ACL reconstruction. The femoral tunnels were aimed at the 10 or 2 o'clock position and the tibial tunnels were used with previous tunnels. Previous femoral screws from the improper femoral tunnels were removed and filled with the new allograft bones. Results: The average periods of follow up were 22.2 months (12~52 months). There was improvement on an average Lysholm knee score from $61.5{\pm}16.8$ to $86.3{\pm}11.5$, IKDC score from $63.9{\pm}15.1$ to $81.3{\pm}14.3$. Mean side to side difference was decreased from $6.0{\pm}2.2\;mm$ to $1.6{\pm}1.4\;mm$ using KT-2000 arthrometer. Conclusion: One stage revision ACL reconstruction can be a useful method with good clinical results.

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Combined Reconstruction of Posterior Cruciate Ligament and Posterolateral Corner with a Fresh Frozen Achilles Tendon Allograft (한 개의 신선동결 동종아킬레스건을 이용한 후방십자인대 및 후외방구조의 동시 재건술)

  • Kyung, Hee-Soo;Oh, Chang-Wug;Lee, Hyun-Joo;Ihn, Joo-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.102-108
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    • 2009
  • Purpose: The purpose of this study is to report a result of the technique that reconstruct posterior cruciate ligament (PCL) and posterolateral corner (PLC) simultaneously using a fresh-frozen Achilles tendon allograft. Materials and Methods: Forty two patients (45 legs) underwent PCL and PLC reconstruction were included. There were 38 males and 4 females. Mean age was 39 years. Used graft was a fresh frozen Achilles tendon allograft, which was divided by two size, larger one (${\emptyset}$ 10 mm) for PCL reconstruction and smaller one (${\emptyset}$ 8 mm) for PLC reconstruction. Arthroscopic reconstruction of the PCL was performed using transtibial, single incision, and single bundle technique with 10mm fresh frozen Achilles allograft tendon first. After PCL reconstruction, reconstruction procedure for posterolateral instability was performed using modified figure of "8" technique using smaller gtaft. For clinical evaluation, range of motion, posterior drawer test, varus stress test, prone external rotation (dial) test, Lysholm score, Tegner activity scale and posterior stress radiograph were used. Mean follow up period was 25 months. Results: Preoperatively posterior drawer test was 5 cases in grade II and 40 cases in grade III posterior instability. At final follow-up 22 cases returned within normal condition, 18 cases grade I and 5 cases grade II posterior instability. Though all patients showed positive result over 10 degrees in dial and varus stress test preoperatively, but only 9 cases showed positive both test at final follow-up. The range of motion deficit over $10^{\circ}$ flexion was 3 cases. Lysholm score was improved from mean 50 preoperatively to mean 83(p<0.05) and Tegner activity scale improved from mean 2.1 preoperatively to mean 4.6(p<0.05). In posterior stress radiographs, posterior displacement was improve from mean 16mm preoperatively to 4.1mm after treatment(p<0.05). All patients had improved compared to their pre-operative status as measured by physical examination such as posterior drawer test, varus stress test, dial test. Conclusion: We had successful results by combined reconstruction of the PCL & PLC with a fresh frozen Achilles tendon allograft in patients with PCL and posterolateral rotatory instability at a time.

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Double Hill-Sachs Lesion in a Recurrent Anterior Shoulder Dislocation Patient -A Case Report - (견관절 전방 재발성 탈구 환자에서 발생한 이중 Hill-Sachs 병변 - 증례 보고 -)

  • Kim, Yong-Min;Park, Kyoung-Jin;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Hong, Kyung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.121-124
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    • 2011
  • Hill-Sachs lesion is the most common lesion in shoulder dislocation patient and it represented by postero-lateral bony defect of humerus. The lesion could be found in patients who dislocate shoulder joint first time, and it is reported that Hill-Sachs lesion proportionally increases as dislocation does. The location and presence of Hill-Sachs lesion play significant roles in shoulder instability. Authors experienced a double Hill-Sachs lesion in a recurrent anterior shoulder dislocation patient, and thereby report the case with a review of the literature.

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