• Title/Summary/Keyword: Arthroscopic knee surgery

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The Effect of Knee Flexion and Posterior Septal Release on the Location of Popliteal Artery (무릎 굴곡 및 후방 관절낭 절제술이 슬와 동맥의 위치에 주는 영향)

  • Seo, Seung-Suk;Seo, Jin-Hyuk;Kim, Chang-Wan;Kwon, Yong-Wook
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.2
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    • pp.69-74
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    • 2012
  • Purpose: By confirm the change of popliteal arterial position when extension or flexion of the knee and estimate the change of popliteal arterial position after posterior capsular release, we tried to know the position can minimize injury of popliteal artery during arthroscopic surgery and usefulness of posterior capsular release. Materials and Methods: Total of two middle-aged man and woman, fresh frozen cadavers as systemic, all four cases of the knee were included in this study. After the knee was flexed to 0 degrees, 30 degrees, 60 degrees, 90 degrees angle, we estimated distance from posterior tibial cortex to popliteal artery at articular surface, the distal 1 cm and 2 cm from articular surface. We performed posterior capsular release by arthroscopy, and estimated distance between posterior tibial cortex and popliteal artery in the same way. Results: Mean distance between popliteal artery and posterior tibial cortex was 6.3 mm (4.5~7), 4.6 mm (3.6~6), 4.9 mm (3.9~5.8) when knee flexion to 0 degrees at articular surface, distal 1 cm and 2 cm from articular surface each. When knee flexion to 30 degrees, it was 7.4 mm (5.2~9), 4.9 mm (3.6~7.2), 5.3 mm (3.8~6.6). When knee flexion to 60 degrees, it was 8.7 mm (5.4~11), 5.2 mm (4.9~7.3), 6.2 mm (5.4~9.6). When knee flexion to 90 degrees, it was 9.8 mm (5.8~12.1), 5.5 mm (5.1~7.4), 6.5 mm (5.4~10.7). After posterior capsule release, the distance was 6.5 mm (5.5~7.5), 5.8 mm (3.9~7.2), 5.2 mm (3.8~7.0) when knee flexion to 0 degrees, 7.7 mm (5.5~9,1), 7.1 mm (4.6~7.6), 5.5 mm (4.1~6.9) when knee flexion to 30 degrees, 8.9 mm (5.7~11.2), 8.5 mm (5.5~9.2), 6.4 mm (5.3~10.1) when knee flexion to 60 degrees and 10.2 mm (6.3~13.6), 9.5 mm (6.5~11), 6.6 mm (5.9~9.8) when knee flexion to 90 degrees. Conclusion: As knee joint is flexed, the distance from posterial tibial cortex to popliteal artery are increased beween knee joint articular surface and distal 2 cm from knee joint. So popliteal artery injury will be reduced at knee joint surgery. Posterior capsular release could also reduce popliteal artery injury by increasing distance between posterior tibial cortex and popliteal artery.

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Second look Arthroscopic finding after Osteochondral Autogenous Graft Transfer for the Chondral defect of the Knee (연골결손에 대한 자가 골연골 이식 수술 후 이차 관절경 소견)

  • Choi Nam-Hong;Kwak Ho-Yoon;Song Baek-Yong;Bae Sang-Wook;Lee In-Mook;Kim Woo-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.99-103
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    • 2001
  • Purpose : The purpose of this prospective study was to evaluate second look arthroscopic finding after osteochondral autograft transfer(OAT) for the treatment of the chondral defect of the knee. Materials & Methods : Fourteen out of forty cases underwent second look arthroscopy after the OAT for the treatment of the chondral defect of the knee. The average age of patients was 34 years. Preoperatively, magnetic resonance imaging was performed in eleven cases and chondral defect was confirmed in nine cases. The site of the chondral defect located at medial femoral condyle at seven, trochlea in four, and lateral fomoral condyle in three cases. The average size of the condral defect was $13\times10mm$, maximum $22\times20mm$. The number of graft was one in eight, two in three, three in two, and five in one case. The average follow-up period was twenty-one months. Second look arthroscopy was performed at six months in almost cases. Results : After the OAT, $86\%$ of cases showed that the consistency of grafted cartilage was firm and $93\%$ of cases showed that grafted cartilage was well incorporated with surrounding cartilage. Conclusion : The results of this study suggest that OAT can be one of treatment modality in the chondral defect of the knee.

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A Ganglion Cyst in the Anterior Cruciate Ligament Accompanying with Discoid Lateral Meniscus - A Case Report - (원판형 외측 반월상 연골과 동반된 전방 십자 인대의 결절종 - 증례보고 -)

  • Kang, Chung-Nam;Kim, Dong-Wook;Kim, Jong-Oh;Choi, Chang-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.64-67
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    • 1998
  • A ganglion cyst is a soft tissue mass that is surrounded by a dense connective-tissue capsule. The capsule is filled with a viscous fluid that is rich in hyaluronic acid and other mucopolysaccharides. But, Ganglion cysts in the knee joint are rare. There are very few case reports of ganglion cysts related to the surface of the anterior cruciate ligament, Posterior cruciate ligament and medial meniscus. We are reporting a case of a ganglion cyst in the anterior aspect of the anterior cruciate ligament accompanying with discoid lateral meniscus in the right knee of a 46-year-old woman without any history of trauma. The cyst and discoid lateral meniscus were treated successfully with arthroscopic excision and partial meniscectomy.

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Symptomatic Mid-Substance Posterior Cruciate Ligament Calcification of the Knee Joint (증상을 동반한 슬관절의 후방십자인대 실질부에 발생한 석회화)

  • Ahn, Gil Yeong;Lee, Tae Hun;Hwang, Sung Hyun;Lee, Kyung Jin
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.93-97
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    • 2021
  • Calcification in the tendon is a common disease especially in the rotator cuff. The condition can be treated conservatively in the chronic stage, but surgically in the acute stage. On the other hand there are few reports of calcification in the cruciate ligament of the knee joint, especially calcification of the posterior cruciate ligament. A 51-year-old patient with symptomatic calcification in the mid-substance of the posterior cruciate ligament was treated conservatively. The symptoms did not improve after eight months of conservative treatment, so arthroscopic surgery was performed. During arthroscopic removal of the calcification, the ligament was damaged beyond preservation. Eventually a posterior cruciate ligament reconstruction was performed. At two years after surgery, radiography confirmed no recurrence of the calcification, and the patient was free. We report this case study with a review of the relevant literature.

Arthroscopic Reduction and Fixation of an Anterior Cruciate Ligament Avulsion Fracture From the Tibial Eminence Using Bioabsorbable Pins - Technical Note - (생흡수성 핀을 이용한 소아 경골 과간부 견열 골절의 관절경적 정복 및 고정 방법 - 수술 술기 -)

  • Lee, Su-Chan;Yang, Il-Soon;Seo, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.183-187
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    • 2009
  • Purpose: We describe a new and simple technique for arthroscopic fixation of tibial intercondylar eminence avulsion fracture using bioabsorbable pins in skeletally immature patients. Operative Technique: Diagnostic knee arthroscopy is performed using anterolateral and anteromedial portals. Fracture debris and blood clot are debrided to expose the injured site well. The fragment is reduced with the probe and fixed temporarily with a 1.1-mm diameter K-wire that is inserted percutaneously from the anterosuperior aspect of the knee joint. The drill guide is introduced into the joint and the fragment is secured by bioabsorbable, poly-p-dioxanone 1.3-mm pins inserted from different angles. The pins are 40 mm in length. The knee is placed in a long leg cast in extension for 4 weeks to assure that full extension is obtained. Conclusion: Arthroscopic fixation of an tibial intercondylar eminence avulsion fracture using bioabsorbable pins is not a technically demanding, suitable method that ensures fracture healing and restores the stability of the joint.

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Clinical Results of Arthroscopic Salvage Repair including Popliteus Tendon as a Post for Complex Lateral Meniscus Tear (복합성 외측 반월상 연골판 파열에서 슬와건을 한시적 지주로 시행한 구제적 성격의 관절경 봉합술의 임상 결과)

  • Park, Sang-Eun;Kim, Sang-Kil
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.1-6
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    • 2010
  • This study was undertaken to document the clinical results and technical aspects of arthroscopic repair including popliteus tendon as a post for the treatment of complex lateral meniscus in young people indicated as total meniscectomy. From June 2004 to May 2006, we prospectively studied arthroscopic repairs on 32 young people knees with symptomatic complex lateral meniscus that was treated by all inside repair technique using Popliteus tendon as a post. Clinical results were evaluated using Lysholm knee scores preoperatively and at final follow-up. 2nd look arthroscopy or MRI was taken at final follow-up. 80% of patients carried out MRI or 2nd look arthroscopy under permission. Most patients who follow up were able to return to their previous life activities with little or no limitation, and no reoperation was required after an average follow-up of 42.8 months. Mean Lysholm knee scores improved from 65.4 (range, 55 to 75) preoperatively to 93.9 (range, 79 to 100) at the final follow-up (P<.001). 80% meniscus healing was found on arthroscopic or MRI follow up. Conclusively, arthroscopic repair using Popliteus tendon as a post is effective for treating young people with complex lateral meniscus tear as a salvage procedure.

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Long-term Follow-up Results of the Localized Pigmented Villonodular Synovitis of the Knee (more than 5 years) (슬관절 국소형 색소융모결절성 활액막염의 장기 추시 결과 (5년이상))

  • Lee, Byung-Il;Choi, Hyung-Suk;Min, Kyung-Dae;Rah, Soo-Kyun;Cho, Sang-Hyuck
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.37-44
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    • 2008
  • Purpose: To purpose of this study was to review the long-term follow up results of surgical treatment of the localized pigmented villonodular synovitis in the knee. Materials and Methods: We evaluated and analyzed 6 patients (6 cases) who underwent arthroscopy and excisional biopsy as pigmented villonodular synovitis from March 1988 to June 2002. The clinical diagnosis was confirmed by pathologic findings. All patients had been managed with arthroscopic excision, but two patients underwent mini-open excision. The recurrence was evaluated by the loss of preoperative symptom and physical examination for range of motion, pain and finding of swelling. Results: According to the arthroscopic findings, all patients had localized form of pigmented villonodular synovitis. Three patients had pedunculated type (one of them had torsion) and the two patients had nodular type and one patient had mixed type. All patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion: In terms of long term follow up results, precise preoperative diagnosis and the adequate surgical treatment, especially arthroscopic excision for the localized pigmented villonodular synovitis, would be considered one of the fundamental modality to expect the good results.

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Comparison Study of Anterior Cruciate Ligament Reconstruction Using Bone-Patella Tendon-Bone Autograft and Achilles Tendon Allograft (이식건에 따른 관절경하 전방 십자 인대 재건술의 비교 -자가 골-슬개건-골과 동종 아킬레스건의 비교-)

  • Seo, Joong-Bae;Jung, Hong-Geun;Kim, Myung-Ho;Park, Hee-Gon;Yoo, Moon-Jib;Byun, Woo-Sup;Lee, Joo-Hong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.132-136
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    • 2005
  • Purpose: The purpose of this study was to compare the clinical results of the arthroscopic anterior cruciate ligament reconstruction used by Bone-Patella tendon-Bone autograft and Achilles tendon allograft. Materials and Methods: We reviewed the results of patients who had been managed with arthroscopic anterior cruciate ligament reconstruction using different graft such as Bone-Patella tendon-Bone autograft and Achilles les tendon allograft. 60patients (average age, 33.5 years)were retrospectively evaluated. The one group(average age, 33.4 years) was 32 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Bone-Patella tendon-Bone autograft. The other group(average age, 32.1 years) was 28 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Achilles tendon allograft. 2 groups were evaluated subjectively by Lysholm knee scoring scale and objectively by KT-2000 arthrometer. The follow-up period was more than a year(average, 18 month). An early rehabilitation protocol was instituted. Results: On Lysholm knee scoring scale, the final evaluation was nearly normal in all patients. We could not find statistical difference among the two groups by KT-2000TM arthrometer. Conclusion: The use of allografts may be an acceptable choice for ACL reconstruction.

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Osteochondritis Dissecans in Medial Trochlea of the Humerus in a Pitcher - A Case Report

  • Lee, Jin-Ho;Kim, Myung-Sun
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.40-43
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    • 2014
  • Osteochondritis dissecans (OCD) is an idiopathic condition affecting the articular epiphysis. Initially described in the knee, this entity affects several other parts of the body such as the talar dome, tarsal navicular, and femoral capital epiphysis. Osteochondritis dissecans (OCD) of the elbow is typically located in the capitellum of the humerus in young teenagers. OCD of humeral trochlea is very rare, but can be occurred among young athletes. OCD developed medial trochlea was extremely rare, especially, without any other trauma. We present a patient, pitcher with OCD in the medial trochlea of the humerus who underwent arthroscopic debridement and microfracture.

Integration of Four-Strand Hamstring Tendon Graft with Bone in Reconstruction of the Anterior Cruciate Ligament -Report of one case- (슬괵건을 이용한 전방십자인대 재건술시 이식건과 골 사이의 골통합에 대한 조직학적 변화 - 1례 보고 -)

  • Jung, Young-Bok;Jang, Eui-Chan;Yum, Jae-Kwang;Park, Geun-Hyung
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.40-43
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    • 1999
  • Arthroscopic anterior cruciate ligament(ACL) reconstruction using four-strand hamstring tendon with looping around transfixing screw in femoral tunnel requires osteointegration between the grafted tendon and bone for stability of the knee. Authors have experienced a histologic finding of osteointegration between the grafted autogenous hamstring tendon and bone in femoral tunnel after arthroscopic ACL reconstruction. A patient received arthroscopic ACL reconstruction with autogenous four strand hamstring tendon for the ACL injury. Traumatic re-rupture of mid-substance of ACL graft was developed at thirteenth week after operation. During the procedures of arthroscopic revision at fifteenth week after initial ACL reconstruction, biopsy was performed at the site of interface between grafted tendon and bone in femoral tunnel. Integration between the grafted tendon and bone was evident by demonstrating the continuity of collagen fiber between bond and tendon. This histologic finding and the low incidence of early graft failure suggest that free tendon autograft attached to bone by looping around a transfixing screw in femoral tunnel undergoes adequate osteointegration between 12 and 15 weeks after surgery and authors thought that insertion of bone chip into the femoral tunnel would accelerate osteointegration procedure.

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