• 제목/요약/키워드: Arthroscopic evaluation

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슬괵 건을 이용한 전방십자인대 재건술후 2차 관절경적 평가 (Arthroscopic Evaluation for Endoscopic ACL Reconstruction Using a Multi-stranded Hamstring Tendon Graft and EndoButton)

  • 이광원;이병기;류창수;금덕섭;최원식;김준식
    • 대한관절경학회지
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    • 제2권2호
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    • pp.124-128
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    • 1998
  • From Feb. 1996 to Feb. 1997. among sixty-four patients of anterior cruciate ligament(ACL) reconstruction using multi-stranded hamstring tendon and EndoButton fixation, twenty-five patients of volunteer, 15 men and 10 women, from 16 to 50 years of age(mean 27.6 years) underwent arthroscopic evaluation. Arthroscopic evaluation was routinely performed one year after surgery along with an examination of stability. The purpose of this study was to arthroscopically evaluate the morphological changes that occurred in hamstring tendon autograft one year after ACL reconstruction. Both of the tendon graft and the adjacent fibrous tissues were observed for gross appearance and physical properties with probing and response to passive anterior translation. Biopsy samples were taken from the surrounding fibrous tissue and the tendon graft. Grossly, we found a well-defined ligamentous structure with good tension tested with a probe. A common finding was that the reconstructed ligaments were embedded in a layer of the synovium, and blood vessels could be seen on the anterior surface of the ligament. The biopsy tissue was placed in formalin solution and subjected to histological preparation by hematoxylin and eosin staining method. The hamstring tendon graft appeared histologically normal under light microscopic finding. There were a few vessels located between existing collagen bundles, and the vessels had an orderly pattern. The surrounding fibrous tissue envelope was covered with synovium. We pleased with preliminary findings in our evaluation.

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Evaluation of Deltoid Origin Status Following Open and Arthroscopic Repair of Large Rotator Cuff Tears: A Propensity-Matched Case-Control Study

  • Kholinne, Erica;Kwak, Jae-Man;Sun, Yucheng;Kim, Hyojune;Koh, Kyoung Hwan;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • 제23권1호
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    • pp.11-19
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    • 2020
  • Background: The purpose of this study was to evaluate and compare deltoid origin status following large rotator cuff repair carried out using either an open or an arthroscopic method with a propensity score matching technique. Methods: A retrospective review of 112 patients treated for full-thickness, large rotator cuff tear via either a classic open repair (open group) or an arthroscopic repair (arthroscopic group) was conducted. All patients included in the study had undergone postoperative magnetic resonance imaging (MRI) and clinical follow-up for at least 12 and 18 months after surgery, respectively. Propensity score matching was used to select controls matched for age, sex, body mass index, and affected site. There were 56 patients in each group, with a mean age of 63.3 years (range, 50-77 years). The postoperative functional and radiologic outcomes for both groups were compared. Radiologic evaluation for postoperative rotator cuff integrity and deltoid origin status was performed with 3-Tesla MRI. Results: The deltoid origin thickness was significantly greater in the arthroscopic group when measured at the anterior acromion (P=0.006), anterior third (P=0.005), and middle third of the lateral border of the acromion level (P=0.005). The deltoid origin thickness at the posterior third of the lateral acromion was not significantly different between the arthroscopic and open groups. The arthroscopic group had significantly higher intact deltoid integrity with less scarring (P=0.04). There were no full-thickness deltoid tears in either the open or arthroscopic group. Conclusions: Open rotator cuff repair resulted in a thinner deltoid origin, especially from the anterior acromion to the middle third of the lateral border of the acromion, at the 1-year postoperative MRI evaluation. Meticulous reattachment of the deltoid origin is as essential as rotator cuff repair when an open approach is selected.

Clinical Results of the Arthroscopic "Multiple Pulled Suture" Technique for Large or Comminuted Bony Bankart Lesion

  • Lee, Byung-Ill;Kim, Byoung-Min;Kho, Duk-Hwan;Kim, Hyeung-June
    • Clinics in Shoulder and Elbow
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    • 제20권3호
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    • pp.138-146
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    • 2017
  • Background: Arthroscopic fixations for large and comminuted bony Bankart lesions are technically difficult. We developed an arthroscopic multiple pulled suture (MPS) technique to restore large and comminuted bony Bankart lesions. Methods: Ten patients (mean age, 49.8 years; range, 31-79 years) underwent bony Bankart repair using the illustrated MPS technique and were then followed for a mean of 27.3 months. A plain radiograph series and three-dimensional computed tomography scans were taken at the initial clinical evaluation and 3 months postoperatively. Outcome measurements included the American Shoulder and Elbow Surgeons (ASES) score, Rowe score, University of California at Los Angeles (UCLA) score, and subjective patient satisfaction, along with surgical complications. Results: Union of an osseous fragment with the glenoid rim was confirmed in all patients on a computed tomography scan 3 months after operation. The osseous fragment was restored to proper articular congruence and reduction. The affected shoulder was stable in nine of the 10 patients. One patient presented with a redislocation after a sports injury 3 years postoperatively. The ASES, Rowe, and UCLA scores improved at the final evaluation, and median patient satisfaction at the final follow-up was 9 of 10 points (range, 6-10 points). Conclusions: The arthroscopic MPS technique for bony Bankart lesions with large or comminuted osseous fragments was a relatively easy and safe method for stable fixation of the osseous fragment. Therefore, the arthroscopic MPS technique resulted in good restoration of stability with high patient satisfaction and low complication rates.

족관절 만성 외측 불안정증에서 관절경하 변형 Brostr$\ddot{o}$m 술식의 수술적 결과 (Surgical Outcomes of Arthroscopic Modified Brostr$\ddot{o}$m Procedure in Chronic Lateral Ankle Instability)

  • 차민석;차승도;김응수
    • 대한족부족관절학회지
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    • 제17권4호
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    • pp.283-287
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    • 2013
  • Purpose: To evaluate the result of arthroscopic modified Brostrom procedure with suture anchor for chronic lateral ankle instability. Materials and Methods: Fifty-two patients with chronic lateral ankle instability were analyzed, who underwent arthroscopic modified Brostrom procedure between December 2010 and May 2012. Clinical evaluation was performed using AOFAS scroring and Sefton grading system. Results: The average AOFAS hind foot score increased from preoperative 61.9 to 88.8 at the last follow up. There were 35 excellent, 9 good, 4 fair, 4 poor results according to Sefton grading system. For one patient, lateral ankle instability recurred. Conclusion: Arthroscopic modified Brostrom procedure is considered to be an effective and satisfactory technique.

Delayed surgical repair of the deltoid following acromioplasty: a case report

  • Zohaib Sherwani;Chase Kelley;Hassan Farooq;Nickolas G. Garbis
    • Clinics in Shoulder and Elbow
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    • 제25권4호
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    • pp.334-338
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    • 2022
  • Currently, the literature contains few studies that describe any potential complications following arthroscopic acromioplasty. Because part of the anterior deltoid originates from the anterior acromion, there is a risk for violation and subsequent iatrogenic rupture or avulsion during this procedure. This type of injury can be a devastating problem for patients that may lead to poor function and debilitating pain. We present a patient with deltoid insufficiency following arthroscopic acromioplasty who elected to proceed with operative management with a planned arthroscopic evaluation of the shoulder followed by an open deltoid repair. At the final follow-up visit 2.5 years postoperatively, the patient reported improved pain from baseline and no residual disability and was able to perform most activities of daily living without difficulty. This case serves as an example of a surgical repair for a deltoid avulsion following arthroscopic acromioplasty. As there is still a lack of standard guidelines, our suture repair technique can be considered one method of treatment for this type of injury.

후방십자인대의 단독 및 동반 손상에서 관절경적 재건술 후 기능적 평가 (Functional Evaluation after Arthroscopic Reconstruction in Isolated and Combined Injury of Posterior Cruciate Ligament)

  • 이광원;이승훈;박재국;김하용;김병성;최원식
    • 대한관절경학회지
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    • 제6권2호
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    • pp.115-120
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    • 2002
  • 목적 : 후방십자인대의 단독 손상군과 동반 손상군에서 재건술 시행 후 발생되는 후방 전위의 정도를 분석하고 슬관절의 기능적 평가와 비교하고자 하였다. 대상 및 방법 : 1994년 6월부터 2000년 6월까지 동종 아킬레스건을 이용한 관절경적 후방십자인대 재건술을 시행받은 45명을 대상으로 하였으며 평균 추시 기간은 49개월이었다. 후방 전위 정도는 후방 부하 방사선 사진과 KT-2000 슬관절계를 이용하였고 슬관절 기능 평가는 Lysholm score와 IKDC evaluation form을 이용하였다. 결과 : 건측과 비교한 방사선학적 후방 전위의 차이는 단독 손상군에서 술 전 평균 11.83 mm, 최종 추시 6.38 mm였고, 동반 손상군에서 술 전 12.7 mm, 최종 추시 6.7 mm이었다. 최종 추시에서 단독 손상군과 동반 손상군의 KT-2000슬관절계를 이용한 후방 전위는 각각 평균 3.5 mm, 4.1 mm, Lysholm score는 평균 87.4점, 81.2점, IKDC 평가표상 grade B 이상은 16례$(88.9\%)$, 23례$(85.2\%)$ 조사되었다. 결론 : 후방십자인대 재건술 후 동반 손상군이 단독 손상군에 비해 후방 전위가 좀더 잔존하는 경향을 보였으나 통계학적인 의미는 없었고 두 군에서 후방 전위의 정도와 슬관절의 기능적 평가와는 상관관계가 없었다.

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Comparison of dorsal and medial arthroscopic approach to canine coxofemoral joint: a cadaveric study

  • Sangjun Oh;Jinsu Kang;Namsoo Kim;Suyoung Heo
    • Journal of Veterinary Science
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    • 제24권1호
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    • pp.12.1-12.10
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    • 2023
  • Background: Arthroscopic exploration of ventromedial part of canine coxofemoral joint is limited in conventional dorsal approach. Objectives: We evaluated the efficacy of a medial arthroscopic approach to the coxofemoral joint of dogs by analyzing the joint visible area and performing a safety analysis. Methods: Arthroscopic approaches to the coxofemoral joint were made in five cadavers using a traditional (dorsal) and novel (medial) approach. Three observers scored the visible area of images and videos of the acetabulum and femur. A safety analysis was performed via dissection of the medial hind limb. The distance between neurovascular structures and arthroscopic portals was measured. Results: The acetabulum was more visible in the dorsal than in the medial approach, with mean visualization scores of 16 ± 0.00 and 11.83 ± 1.26, respectively. The medioventral side of the femur was significantly more visible in the medial than in the dorsal approach, with mean visualization scores of 3.9 ± 0.99 and 6.93 ± 0.58, respectively. Safety analysis confirmed the medial portal site was safe, provided that the surgeon has comprehensive knowledge of the joint. The minimum distance from the arthroscopic medial portals to the nearest neurovascular structures was 2.5 mm. Conclusions: A medial arthroscopic approach to the canine coxofemoral joint has potential clinical application. Dorsal and medial approaches differ significantly and have distinct purposes. The medial approach is useful to access the ventromedial joint, making it an eligible diagnostic method for an arthroscopic evaluation of this area.

견관절 전방 재발성 탈구에 대한 관혈적 술식과 관절경적 술식의 결과 비교 (Open Versus Arthroscopic Technique in the Traumatic Recurrent Anterior Dislocation of the Shoulder)

  • 경희수;전인호;김성중;여준영
    • Clinics in Shoulder and Elbow
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    • 제5권2호
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    • pp.110-117
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    • 2002
  • Purpose: We compared the results of open and arthroscopic Bankart repair in traumatic recurrent anterior dislocation ,3f the shoulder. Materials and methods: We analysed 7 cases underwent open Bankart repair (group I) and 13 cases underwent arthroscopic Bankart repair (group Ⅱ). The average follow-up period was 68.1 months (51-113 months) in group I and 41.1 months (16~57 months) in group Ⅱ. All patients in group I and Ⅱ were non-athletes. We analyzed statistically objective evaluation, such as the stability of shoulder joint, the range of motion, pain, impaired throwing, Bankart rating system by Rowe and subjective evaluation, visual analog scale (VAS) between two groups. Results: In terms of dominant and non-dominant shoulders, the age at initial episode of dislocation, the elapsed time from injury to surgery, the number of preoperative dislocations associated with susceptibility to apprehension. respectively, there was no statistically significant differences between two groups. In group I the average Rowe's scortls was 84.3 and 3 cases (43%) had excellent results,4 cases (S7cfo), good ones. In group H the average Rowe's scores was 87.3 and 7 cases (54%) had excellent results,6 cases, good ones. There was tendency to show more excellent results in group ll, but there was no statistically significant differences. The average VAS were 90.3 points in group I and 88 points in group Ⅱ, which showed also no statistically significant differences. Conclusion: Open and arthroscopic Bankart repairs had no significant difference and showed also good results in travinatic recurrent anterior dislocation of shoulder.