• Title/Summary/Keyword: Arthroscopic findings

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Arthroscopic Findings of the Canine Stifle Joint (정상견 무릎의 관절경 검사소견)

  • 정순욱;정월순
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.300-308
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    • 1999
  • Arthroscopy is a valuable diagnostic and operative tool in equine and human orthopedics. The arthroscope is a difficult instrument to use and requires patience, practice, and persistence in order to obtain good results. This technique was found to be less traumatic than arthrotomy, invasiveness, rapid recovery and the feasibility of surgically correcting many arthropathies. The use of the arthroscope in the dog provides a new dimension in the study and diagnosis of joint derangements. The purpose of this report is to introduce the use of the arthroscope in the dog-more specifically, in the stifle of the dog. A diameter 2.7 mm fore-oblique viewing arthroscope, cold light source, video and video printer are used. With the fore-oblique viewing type it is possible to view directly as well as slightly to the side and the range of viewing can be increased by rotating the arthroscope around the object The scope is connected with a cold light source by means of a fiber-optic light guide. The stifle joint was flexed to 20~30$^{\circ}$. The joint were lavaged with lactated Ringer's solution during arthroscopic examination. Arthroscopy of the stifle was performed prior to arthrotomy in 1 dead dog and 4 healthy dogs, and other 3 dogs was performed only arthroscopic examination. In this study only the conventional approaches were used and in most cases it was possible to view all the intra-articular structures via the lateral infrapatellar approach. In the stifle joint, endoscopic observation was performed to find lateral femoral condyle, patella, medial femoral condyle, trochlear groove, tibia, fat, cranial cruciate ligament, caudal cruciate ligament lateral meniscus, tendon of long digital extensor muscle, medial meniscus, and medial collateral ligament Post-arthroscopic examination, the lameness had disappeared within 12~24 hours. Pain and swelling in the stifle joint had disappeared within 24~36 hours. Post-arthroscopic secondary infection was never encountered in the dogs. In conclusion, arthroscopic insertion technique in canine stifle joint using a diameter 2.7 mm 30$^{\circ}$ arthroscope was established and arthroscopical views of all anatomical structures in the normal stilfe joint were obtained through lateral infrapatellar portal.

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Analysis of Clinical Outcomes in Ankle Arthroscopy Focusing on Prognostic Factors and Usefulness of High Portals (Outcomes in 169 Consecutive patients) (족근관절 관절경의 예후 인자와 상방 입구의 유용성에 대한 임상적 분석 (169례 보고))

  • Kim, Sung-Jae;Kim, Sung-Hun;Kang, Eung-Shick;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.103-111
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    • 2001
  • Purpose: The purpose of this study was to evaluate prognostic factors of ankle arthroscopy and the effectiveness of high anteromedial and anterolateral portals in diagnosis and treatment for various disease entities. Materials and Methods: The results of ankle arthroscopy were evaluated between March 1992 and January 2000 by one surgeon. Total 169 patients who were followed for a minimum of 12 months, were included in this study. Using high anteromedial and high anterolateral portals, all procedures were done with accessory portals if necessary. A functional evaluation was performed using the Karlsson score and questionnaire subjectively. Results: Fifty-six synovial impingement, 48 osteochondral lesion on talus, 10 impingement exostosis, 8 loose body, 27 osteoarthritis and chondromalacia, 10 postfracture fibrosis, 3 lateral plica, and 1 pigmented villonodular synivitis(PVNS) among 169 patients were diagnosed. Patients with the former four groups had satisfactory results and the latter four groups had not. Remaining 6 patients underwent arthroscopic arthrodesis, and 5 had satisfactory results. Conclusion: Using high anteromedial and anterolateral portals, we could get better visualization of talar dome and posterior chamber of ankle. For better clinical results, in ankle arthroscopy, not only operative skill but also proper indications are important. In case of synovial impingement after trauma, arthroscopy should be considered within one year after initial trauma. There were little correlation between the radiographic findings and arthroscopic findings of articular cartilage in osteochondral lesion of talus, and it is better to determine treatment modality based on the arthroscopic or MRI findings. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

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Evaluation of Knee Joint after Double-Bundle ACL Reconstruction with Three-Dimensional Isotropic MRI

  • Jung, Min ju;Jeong, Yu Mi;Lee, Beom Goo;Sim, Jae Ang;Choi, Hye-Young;Kim, Jeong Ho;Lee, Sheen-Woo
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.2
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    • pp.95-104
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    • 2016
  • Purpose: To evaluate the knee joint after double-bundle anterior cruciate ligament (ACL) reconstruction with three-dimensional (3D) isotropic magnetic resonance (MR) image, and to directly compare the ACL graft findings on 3D MR with the clinical results. Materials and Methods: From January 2009 to December 2014, we retrospectively reviewed MRIs of 39 patients who had reconstructed ACL with double bundle technique. The subjects were examined using 3D isotropic proton-density sequence and routine two-dimensional (2D) sequence on 3.0T scanner. The MR images were qualitatively evaluated for the intraarticular curvature, graft tear, bony impingement, intraosseous tunnel cyst, and synovitis of anteromedial and posterolateral bundles (AMB, PLB). In addition anterior tibial translation, PCL angle, PCL ratio were quantitatively measured. KT arthrometric values were reviewed for anterior tibial translation as positive or negative. The second look arthroscopy results including tear and laxity were reviewed. Results: Significant correlations were found between an AMB tear on 3D-isotropic proton density MR images and arthroscopic proven AMB tear or laxity (P < 0.05). Also, a significant correlation was observed between increased PCL ratio on 3D isotropic MRI and the arthroscopic findings such as tear, laxities of grafts (P < 0.05). KT arthrometric results were found to be significantly correlated with AMB tears (P < 0.05) and tibial tunnel cysts (P < 0.05). Conclusion: An AMB tear on 3D-isotropic MRI was correlated with arthroscopic results qualitatively and quantitatively. 3D isotropic MRI findings can aid the evaluation of ACL grafts after double bundle reconstruction.

Functional Recovery of the Shoulder after Arthroscopic Treatment for Chronic Calcific Tendinitis

  • Lee, Tae Kyoung;Shin, Sang-Jin
    • Clinics in Shoulder and Elbow
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    • v.21 no.2
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    • pp.75-81
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    • 2018
  • Background: We investigated the resolution of pain and functional recovery of shoulder after arthroscopic removal of calcific deposits in patients with chronic calcific tendinitis. Methods: We enrolled 39 patients who were treated arthroscopically for chronic calcific tendinitis that had been non-responsive to at least 6 months of conservative treatment. We evaluated clinical outcome in terms of the American Shoulder Elbow Surgeons (ASES), the Constant score, the visual analogue score (VAS) for pain. We used plain radiography to measure the size of the calcific deposits. We also analyzed the clinical outcomes in terms of whether or not a cuff repair was performed or the degree of removal of calcific deposits. Results: We found that complete resolution of pain took on average 5.7 months after the arthroscopic treatment. The ASES and the Constant score significantly improved from the 3-month follow-up, however it took 6 months until the scores reached on average 80 points or above. We found that these clinical outcomes at the final follow-up did not significantly differ by whether or not cuff repair was performed. Similarly, we found that the clinical outcomes did not significantly differ by the degree of calcium removal. Conclusions: We found that arthroscopic removal of calcification leads to improved clinical outcomes in patients with chronic calcific tendinitis. However, our findings show it takes at least 6 months for the clinical improvement to become statistically significant. We also found that concomitant cuff repairs or the degree of removal of calcification does not affect the clinical outcome of the arthroscopic treatment.

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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All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

  • Altintas, Burak;Yildiz, Fatih;Uzer, Gokcer;Kapicioglu, Mehmet;Bilsel, Kerem
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.59-67
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    • 2017
  • Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

Bankart Lesion and ALPSA Lesion in Anterior Instability of the Shoulder (견관절 전방 불안정성에서 Bankart 병변과 ALPSA 병변)

  • Kim, Young-Kyu;Ahn, Seung-Jun;Ko, Young-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.186-193
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    • 2005
  • Purpose: To determine whether it is possible to differentiate between ALPSA(anterior labroligamentous periosteal sleeve avulsion) lesion and Bankart lesion using arthroscopic findings and to investigate the clinical significance of ALPSA lesion. Materials and Methods: This study was performed on 66 cases that underwent arthroscopic Bankart repair for the anterior instability of the shoulder. By the readings of MRI, there were 56 cases(85%) of Bankart lesion and ten cases(15%) of ALPSA lesion. Arthroscopic findings of Each cases were classified and their average follow-up period was 22 months. Results: It was observed that ALPSA lesions developed in younger age groups than Bankart lesions. Under the arthroscope, ALPSA lesions showed various forms, especially there were five cases of severe inferomedial displacements. Within Bankart lesion, 21 cases were observed to be severely displaced and from the arthroscopic findings, it was difficult to distinguish the difference of Bankart lesion cases displaced inferomedially from the neck of scapula without severe lateral displacements and ALPSA lesion. Regarding the recurrence, there were no redislocation but apprehension shows in two cases(20%) with severe inferomedial displacement in ALPSA group. In Bankart lesion, there were four recurrent cases(7.1%); one of redislocation; one case of subluxation; two of apprehension. Conclusion: It was difficult to differentiate Bankart lesion and ALPSA lesion with severe inferomedial displacement and severely displaced ALPSA lesion showed high rate of recurrence. Thus, complete detachment of ALPSA lesion should be performed more carefully to reduce the recurrence rate.

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