• Journal of Korean Foot and Ankle Society
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• v.27 no.2
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• pp.71-74
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• 2023

A medial opening wedge supramalleolar osteotomy (SMO) introduced by Takakura et al. is a useful realignment procedure for patients with ankle joint arthritis and varus malalignment by shifting the weight-bearing axis laterally and redistributing the loads on the ankle joint. When pain persists after arthroscopic microfracture in patients with medial osteochondral lesion of the talus (OLT), redo arthroscopy, osteochondral autograft transplantation, autologous chondrocyte implantation, or matrix-induced chondrogenesis might be indicated. On the other hand, there is insufficient scientific evidence for realignment surgery through SMO, while the effect of realignment surgery has been studied consecutively for osteochondral lesions of the knee. Therefore, this paper reports a patient with medial OLT who underwent redo arthroscopy combined with SMO for persistent pain after primary arthroscopic microfracture.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.423-437
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• 2023

Background: Radiofrequency has seen an increase in use in orthopedics including cartilage lesion debridement in the hip and knee as well as many applications in arthroscopic shoulder surgery. The purpose of this systematic review is to evaluate the safety and usage of radiofrequency in the shoulder. Methods: This systematic review was registered with PROSPERO (international registry) and followed the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines. Embase and PubMed were searched using: "shoulder," "rotator cuff," "biceps," "acromion" AND "monopolar," "bipolar," "ablation," "coblation," and "radiofrequency ablation." The title and abstract review were performed independently. Any discrepancies were addressed through open discussion. Results: A total of 63 studies were included. Radiofrequency is currently utilized in impingement syndrome, fracture fixation, instability, nerve injury, adhesive capsulitis, postoperative stiffness, and rotator cuff disease. Adverse events, namely superficial burns, are limited to case reports and case series, with higher-level evidence demonstrating safe use when used below the temperature threshold. Bipolar radiofrequency may decrease operative time and decrease the cost per case. Conclusions: Shoulder radiofrequency has a wide scope of application in various shoulder pathologies. Shoulder radiofrequency is safe; however, requires practitioners to be cognizant of the potential for thermal burn injuries. Bipolar radiofrequency may represent a more efficacious and economic treatment modality. Safety precautions have been executed by institutions to cut down patient complications from shoulder radiofrequency. Future research is required to determine what measures can be taken to further minimize the risk of thermal burns.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.54-60
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• 2011

Puropse: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) reconstruction using fresh-frozen achilles allograft tendon with preservation of ligament remnant or elongated ligament. Materials and Methods: From October 2004 to March 2010, we performed PCL reconstruction with Achilles tendon allografts in 22 complete rupture patients. Mean age was 31.5 years. 14 cases were male and 8 cases were female. Average follow-up period was 3 years and 7 months, range from 1 year to 6 years and 4 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, IKDC score, and second look arthroscopic examination. Results: Postoperative Lysholm knee score, IKDC scores, Tegner activity scale, and posterior displacement by the Telos stress test demonstrated statistically significant improvement compared to the preoperative state. Conclusion: Arthroscopic PCL reconstruction using fresh-frozen achilles allograft tendon with preservation of ligament remnant showed good clinical results and posterior stability.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.135-140
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• 1998

From 1989 to 1994, authors have reconstructed the posterior cruciate ligament(PCL) in 51 knees with an autogenous central one-third of the patellar tendon by transtibial two tunnel technique, but there were not a few cases of unfavorable results. So from January 1995, we have reconstructed the PCL deficient knees by "modified tibial inlay technique" to avoid the grafted tendon abrasion at the posterior opening of the tibial tunnel(killer turn). Purpose of this study was to compare the results of two surgical techniques and what its advantages and disadvantages are. We could follow up 39 cases of transtibial two tunnel techique group(group A) more than one year, average being 23.7 months and 21 cases of modified tibial inlay technique group(group B) more than 12 months, average being 14.7 months. The clinical results were evaluated by the OAK knee scoring system ($M{\ddot{u}}ller$'s criteria) and the posteror stress roentgenography (push view) with Telos stress device compared with the uninjured knees. The arthroscopic second-look findings were also evaluated. In group A : The $M{\ddot{u}}ller$'s knee score was average 80.1 points, the posteror displacement in push view was average 4.4mm at the last follow up. There were 17 cases(44%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view. Among the 19 cases of arthroscopic second look examinations, nearly normal PCL appearances of the grafted tendons were noted only in 9 cases(47%). In group B : The $M{\ddot{u}}ller$'s knee score was average 86.7 points, the posterior displacemnet in push view was average 3.6mm at the last follow up. There were 5 cases(23.8%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view but 4 out of 5 cases showed 6mm posterior displacement in push views. Among the 7 cases of arthroscopic second-look examinations, 6 cases(86%) showed nearly normal PCL appearances of the grafted tendons. In modified tibial inlay technique of PCL reconstruction, it was easier to pull out the BPTB and in cases of remained laxed meniscofemoral ligament it was easier to preserve the remained structures than transtibial two tunnel technique. We expect the "modified tibial inlay technique" may solve the problem of grafted patellar tendon abrasion at the posterior orifice of tibial tunnel and may contribute to the successful PCL reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.214-217
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• 2005

Meniscal cyst is an uncommon disease of knee joints, arising less frequently from medial meniscus than lateral. Most of they are accompanied with horizontal tear of meniscus. This is the case of 24 year old man who had 2 separate medial meniscal cysts with longitudinal tear on posterolateral side of medial meniscus without trauma. Treatment consisted of arthroscopic decompression of cysts and meniscal repair.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.151-154
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• 1998

In the diagnosis of the meniscal tear of the knee, the high accuracy of the MRI diagnosis is well-known, but the accuracy of the MRI in the diagnosis of the very pattern of the tear of menisci is not well-established. The purpose of this study is to give some informations to consider in the diagnosis and therapeutic planning of torn menisci. The authors performed a retrospective study comparing the MRI and arthroscopic findings of 141 knees which had undergone arthroscopic surgery from Mar. 1997 to Mar. 1998. The results are as follows. In the diagnosis of tear of the menisci, MRI had sensitivity of 91%, specificity of 96%, accuracy of 95%. The mismatch of the tear patterns of the menisci between MRI and arthroscopic findings was identified in 59%, especially high in flap tear(100%), complex tear(84%), peripheral tear(55%). In conclusion, MRI is very accurate in the diagnosis of the tear of menisci, but the tear patterns of the menisci cannot be accurately determined by MRI. In the cases of flap tears, complex tears and peripheral tears, it is more difficult to determine the tear patterns of the menisci by MRI. False-negative rate of MRI was especially high(44%) in the peripheral tear type. So, other clinical correlations should be made in determination of the presence of the tear in the diagnosis of peripheral tear of the menisci.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.111-116
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• 2000

Purpose : We reviewed the results of arthroscopic posterior cruciate ligament reconstruction using Achilles tendon allograft, and the efficacy of the surgical technique using gradual tibial tunneling and posterior transseptal technique. Materials and Methods : From september 1997 to September 1999, 8 patients with complete PCL injury were treated by arthroscopic PCL reconstruction using Achilles tendon allograft. Mean follow-up period was 21.7 months. Mean preoperative posterior laxity was 14mm. The clinical outcome was assessed by Telos stress test, Lysholm knee score and IKDC score. Result : There was no complication such as infection and neurovascular injury. Posterior translation using Telos device was less than 5mm in 6 cases$(75\%)$, and between 6 to 10mm in 2 cases$(25\%)$. The mean Lysholm knee score was 45 preoperatively and improved to 87 postoperatively. In IKDC system, 2 of 8 patients were group A and 6 were group B. Conclusion : Arthroscopic PCL reconstruction using achilles tendon allograft and posterior transseptal technique shows reliable stability, short operative time and minimizing donor site morbidity but needs more long term follow-up.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.1
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• pp.97-107
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• 2018

Objectives This is one of the manuals of East-West integrative medicine which was created by the committee on integrative medicine of Chung-Yeon Korean Medicine Hospital. The purpose of this manual is to support clinical decision-making and communication between Korean and western medical staff in a Korean medicine hospital during the rehabilitation of patients after knee surgery. Methods The draft was made by two rehabilitation specialists in Korean medicine. After a rehabilitation specialist in western medicine reviewed the draft and exchanged their ideas, a revised version that reflects the goal of consultation was made. Then the committee agreed to adopt the manuals through the process of review and feedback in addition to face-to-face discussions. Results This manual describes clinical decision-making for rehabilitation after arthroscopic partial meniscus resection, meniscus refixation, reconstruction of anterior and posterior cruciate ligaments. Therefore, it contains the schedule of rehabilitation treatment by the surgical technique, general goal of the rehabilitation by phase, guide for patients and postoperative infection management. Conclusions Despite some limitations, this manual has significance as the first example of a decision-making protocol suggestion for East-West integrative rehabilitation treatment after a knee surgery in one medical institution.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.132-137
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• 1999

Displaced tibial spine fractures need the anatomical reduction of the displaced bone fragment to achieve normal range of motion and anterior stability of the knee joint. The purpose of this paper is to describe details of arthroscopic technique using suture hook and pull-out PDS and to evaluate the clinical results. We report 7 cases who underwent arthroscopic reduction and internal fixation using suture hook and pull-out PDS. All cases had fresh fractures generated within 3 weeks. The follow up period was at average 16.6 months. The fracture union was achieved at average 7.4 weeks. Knee exercise was started 2 weeks after the operation. One of the patients, who had combined injury of posterior cruciate ligament and lateral meniscus, showed limitation of knee movement. But he was underwent the arthroscopic fibrolysis at one year later, he returned to normal range of motion. Arthroscopic treatment of displaced tibial spine fracture using suture hook and pull-out PDS showed good results including rigid fixation and early mobilization. Therefore it is thought to be one of the effective operative techniques in treatment of the tibial spine fractures.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.115-120
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• 2002

Purpose : To compare the functional evaluation with the posterior translation after arthroscopic PCL reconstruction in isolated and combined PCL-deficient knees. Materials and Methods : We retrospectively evaluated 45 patients with PCL-deficient knees who were treated by arthroscopic PCL reconstruction using Achilles tendon allograft from June 1994 to June 2000. The differences of posterior translation were measured with posterior stress lateral radiographs and KT-2000 arthrometer. The functional results were evaluated using the Lysholm knee score and IKDC evaluation form. Results : Preoperative mean side to side differences of the posterior translation were 11.83 mm in isolated PCL-deficient knees and 12.7 mm in combined PCL-deficient knees respectively. At the last follow-up in isolated and combined PCL-deficient knees, the mean radiographic side to side differences of the posterior translation were 6.38 mm and 6.7 mm, the average corrected 20 Ib posterior displacements using KT-2000 arthrometer were 3.5 mm and 4.1 mm, the mean Lysholm score were 87.4 and 81.2, the grade A and B of IKDC evaluation form were 16 cases $(88.9\%)$ and 23 cases $(85.2\%)$, respectively. Conclusion : The functional results had no relationship with the degree of posterior translation after arthroscopic PCL reconstruction. Tendency of posterior translation may be influenced by associated injury of the knee.