• Title/Summary/Keyword: Arthroscopic debridement

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Technical Note of Arthroscopic Subtalar Arthrodesis Using Posterior Portals - Operative Technique - (후방 삽입구를 이용한 관절경적 거골하 관절 유합술- 수술 방법-)

  • Lee, Keun-Bae;Choi, Jin;Park, Yu-Bok;Seo, Hyeong-Yeon;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.193-196
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    • 2005
  • A posterior 3-portal arthroscopic approach with the patient in the prone position provides a novel and optimal approach for isolated subtalar arthrodesis. This approach facilitates access to the posterior talocalcaneal facet and facilitates safe access with regard to the posteromedial neuromuscular bundle. The technique involves prone positioning, establishment of two posterolateral portals and one posteromedial portal, arthroscopic posterior talocalcaneal facet debridement, percutaneous morcellized bone grafting and internal screw fixation. Preliminary results have shown high patient satisfaction, an excellent fusion rate and less postoperative morbidity than open subtalar arthrodesis.

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Arthroscopic Anterior Debridement and Mini-Open Posterior Resection for Primary Osteoarthritis of the Elbow (주관절 원발성 골성 관절염의 관절경적 전방 변연 절제술 및 최소 절개 후방 절제술)

  • Kim, Young-Kyu;Moon, Sung-Hoon;Cho, Seung-Hyun;Oh, Won-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.40-46
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    • 2012
  • Purpose: This study evaluated the clinical outcome of arthroscopic debridement of anterior compartment and mini-open resection of posterior osteophyte for the treatment of primary osteoarthritis of the elbow. Materials and Methods: Between March 2003 and Feburary 2010, 19 cases who were performed arthroscopic debridement of anterior compartment and resection of posterior osteophyte through mini-open procedure for refractory osteoarthritis of the elbow were enrolled. Average follow-up period was 19 months. Mean age was 49 years old. Clinical results were evaluated by the scoring system of Andrew-Carson Rating Scale (ACRS) and Mayo Elbow Performance Score (MEPS). Results: In the range of motion, flexion contracture was improved from $28.7^{\circ}$ preoperatively to $17.9^{\circ}$ postoperatively, further flexion was improved from $105.1^{\circ}$ to $121.8^{\circ}$. In the scoring system of MEPS, score was improved from 51.1 points preoperatively to 87.9 points in last follow up, 3 cases had in excellent result, 13 good and 3 fair. According to the scoring system of ACRS, score was improved from 92.9 points to 168.2 points, 3 excellent, 14 good and 2 fair. Except one case, all cases returned to preoperative ordinary daily living activity and their own job. Conclusion: For the treatment of refractory osteoarthritis of the elbow, arthroscopic debridement of the anterior compartment and mini-open resection of posterior osteophyte would be helpful on pain relief and functional recovery of the elbow. But this procedure was required long term follow-up in aspect of recurrence of osteophytes and progress of arthritis of the elbow.

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Diagnostic efficacy of specialized MRI & clinical results of arthroscopic treatment in ankle soft tissue impingement syndrome (족근 관절 연부조직 충돌 증후군에서 MRI의 진단적 의의 및 관절경적 치료 결과)

  • Lee, Jin-Woo;Moon, Eun-Su;Kim, Sung-Jae;Hahn, Soo-Bong;Kang, Eung-Shick
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.208-217
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    • 2003
  • Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

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Arthroscopic Excisional Debridement of Cyst-like lesion in juxta-articular Knee Joint (관절경을 이용한 슬관절주위 낭종유사 병변의 절제제거술)

  • Ko, Sang-Hun;Cho, Sung-Do;Kim, Jong-Oh
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.70-75
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    • 2003
  • Purpose : A cyst-like lesion within and around the knee joint is very rare, with very few articles available in the literature. The aim of this study is to evaluate effectiveness of arthroscopic treatment of cyst-like lesion within and around the knee joint which reported rarely. Materials and Methods : We are reporting 14 cases of cyst-like lesion around the knee joint. Our cases include 3 ganglion cyst in infrapatellar fat pad, 1 fibroma, 1 giant cell tumor and 1 epidermoid cyst which have not yet been reported. The diagnosis of cyst-like lesion in Juxta-articular knee Joint was made only by MRI study and we confirmed pathology. Male was 9, female was 5 cases, average age was 24(11-43)year old. Follow up was average 45(12months-8years)months. Minimum follow up was 12 months. Results : All the patients were treated arthroscopic excisional debridements successfully. All the cases were excellent result in last follow up by functional criteria in Lysholm knee score average 98.9(95-100). All examimation was normal except 3 cases in last follow up. But all patients satisfied in arthroscopic treatment. Conclusion : Arthroscopic excisional debridement of the cyst-1ike lesion in juxta-arthcular knee joint is excellent method, but long term follow up needed in the future.

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Subtalar Arthroscopy (거골하 관절의 관절경술)

  • Ahn, Jae-Hoon
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.235-241
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    • 2009
  • The development of good quality small-diametered arthroscopes and refined arthroscopic techniques has contributed to the improvement of the subtalar arthroscopy. The therapeutic indications are synovectomy, removal of loose bodies, debridement and drilling of osteochondritis dissecans, excision of subtalar impingement lesions and osteophytes, lysis of adhesions for post-traumatic arthrofibrosis, removal of a symptomatic os trigonum, calcaneal fracture assessment and reduction, and arthroscopic arthrodesis of the subtalar joint. The subtalar arthroscopy can be done in supine position using thigh holder or in lateral decubitus position. The arthroscope generally used is a 2.7-mm 30 degrees short arthroscope. Noninvasive distraction with a strap around the hindfoot can be helpful. Usually anterolateral, middle and posterolateral portals are utilized for inspection and instrumentation within the joint. Twoportal posterior subtalar arthroscopy in prone position can be performed as well with 4.0-mm 30 degrees arthroscope, depending on the type and location of the subtalar pathology. The subtalar arthroscopy is a technically demanding procedure, which requires proper instrumentation and careful operative technique. Possible complications are nerve damage and persistent wound drainage.

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Arthroscopic Treatment of Fungal Knee Arthritis after Repetitive Intraarticular Steroid Injection in a Healthy Adult - A Case Report - (건강한 성인에서 반복적인 관절 내 스테로이드 주사 후 발생한 진균성 슬관절염의 관절경적 치료 - 증례 보고 -)

  • Baek, Seung-Hoon;Park, Chang Min
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.180-184
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    • 2012
  • Fungal arthritis is a rare joint infection that occurs in immunosuppressant patient, intravenous drug abuser and long term antibiotics user, and is especially rare in a healthy adult. Two case reports of fungal arthritis have been demonstrated in the country, but those in healthy adults have not been reported yet. Here, we experienced an antifungal treatment following successful arthroscopic debridement of fungal arthritis with a popliteal cyst in a healthy adult who got repetitive intraarticular steroid injections and report the case with review of relevant literatures. Surgeons should consider the possibility of fungal arthritis although it is rare and demonstrates nonspecific clinical features.

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Arthroscopic Management of Septic Arthritis of the Elbow (화농성 주관절염의 관절경적 처치)

  • Moon, Young Lae;Park, Joon Kwang;Oh, Seo Jin
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.138-141
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    • 1999
  • Purpose : This study was to evaluate the effectiveness of arthroscopic management for septic elbows. Materials and Methods : The subjects were 7 patients ranged in age from 6 to 32 years. All patients were diagnosed as having septic arthritis of the elbow after arthrocentesis. Emergency arthroscopic lavage, debridement, and selective synovectomy for infective and necrotic tissue were performed. All patients had a follow-up period of more than 12 months by checking leukocyte count, ESR, CRP and range of motion. Results : For children, we found a return to normal of laboratory tests for infection after an average of 8.4 days while for adults, it required 12.3 days. After 12 months all patients showed normal elbow function as well as normal blood tests. Conclusion : We found arthroscopic management for septic arthritis of the elbows made it possible to visualize the pathologic findings directly and protect further articular damage. In conclusion, arthroscopic management is one of the efficient methods for controlling the joint infection.

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Arthroscopic Treatment of a Type II Superior Labrum Anterior to Posterior (SLAP) Lesion Combined with a Bankart Lesion: Comparative Study between Debridement and Repair of Type II SLAP Lesion by the Status of Lesion

  • Lee, Sung Hyun;Joo, Min Su;Lim, Kyeong Hoon;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.37-41
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    • 2018
  • Background: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions. Methods: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments. Results: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021). Conclusions: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).

Arthroscopic Management of the Triangular Fibrocartilage Complex Injuries (삼각 섬유 연골 복합체 손상의 관절경적 처치)

  • Moon Young Lae;You Jae Won;Oh Jong Ho;Jin Dae Sik
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.32-35
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    • 2001
  • Purpose : To evaluate the efficacy of arthroscopic management of the triangular fibrocartilage complex(TFCC). Materials and Methods : Thirteen patients(14 wrists) with acute or chronic traumatic triangular fibrocartilage complex lesions were included in the study. The mean patients' age was 28.3 years, with a range of 21 to 45 years. All patients were diagnosed by physical examination, arthrographic or magnetic resonance imaging studies. Eight of the 14 wrists had central TFCC tear while 6 wrists had peripheral tear. Under arthroscopic control, injuries to the central portions were treated by debridement and excision of unstable tissue fragment while peripheral tears were repaired. The follow-up period averaged 28 months. The results were analyzed clinically using the Mayo modification of the Green and O' Brien wrist scoring system. Results : Nine of the 14 wrists were rated excellent,3 good and 2 fair Overall, 12 of the 14 patients rated as satisfactory and returned to sports or work activities. Conclusion : Arthroscopic treatment of TFCC resulted in a high degree of patient satisfaction and an increase in the ability to perform at workshop.

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Arthroscopic Treatment of Symptomatic Shoulders with Minimally Displaced Greater Thberosity Fracture (상완골 대결절의 미세전위골절의 관절경적치료)

  • Kim Seung-Ho;Ha Kwon-Ick
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.178-186
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    • 1999
  • Twenty-three patients with chronic shoulder pain beyond 6 months after the fracture of the greater tuberosity underwent arthroscopic treatment and were retrospectively assessed after an average of 29 months(range, 22 to 40 months). There were 18 men and 5 women with the average age of 39 years(range, 24 to 61 years). Fourteen were isolated fractures and nine were related to acute anterior instability episode. The average displacement of the fracture was 2.3mm(range, 0 to 4mm) on the anteroposterior view of the plane radiographs. At the time of arthroscopy, all patients had partial thickness rotator cuff tears in the articular surface. The cuff tears were located on the tuberosity fracture area and were an Ellman's grade I to n in depth. With the arthroscopic debridement or repair of the tear depending on the condition of the tear itself, as well as the subacromial decompression, the UCLA score revealed good to excellent results in 20 and fair in 3 patients. Nineteen of the patients had returned to the previous level of activities. The patient with a higher activity demand revealed a lower level of activity return(p=0.034). The partial thickness rotator cuff tear should be considered in patients with chronic shoulder pain after the minimally displaced fracture of the greater tuberosity, and arthroscopic debridement or repair is an appropriate procedure.

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