• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.28-34
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• 2002

Purpose: The purpose of this study was to evaluate outcome of ankle arthroscopy with high anteromedial and anterolateral portals for osteochondral talar lesion. Materials and Methods: A prospective study was conducted between March 1992 and January 2000 by one surgeon. Total 48 patients who had osteochondral talar lesion were included. Using high anteromedial and anterolateral portals, arthroscopic treatment was performed. A functional evaluation was performed with the Karlsson scoring scale. Results: Of the 48 patients, 28 cases had anterolateral talar lesion and 18 cases had medial talar lesion and 2 cases had central lesion. The 42 cases(87.5 %) had trauma history. On Karlsson scoring scale, anterolateral talar lesion was better than medial talar lesion(p=0.035). Conclusion: Using high portals, we could get better visualization of talar dome and posterior chamber of ankle, and do some limited procedures without additional portals. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.20-24
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• 2010

Purpose: To evaluate the long term outcomes of the ACL reconstruction from the standpoint of osteoarthritis. Materials and Methods: We evaluated 31 patients who underwent ACL reconstruction from April 1986 to April 1999 and could be followed-up more than 7 years. Mean follow-up period was 10.1 years (7~22 years). In terms of the graft, 11 cases were treated with the ACL reconstruction using a autologous hamstring tendon graft, 20 cases were treated with using a autologous bone patellar tendon bone graft. For femoral tunnel, 11 cases were placed through transtibial tunnel, 20 cases were placed through anteromedial portal using mini-open arthrotomy. Functional and radiographic evaluation was performed. Results: Mean Lysholm score was $89.2{\pm}11.7$ points. Patients had KT-2000 side-to-side differences were $2.1{\pm}1.9\;mm$. IKDC ligament evaluation showed 38.7% type A, 48.3% type B, 6.5% type C and 6.5% type D. Femoral tunnel were placed at 11 or 1 o'clock position in transtibial technique and placed 10 to 10:30 or 2 to 2:30 o'clock position in technique using anteromedial portal. Radiographic analysis for degenerative arthritis revealed that in group using anteromedial tunnel, 50.0% were excellent, 25.0% were good. In group using transtibial tunnel 18.2% were excellent, 18.2% were good. Conclusion: More than 87.1% of cases, long term result of the ACL reconstruction showed good and excellent result in IKDC score. Especially, the group using tunnel through anteromedial portal showed good results for degenerative arthritis.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.63-68
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• 2007

Purpose: The authors introduce a new technique of arthroscopic all inside repair using anterolateral and anteromedial portals for lateral meniscus root complete radial tear in patients who underwent concurrent anterior cruciate ligament (ACL) reconstruction. Operative technique: Arthroscope is placed through anteromedial portal and suture hook ($Linvatec^{TM}$, Largo, Florida, USA) is delivered through anterolateral portal. By rotating the suture hook, it penetrates posterior horn of the torn meniscus from femoral to tibial surface for vertical orientation. PDS No. 1 ($Ethicon^{TM}$, Somerville, NJ, USA) is delivered through the suture hook, and then it is withdrawn. Both end of PDS No. 1 are taken out through the anterolateral portal. MAXON 2-0 ($Syneture^{TM}$, Norwalk, Connecticut, USA) is used to penetrates remnant of tibial attachment of the torn meniscus from tibial to femoral surface in a same manner. MAXON 2-0 is changed for PDS No. 1 from tibial to femoral surface by shuttle relay technique. PDS No. 1 is tied using SMC (Samsung Medical Center) knot. Conclusion: All inside repair is a useful technique to achieve anatomical repair and to restore the hoop tension in lateral meniscus root complete radial tear.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.280-284
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• 2009

Purpose: The authors introduce a new technique of arthroscopic reduction of subluxed medial meniscus using suture anchor for the restoration of hoop stress. Operative Technique: Anterolateral, anteromedial, and medial midpatellar arthroscopic portal are used. Arthroscope was inserted through anterolateral portal. Through the scope, we confirmed subluxation of medial meniscus. Transection of menisci including radial and root tear were excluded. We released the anterior horn of medial meniscus through anteromedial and burred the future insertion site of suture anchor. After inserting suture anchor through medial midpatellar portal, we used 90 degree suture hook and no.2 Nylon to retrieve the suture of inserted anchor. We tied the suture by sliding knot-tying method. Weight bearing was limited for 6 weeks postoperatively. Conclusion: Arthroscopic retightening of medial meniscus is less invasive, conserving and progressed method for subluxed meniscus.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.118-122
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• 2006

Purpose: We introduce a technique of all inside arthroscopic capsular imbrication and lateral release used to treat patellofemoral instability. Methods: With the arthroscope in the anteromedial portal for best viewing, the arthroscopic scissor is placed through superolateral portal for proximal to distal release. The release performed 5mm to 1cm from the edge of the patella. After completion of the procedure, with the arthroscope in anterolateral portal, we inserted 5mm cannula in superolateral portal and made working portal from superomedial portal. Medial reefing was performed with all inside technique by using curved needle of the spectrum suturing system and No. 1 monofilament PDS suture is passed through the superomedial portal percutaneously and retrieved through a superolateral portal. Conclusion: Several methods for arthroscopic patella realignment have been proposed, but they have consisted primarily of arthroscopically assisted techniques using a medial incision. We believe that our procedure is preferable to arthroscopically assisted methods commonly used, in that an incision is avoided and the vastus medialis obliqqus is not violated. Our technique is minimally invasive and is easy to control the tightness of the medial patellofemoral ligament (MPFL) under direct vision.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.162-162
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• 2009

After preparation of the bone bed, two doubly loaded suture anchors with suture eyelets are inserted at the articular margin of the greater tuberosity. A retrograde suture-passing instrument penetrates the rotator cuff to retrieve the sutures through the modiWed Neviaser or subclavian portal. An ipsilateral pair of suture eyelets in the suture anchor is passed through the margins of the rotator cuff tear. The blue suture of the second and third pair is pulled out of the lateral cannula, and the threaded blue suture of the third pair in the needle is passed through the blue suture of the second pair. After retrieving the blue suture of the firrst pair through the anterior portal, it is pulled out to pass the blue suture of the third pair through the eyelet of the anteromedial anchor. The blue suture is linked between two anchors. The medial row of suture bridge is repaired with a sliding knot, and the sutures are not cut. Once the rotator cuff repair using the suture-bridge technique has been performed, the two blue strands in the anterior portal are tied. We describe our technique that possesses the advantages of both the double-pulley and suturebridge techniques, which improves the pressurized contact area and maximizes compression along the medial row.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.203-208
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• 2006

Purpose: Previous transtibial double bundle posterior cruciate ligament (PCL) reconstruction methods have several problems in graft length and tibial fixation. We introduce new surgical method that is less restrictive by graft length and is more stable with single tibial fixation. Operative technique: After diagnostic arthroscopy, we prepare the graft, ream the tibial tunnel and perform the procedure for TransFix tibial fixation. Femoral 2 tunnel is made and graft is passed via anteromedial (AM) portal. Tibial fixation is done and femoral 2 graft is fixed sequentially at each knee position. Conclusion: TtransFix tibial single fixation method in double bundle PCL reconstruction provides more stable fixation, more free graft selection and prevents graft damage by passing the graft via AM portal.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.155-158
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• 1998

The purpose of this study is to evaluate the cause, size, number, nature and locaton of loose bodies in the knee joint and to describe the proper arthroscopic technique to remae the loose bodies according to the location of them. We retrospectively analysed thirty-three operations of arthroscopic removal of loose bodies from the knee. Eleven males and 22 females were included with average age of 38(range 7-71). Total number of removed loose bodies were more than sixty. The loose bodies were found most commonly at anterior intercondylar notch area. The most common associated pathology was degenerative arthritis. The most common size of loose bodies was in the range of 5mm to 10mm in diameter. The most common nature of loose bodies was osteochondral. The loose bodies located in suprapatellar pouch, medial gutter, lateral gutter. anterior intercondylar notch or posterior intercondylar notch were removed using standard portals such as anteromedial, anterolateral, superomedial and posteromedial portals. The removal of loose bodies located in upper portion of posteromedial or posterolateral compartment were greatly enhanced using posterior trans-septal portal. The proper portals for the visualization and removal of loose bodies were identified according to the location of loose bodies in the knee joint. More skill in the use of the arthroscope is required for the removal of loose bodies than for simple diagnostic arthroscopy.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.1
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• pp.41-47
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• 2010

Purpose: To compare the obliquity of femoral tunnels prepared with transtibial (TT) versus anteromedial portal technique (AM) using x-ray in single-bundle anterior cruciate ligament (ACL) reconstruction. Materials and Methods: Among one-hundred thirty two patients who were undergoing ACL reconstruction from January 2007 to December 2009, thirty patients using TT and twenty patients using AM, those who had single-bundle ACL reconstruction, were evaluated with plain radiographs including anteroposterior, intercondylar notch and lateral view to compare the obliquity of bone tunnels. Results: The mean coronal obliquity of femoral tunnel for TT was $71^{\circ}$ (range; $65^{\circ}{\sim}77^{\circ}$), while for AM was $51^{\circ}$ (range; $39^{\circ}{\sim}60^{\circ}$) and the mean sagittal obliquity of femoral tunnel for TT was $22.7^{\circ}{\pm}7.8$, while for AM was $30.2^{\circ}{\pm}6.9$, their differences between them were statistically significant (P<0.05). However, there were no differences between two techniques on the tibial tunnel obliquity in coronal and sagittal plane. Conclusion: Anterior cruciate ligament reconstruction using AM portal technique allows more horizontally oriented and divergent femoral tunnel compared to that of transtibial technique. This seems to enable the graft placement into the femoral footprint and preserve the posterior cortical wall.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.60-63
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• 2002

Purpose : The purpose of this study was to introduce new femoral fixation technique using a cross-pin and a bioabsorbable interference screw in hamstring ACL reconstruction. Method : Semitendinosus and gracilis were harvested for quadrapled graft. After tibial tunnel had been made, femoral tunnel was made 35 mm in depth. Then the graft passed through the tunnels. Cross-pin was fixed through the drill hole which had been made through upper sleeve of the Rigidfix system. While pulling the graft, bioabsorbable interference screw was fixed through the anteromedial portal. Conclusion : We introduced the new femoral fixation technique using a cross-pin and a bioabsorbable interference screw as a good method with high fixation strength and tight graft-bone contact.