• Knee surgery & related research
• /
• v.30 no.4
• /
• pp.275-283
• /
• 2018

Purpose: To compare the clinical outcomes between the open posterior approach and arthroscopic suture fixation for displaced posterior cruciate ligament (PCL) avulsion fractures. Methods: A literature search was performed on MEDLINE, EMBASE, and the Cochrane Library databases. The inclusion criteria were as follows: papers written in English on displaced PCL avulsion fractures, clinical trial(s) with clear description of surgical technique, adult subjects, a follow-up longer than 12 months and modified Coleman methodology score (CMS) more than 60 points. Results: Twelve studies were included with a mean CMS value of 72.4 (standard deviation, 7.6). Overall, 134 patients underwent the open posterior approach with a minimum 12-month follow-up, and 174 patients underwent arthroscopic suture fixation. At final follow-up, the range of Lysholm score was 85-100 for the open approach and 80-100 for the arthroscopic approach. Patients who were rated as normal or nearly normal in the International Knee Documentation Committee subjective knee assessment were 92%-100% for the open approach and 90%-100% for the arthroscopic approach. The range of side-to-side difference was 0-5 mm for both approaches. Conclusions: Both arthroscopic and open methods for the treatment of PCL tibial-side avulsion injuries resulted in comparably good clinical outcomes, radiological healing, and stable knees.

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.28-33
• /
• 1997

Background : Analgesic effect of intra-articular morphine or ketoronac treatment alone, or a combination of both drugs, on postoperative pain were evaluated in 40 healthy male patients undergoing arthroscopic knee surgery. Method : Upon completion of surgery under spinal anesthesia, each patients knee joint was injected with 30 ml of 0.25% bupivacaine. Then, via parenteral or intra-articular route, one study group received morphine and other group received ketorolac. Results : Groups who received either intra-articular ketorolac, or morphine, experienced decreased postoperative pain reducing need for additional analgesics. The combination treatment of intra-articular morphine and ketorolac did not improved results. Conclusions : Singular use of either intra-articular morphine, or ketorolac, improves postoperative analgesia in patients undergoing arthroscopic sugery: Combination of these drugs offered no further advantage over its single prescription.

• Knee surgery & related research
• /
• v.30 no.4
• /
• pp.356-363
• /
• 2018

Purpose: A meta-analysis was performed to assess the outcomes following surgical intervention for medial knee plica. Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient-reported postoperative scores of "good" and "excellent". Meta-analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta-analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8-91.4). In those cases that had non-surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1-87). Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first-line treatment or when symptoms have not responded to non-surgical interventions. Level of Evidence: IV.

• The Korean Journal of Pain
• /
• v.30 no.2
• /
• pp.134-141
• /
• 2017

Background: Postoperative pain is a common, distressing symptom following arthroscopic knee surgery. The aim of this study was to compare the potential analgesic effect of dexmedetomidine after intrathecal versus intra-articular administration following arthroscopic knee surgery. Methods: Ninety patients undergoing unilateral elective arthroscopic knee surgery were randomly assigned into three groups in a double-blind placebo controlled study. The intrathecal dexmedetomidine group (IT) received an intrathecal block with intrathecal dexmedetomidine, the intra-articular group (IA) received an intrathecal block and intra-articular dexmedetomidine, and the control group received an intrathecal block and intra-articular saline. The primary outcome of our study was postoperative pain as assessed by the visual analogue scale of pain (VAS). Secondary outcomes included the effect of dexmedetomidine on total postoperative analgesic use and time to the first analgesic request, hemodynamics, sedation, postoperative nausea and vomiting, patient satisfaction, and postoperative C-reactive protein (CRP) levels. Results: Dexmedetomidine administration decreased pain scores for 4 h in both the intrathecal and intra-articular groups, compared to only 2 h in the control patient group. Furthermore, there was a significant reduction in pain scores for 6 h in the intra-articular group. The time to the first postoperative analgesia request was longer in the intra-articular group compared to the intrathecal and control groups. The total meperidine requirement was significantly lower in the intra-articular and intrathecal groups than in the control group. Conclusions: Both intrathecal and intra-articular dexmedetomidine enhanced postoperative analgesia after arthroscopic knee surgery. Less total meperidine was required with intra-articular administration to extend postoperative analgesia to 6 h with hemodynamic stability.

• Journal of the Korean Arthroscopy Society
• /
• v.17 no.1
• /
• pp.79-83
• /
• 2013

Candida infection of knee joint is very rare. Diagnosis of Candida infection is difficult due to lack of obvious clinical symptoms. Candida albicans is the most common strain in Candida infection of knee joint, but Candida pelliculosa has been rarely reported. We report a case of Candida pelliculosa infection of knee after intra-articular steroid injection, which was treated successfully by repeated arthroscopic debridement and irrigations and arthroscopic implantation with antifungal agent-impregnated cement bead spacer.

• Journal of the Korean Arthroscopy Society
• /
• v.2 no.2
• /
• pp.159-163
• /
• 1998

We reviewed the cases of 35 knees of 34 patients who had arthroscopic debridement for degenerative osteoarthritis of the knee. The patients were followed up for an average of 29 months (range: 13 months to 45 months). The mean age of the patients at operation was 54 years (range: 44 years to 75 years). At the time of follow up, the patients were evaluated using the nine-point scale by Baumgaertner et al. We divided the knee into 4 stages according to the classification system by Jackson et al. Satisfactory results were achieved in 80%(stage I), 75%(stage II), 55.6%(stage III) and 25%(stage IV) of the patients. Arthroscopic debridement is of significant value in the earlier stages of degenerative osteoarthritis (stage I and II) for the symptom relief as a simple procedure with rare complication as well as in the later stages(stage III and IV) as a time buying procedure before the total knee arthroplasty.

• Journal of the Korean Arthroscopy Society
• /
• v.2 no.1
• /
• pp.72-76
• /
• 1998

Between March 1992 and December 1995 at St. Paul's, Holy Family, St. Vincent and Eui Jung Bu St. Mary Hospitals Catholic University, two hundred and eighty patients underwent arthroscopic anterior cruciate ligament(ACL) reconstruction using central one-third bone-patellar tendon-bone autograft. Nine of these patients had limitation of motion(LOM) defined as a knee flexion contracture greater than 10o or less than 125o of passive knee flexion. This study analyzes the causes of LOM after ACL reconstruction as well as the results after passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM. The results are as follows: 1. Out of nine patients, initially three had isolated ACL injuries and six had combined injuries. Seven of nine cases were perfomed by ACL reconstruction within four weeks and two were performed after four weeks following injury. 2. Treatment for LOM after ACL reconstruction was done after 5.5 months on average. 3. Arthroscopic adhesiolysis was done in 5 cases. There were fibrous adhesions at suprapatellar pouch and femoral intercondylar notch in all cases, respectively, infrapatellar fat pad in 3 cases and medial para patellar gutter in 2 cases. Two patients had a fibrous nodule, "cyclops" lesion, which formed anterior to the ACL graft. 4. Range of motion and Lysholm knee score were much improved following passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM.

• Journal of the Korean Arthroscopy Society
• /
• v.11 no.1
• /
• pp.20-23
• /
• 2007

Purpose: The purpose of this study is to evaluate characteristics of a deep infection after arthroscopic knee surgery. Materials and Methods: We selected 894 patients who underwent arthroscopic knee surgery between February 1994 and August 2006. We analyzed the results of the patients with definite infection. Results: Seven cases out of the 894 knee arthroscopic surgery which was performed by one surgeon during 12 years were diagnosed as postoperative deep infection (0.9%). Infection developed in one repair case among the meniscal surgeries (1419=0.2%). There were six infection cases in intraarticular ligament reconstruction (6/343=2%); 3 in ACL surgeries (3/152), 2 in PCL surgeries (2/70) and 1 in combined cruciate ligament surgery and extra-articular reconstruction (l/26). Conclusion: Postoperative infection rate of arthroscopic knee surgery was relatively low. However an attention for the prevention of postoperative deep infection should be paid in intraarticular ligament reconstruction because of its relatively high risk of infection.

• Journal of the Korean Arthroscopy Society
• /
• v.1 no.1
• /
• pp.91-97
• /
• 1997

There has been a controversy about the effectiveness of the synovectomy of the knee in the rheumatoid arthritis. So we studied to determine if the arthroscopic synovectomy of the knee was of benefit in the rheumatoid arthritis. We ana lysed 25 knees of 15 patients who underwent the arthroscopic synovectomy of the knee joint for their rheumatoid arthritis from Jun. 1995 to Oct. 1996. The average follow-up period was 20.1 months($12\~28$ months). The results were as follows; 1. Satisfactory results were obtained in 20 knees $(80\%)$ for the pain and the effusion each, 23 $(92\%)$ for the range of motion and 19 $(76\%)$ for the functional capacity. 2. In the overall results for the pain. effusion. range of motion and the functional capacity. we obtained excellent results in 14 knees $(56\%)$ and satisfactory results in 9 knees $(32\%)$. 3. In the patient's self assessment, 11 patients $(44\%)$ were delighted and 10 patients $(40\%)$ were satisfactory. 4. In the overall results according to the articular cartilage damage, satisfactory results were obtained in 15 $(93\%)$ out of 16 knees in Grade I and II, and 6 $(75\%)$ out of 8 knees in Grade III and IV. In conclusion, arthroscopic synovectomy could be one of very useful treatments for the rheumatoid knee. But further study is needed to get the long-term results of the synovectomy because there's many reports saying gradual decrease of good results with increasing time. And continuous and proper medical treatment including DMARDs, is needed to effectively control the rheumatoid arthritis even after the synovectomy.

• Journal of the Korean Arthroscopy Society
• /
• v.13 no.2
• /
• pp.161-164
• /
• 2009

Irreducible knee dislocation is a rare injury and often need an open procedure with ligaments reconstruction. This report describes a case of arthroscopic treatment of a patient with traumatic knee dislocation unable to reduce in a closed method. MRI revealed incarceration of the medial collateral ligament and capsule in the medial compartment. And arthroscopic examination confirmed incarcerated medial capsuloligamentous structures which prevented the knee from reduction. Arthroscopic procedure without ligaments reconstruction was complete when the medial condyle was well visualized and the knee reduced. After 4 weeks of immobilization in extension, range of motion exercise and gradual increases in weight bearing was allowed. At the 3- year follow-up, mild laxity was remained but the patient did not have any discomfort of doing ADL activity and showed full range of motion of the knee.