• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.241-245
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• 2007

Objective : So called "minimally invasive procedures" have evolved from chemonucleolysis, automated percutaneous discectomy, arthroscopic microdiscectomy that are mainly working within the confines of intradiscal space to transforaminal endoscopic technique to remove herniated epidural disc materials directly. The purpose of this study is to assess the result of endoscopic spinal surgery and favorable indication in the thoracolumbar spine. Methods : The records of 71 patients, 73 endoscopic procedures, were retrospectively analysed. Yeung Endoscopic Spine Surgery system with 7 mm working sleeve and $25^{\circ}$ viewing angle was used. The mean follow up period was 6 months [range, 3-9]. Results : Operated levels were from T12-L1 disc down to L5-L6 of S1 disc. Of 71 cases, 2 patients underwent transforaminal endoscopic surgery twice due to recurrence after initial operation. MacNab's criteria was used to assess the outcome. Favorable outcome, excellent of good, was seen in 78% [57 procedures] of the patients. Among 11 fair outcomes, only 1 procedure was followed by secondary open procedure, laminectomy with discectomy. Two of 5 poor outcomes were operated again by same procedure which resulted in fair outcomes. One patient with aggravated cauda equina syndrome remained poor and a lumbar fusion procedure was performed in other patient with poor outcome. There were 2 postoperative discitis that were treated with conservative care in one and anterior lumbar interbody fusion in the other. Conclusion : Evolving technology of mechanical, visual instrument enables minimal invasive procedure possible and effective. The transforaminal endoscopic spinal surgery can reach as high as T12-L1 disc level. The rate of favorable outcome is mid-range among reported endoscopic lumbar surgery series. Authors believe that the outcome will be better as cases accumulate and will be able to reach the fate of standard open microsurgery.

• 대한족부족관절학회지
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• 제8권1호
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• pp.81-85
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• 2004

Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

• 대한정형외과스포츠의학회지
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• 제10권2호
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• pp.113-116
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• 2011

발생 빈도가 높진 않지만, 슬관절 탈구 시 슬와 동맥 손상이 종종 동반된다. 발견된 모든 동맥 손상에 대한 치료의 필요성이 보고되어 왔으며 관혈적 수술이 보편적인 방법으로 알려져 왔다. 슬관절 탈구에 동반된 슬와 동맥 손상에 대하여 혈관내 중재술로 혈류를 회복하고 이후 손상된 인대에 대한 수술적 치료를 시행한 1례를 보고하고자 한다.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2005년도 제3차 연수강좌
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• pp.78-93
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• 2005

The posterior and multidirectional instability of the shoulder is a complex problem in terms of diagnosis and treatment. Increased joint volume by redundant capsular ligament has been regarded as a major pathogenesis of the posterior and multidirectional instability. Distinct from multidirectional hyperlaxity, multidirectional instability has symptoms related with increased translations in more than one direction. Recent report that shoulder symptom originates from labral lesion which was created by excessive rim-loading of the humeral head on the posteroinferior glenoid labrum during repetitive subluxation helps us to understand the pathogenesis of such instability. Painful jerk and Kim tests indicate labral lesion in the multidirectionally loose shoulder, suggesting multidirectional instability. Also, painful jerk test is a prognostic sign of failure of nonoperative treatment. The labral lesion can be an incomplete tear or a concealed lesion which often has been underestimated. Operative treatment is indicated when nonoperative treatment has failed. Arthroscopic capsulolabroplasty is a reliable procedure, which not only provides capsular balance, but also restores the labral height.

• Journal of Chest Surgery
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• 제48권4호
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• pp.302-305
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• 2015

Pseudoaneurysm with arteriovenous fistula is a rare complication of arthroscopy, and can be diagnosed by ultrasonography, computed tomography, magnetic resonance imaging, or angiography. This condition can be treated with open surgical repair or endovascular repair. We report our experience with the open surgical repair of a pseudoaneurysm with an arteriovenous fistula in a young male patient who underwent arthroscopy five months previously.

• 대한족부족관절학회지
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• 제16권1호
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• pp.26-30
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• 2012

The subtalar joint is a complex joint that is functionally responsible for inversion and eversion of the hindfoot. Advances in optical technology and surgical instrumentation have allowed the arthorscocpic surgeon to investiagate the small joints including the subtalar joint. Indications for subtalar arthroscopy include pain, swelling, stiffness and locking. Therapeutic indications include treatment of chondromalacia, osteophytes, arthrofibrosis, synovitis, loose bodies, osteochondral lesions, excision of a painful os trigonum, arthrodesis, and FHL tendinopathy. Contraindications to subtalar arthroscopy include infection, advanced osteoarthritis with deformity, severe edema, poor vascularity and poor skin quality. Subtalar arthroscopy is a technically demanding and difficult procedure that should only be performed by experienced surgeons. With proper instrumentation and careful operative techniques, satisfactory results may be obtained with minimal morbidity.

• Clinics in Shoulder and Elbow
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• 제7권2호
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• pp.65-69
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• 2004

Purpose: The purpose of this study is to evaluate the short-term clinical outcome of the capsulolabral repair using absorbable suture anchor in traumatic anterior instability of shoulder. Materials and Methods: From June 2000 to September 2001, 15 shoulders with recurrent anterior instability were operated with arthroscopic Bankart repair using absorbable suture-anchor 'PANALOK' (Mitek, westwood, MA), and were followed up over 1 year (average; 13 months). The mean age was 23-years. There were fourteen males and one female. The mean duration from the initial symptoms to the operation was 24 months. Associated pathologies were Hill-Sachs defect in 12 cases, SLAP in 6 cases, and partial rotator cuff tear in 2 cases. The results were evaluated by patien's satisfaction, Modified Rowe Score in regard to joint stability, mobility, pain and function in comparison with the preoperative ones, and other complications. Results: At the last follow-up, the total Rowe Score increased from 38 points to 92 points. There were no recurrence and 14 patients among 15 patients gained pre-operative level of sports activity and no other complications. Conclusion: Effective capsulolabral repair could be obtained by the absorbable anchoring without any untoward complications. This procedure is simple and safe one and this system can be a good substitute for the metallic anchor.

• 대한관절경학회지
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• 제10권2호
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• pp.187-191
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• 2006

전방 십자 인대 재건술 후 대퇴 간섭 나사가 후방 구획으로 전위된 예는 극히 드물게 보고되고 있다. 이는 대개의 경우 기계적인 증상을 일으키므로 수술적인 제거술이 요구된다. 그러나 나사를 관절경적으로 제거하는 것은 기술적으로 어려운 술기이며 특히, 나사가 후방 구획으로 이동되었으나 전방 십자 인대가 잘 유지되어 있는 경우, 혹은 나사 주위가 막으로 둘러 쌓여 있을 경우 관절경적 제거는 더욱 어렵다. 저자들은 전방 십자 인대 재건술 후 재건 인대가 생착된 11년 후에 대퇴 간섭 나사가 후방 구획으로 전위된 1예를 보고하고자 한다. 저자들은 경우 가장 힘든 후방 구획에 위치한 전위된 대퇴 간섭 나사를 전방십자인대 이식건의 손상 없이 후방 경격막 도달법을 이용한 관절경적으로 제거하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.120-125
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• 1999

Objectives : To evaluate the effects of arthroscopic acromioplasty and debridement for partial thickness articular side rotator cuff tears, Method: We divided 97 patients into 2 groups according to treatment protocol, with both groups having confirmed intra-articular partial tears of the rotator cuff. In group Ⅰ, we debrided the frayed and fibrotic cuff margin while in group II, we performed subacromial decompression in addition to debridement. After the surgery we checked all the patients with the modified UCLA shoulder rating scale. Results: The follow-up observation 12 months after surgery revealed that 44 patients in group I were rated as excellent in 32 cases, good in 10 cases, fair in 1 case, and poor in one case, while 53 patients in group II, were rated as excellent in 38 cases, good in 17 cases, and fair in 2 cases. Twenty-four month after surgery we observed that patients in group I were rated as excellent in 23 cases, good in 16 cases, fair in 4 cases, and poor in 1 case, while patients in group II were rated as excellent in 34 cases, good in 17 cases, and fair in 6 cases. Conclusion: The use of acromioplasty on partial thickness tears of rotator cuff, even in the cases of intra-articular nature, is preferable to the procedure performed without it.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.180-188
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• 2009

목적: 회전근 개 건 전층 파열 시 관절경적 교량형 봉합술 시행 후 단기 추시 관찰을 통해 이 술식의 임상적 결과에 대해 알아보고자 하였다. 대상 및 방법: 회전근 개 건 전층 파열로 관절경적 교량형 봉합술을 시행 받고 조기 재활을 시행한 29명 (남자:17명, 여자:12명)의 환자를 대상으로 시행하였다. 평균 나이는 56.4세 (34~73세)였으며 추시 관찰 기간은 평균 13개월 (12~15개월)이었다. 임상적 및 기능적 평가로 The University of California at Los Angeles (UCLA) score, The Korean Shoulder Scoring system (KSS) 및 Visual Analogue Scale (VAS) score를 이용하였다. 15예에서 최종 추시시 자기 공명 영상을 촬영하여 Sugaya 분류를 통해 회전근 개의 구조적 상태를 분석하였다. 결과: 수술 후의 UCLA score는 수술 전과 수술 후 각각 16.4에서 31.6으로 측정되어 유의할만한 호전을 보였고 (p< 0.05), KSS는 수술 후 6개월에 88이었고, 최종 추시 시 92로 측정되었다. VAS score는 수술 전 8.6에서 수술 후 3개월에 2.1로, 수술 후 6개월에는 1.4로 나타났다. 28예 (96.5%)에서 수술 후 관절 운동 범위가 증가되었다. 추시 시 자기 공명 영상을 촬영한 15예에서 Sugaya 분류에 의해 I형이 6예, II형이 7예, III형이 1예, V형이 1예이었다. 결론: 회전근 개 건 전층 파열에 대한 관절경적 교량형 봉합술을 이용한 회전근 개 봉합술은 임상적으로 96.5%에서 양호 이상의 만족할 만한 결과를 보였으므로 믿을 만한 수술적 방법 중 하나라고 생각한다.