• Title/Summary/Keyword: Arthroscopic procedure

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Advantages of Scorpion Suture Passer and 70 Degrees Arthroscope in Arthroscopic Bankart Repair: Usefulness for Inferior Labral Repair

  • Hyun, Yoon-Suk;Shin, Woo-Jin
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.201-207
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    • 2017
  • Background: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a $70^{\circ}$ arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. Methods: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a $30^{\circ}$ arthroscope in the conventional group, but two portals and a $70^{\circ}$ arthroscope as well as the $30^{\circ}$ one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. Results: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the $70^{\circ}$ arthroscope. Conclusions: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a $70^{\circ}$ arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.

The Role of Ankle Arthroscopy in Patients with Chronic Ankle Pain (만성 족관절통 환자에서의 족관절 관절경 소견)

  • Kim, Seung-Ho;Ha, Kwon-Ick;Han, Kye-Young
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.164-167
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    • 1998
  • The purpose of this study is to evaluate the significance of arthroscopic examination in patients with chronic ankle pain. Eighty eight arthroscopic procedures were conducted due to symptoms of chronic ankle pain. The pathology of the 88 ankles could be categorized into four groups ; 22 anterior impingement syndrome, 20 anterolateal impingement syndrome, 22 instability and 20 osteochondral lesion, 59 of patients(67.0%) had trauma history and 14(15.9%) of patients had injured chronic repetitive microtrauma. During the arthroscopic procedure, we found unexpected chondral lesions of high incidence(39.1%). These lesions were not detected both by the physical examination and radiologic examinantion. These pathologies were treated during the course of arthroscopic procedure. We concluded that ankle arthroscopy may be a very useful and therapeutic tool in the patients who have not reponded to the conservative treatment. And due to high incidence of intra-articular pathology in patients with chronic ankle pain, arthroscopic examination should be performed prior to final decision.

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Arthroscopic Bridging Repair Using Human Dermis Allografts for Irreparable Rotator Cuff Tears

  • Jeong, Ju Seon;Kim, Moo-Won;Kim, In Bo
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.84-89
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    • 2016
  • Background: The purpose of this study was to assess the results of arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Methods: From November 2009 to April 2011, 12 patients underwent arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Patients were followed for an average of 33.9 months. Clinical outcome was evaluated preoperatively and postoperatively using the mean University of California, Los Angeles (UCLA) score and the Korean Shoulder Scoring System (KSS). Magnetic resonance imaging (MRI) was performed postoperatively at an average of 6.5 months. Results: At a mean follow-up of 33.9 months (range, 25 to 42 months), 11 out of 12 patients were satisfied with their procedure. Patients showed significant improvement in their mean modified UCLA score from 15.9 preoperatively to 29.4 postoperatively (p=0.001). The mean KSS score improved from 45.6 preoperatively to 80.5 postoperatively (p=0.002). In MRI studies, 9 out of 12 patients had full incorporation of the graft into the native rotator cuff remnant. To date, there has been no intraoperative or postoperative complication from the graft procedure, such as infection or allograft rejection, in any patient. Conclusions: Arthroscopic bridging repair using a human dermis allograft can be considered as an option in treatment of select cases of massive irreparable rotator cuff tears, resulting in high patient satisfaction.

Arthroscopic Reduction of Irreducible Knee Dislocation - A Case Report - (정복 불가능한 슬관절 탈구의 관절경적 치료)

  • Jeong, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.161-164
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    • 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.

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A Development of Disposable Arthroscopic Shaver (디스포저블 관절경 수술기의 개발)

  • Chee Youngioon;Lim Chanyang;Youn Jae-Woong
    • Journal of the Korean Society for Precision Engineering
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    • v.22 no.10 s.175
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    • pp.218-224
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    • 2005
  • Arthroscopy is a surgical procedure orthopedic surgeons use to visualize, diagnose and treat problems inside a joint. In usual, since the arthroscopic surgery is more accurate and minimally invasive than through 'open' surgery, the surgery of knee, shoulder, and wrist using auto-shaver is increasing in recent. However, repetitive use of arthroscopic-shaver may induce the second infection, hence the disposable arthroscopic-shaver should be developed. In this paper, a unique power transmission mechanism using DC motor, gear trains, and link mechanism is proposed for disposable arthroscopic-shaver and some test results of tissue cutting are introduced.

Additional Thermal Shrinkage in Treatment of Recurrent Traumatic Anterior Shoulder Instability (만성 외상성 견관절 전방 불안정성의 치료에서 병행한 관절낭 열 수축술)

  • Kim Seung-Ki;Song In-Soo;Moon Myung-Sang;Lin Guang
    • Clinics in Shoulder and Elbow
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    • v.7 no.2
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    • pp.76-82
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    • 2004
  • Purpose: In the traumatic anterior shoulder instability, the laxity of joint capsule and ligament is frequently demonstrated. Although a arthroscopic procedure to address anterior instability with joint capsular redundancy have generally provided good results, its recurrence rate is higher than open procedure. By reducing the capsular redundancy, thermal shrinkage is likely to improve the outcome of arthroscopic anterior stabilization. The objective of this study was to evaluate additional thermal capsular shrinkage as a treatment of joint capsular redundancy in anterior shoulder instability. Materials and Methods: From March 1999 to June 2000, 25 shoulders of 23 patients of recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with shrinkage procedure. The mean follow up was 29 months and average age at the time of operation was 26 years. Of these patients, 20 were male and 3 were female who had been experienced the average 8 times of dislocation before operation. Thermal shrinkage alone without Bankart repair was performed in two cases who did not have Bankart lesion. The clinical result was evaluated in according to Modified Rowe Score. Results: The Modified Rowe Score was improved from preoperative 35 points to postoperative 88 points. None of cases showed recurrence of dislocation. But, in two cases, temporary sensory hypesthesia of the axillary nerve was developed and in two cases of postoperative stiffness, arthroscopic capsular release and brisement were performed. Conclusion: Additional capsular shrinkage in arthroscopic technique to address recurrent anterior shoulder instability could treat effectively the capsular redundancy.

Treatment of Chronic Ankle Lateral Instability using Modified Br$\ddot{o}$strom Procedure with Anchor suture & Arthroscopy (봉합 나사를 이용한 변형 Br$\ddot{o}$strom 술식 및 관절경 검사를 이용한 족관절 외측 불안정성의 치료)

  • Lee, Jin-Young;Kim, Gab-Lae;Lee, Eun-Soo;Park, Hyun-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.175-178
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    • 2009
  • Purpose: To evaluate the result of modified Br$\ddot{o}$strom procedure with anchor suture and explore associate lesion under arthroscopy for chronic lateral instability. Materials and Methods: From May 2005 to March 2009, Retrospective analysis of 126 patients with chronic lateral instability who underwent modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure was done. Mean follow-up period was 13 months. Results: Chronic lateral instability of the ankle almost had local synovitis by arthroscopic examination. There were osteochondral lesion of talus on the anteromedial aspect in 63 cases, on the anterolateral aspect in 25 cases, osteochondral lesion of tibia side in 8 cases, fat hypertrophy of tibiofibular space in 120 cases, anterior fat impingement in 26 cases, intra-articular loose body in 13 cases. Mean Karlsson scoring scale was improve from 53 preoperatively to 91 postoperatively, There were 70 cases excellent, 27 cases good, 26 cases fair, 3 cases poor result according to the Sefton procedure. Conclusion: Modified Br$\ddot{o}$strom procedure with anchor suture and arthroscopic procedure are reliable treatment method for chronic ankle lateral instability which has intraarticular pathology.

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Partial Tear of Upper Portion of Subscapularis (견갑하근 상 1/3 파열)

  • Kim Dong-Hui;Kim Kug-Jin;Moon Young-Lae
    • Clinics in Shoulder and Elbow
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    • v.8 no.1
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    • pp.9-13
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    • 2005
  • An isolated tear of the subscapularis is uncommon, and there are a few literatures regarding the treatment of this problem. But, the incidence has increased with development of the arthroscopic techniques. An all-arthroscopic rotator cuff repair is a challenging procedure that can be effectively performed for treatment of subscapularis tendon tears. Often, tears of the subscapularis tendon do not involve entire tendon, and retraction of the torn edge is within to 2 cm of its attachment site. Occasionally, the entire tendon is torn and retracted medially to the glenoid. This article outlines the examination, preoperative planning and details the steps necessary to perform this procedure on upper third of subscapularis tears.

Arthroscopic supraspinatus advancement for retracted rotator cuff tears: a technical note

  • Chris Hyunchul Jo;Pei Wei Wang
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.328-333
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    • 2022
  • Irreparable rotator cuffs with retracted torn ends remain a significant challenge for most shoulder surgeons. Since repairs are preferable to reconstruction or replacement whenever possible, studies for anatomical reductions with minimal tension and secure fixation are important. In this study, the authors introduce an arthroscopic supraspinatus advancement (ASSA) procedure for retracted rotator cuff tears that could not be adequately reduced to the original footprint. Using modified long, narrow, curved Cobb elevators, procedures can be performed through lateral portals without any additional skin incision. Following meticulous stepwise three-compartment elevation procedures based on the supraspinatus insertion anatomy, the supraspinatus muscle could be safely elevated from the fossa and sufficiently advanced laterally. The authors suggest that ASSA could be a useful procedure for management of challenging retracted rotator cuff tears by maximizing lateral excursions that could convert irreparable tears to reparable tears in select patients.

The Results of Bankart Repair for Anterior Instability of the Shoulder - Arthroscopic versus Open Bankart Procedure - (견과절 전방 불안정성에 대한 Bankart 술식의 결과-관절경적 술식과 관혈적 술식의 결과 비교-)

  • Rhee Yong Girl;Park Jae Young
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.60-73
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    • 1999
  • Purpose : The purpose of this study was to compare patients with anterior shoulder instability who were treated with an open Bankart procedure with those treated with an arthroscopic procedure, and to evaluate factors influencing the final outcomes and recurrence. Materials & Methods : One hundred seven shoulders underwent open Bankart repair, and fifty-one shoulders were treated arthroscopically. Average followup for open group was 34 months, and for arthroscopy group was 25 months. The Bankart Rating System by Rowe was used to evaluate the clinical outcome of the procedure. And, the patients were asked about any changes concerning their sports and professional activities. Results: According to Bankart Rating system by Rowe, open group had 97% fair to excellent results with 2 recurrent dislocation(1.8%) and 4 recurrent subluxation(3.6%), and arthroscopy group had 94% fair to excellent results with 3 recurrent dislocation(5.8%) and 4 recurrent subluxation(8%). In open group, 9 shoulders(8.4%) had the mild limitation of range of motion at the time of followup, and 2 shoulders(3.9%) in arthroscopy group. Age and gender do not seem to be a significant factor contributing to an increased re-recurrence rate. The incidence of re-recurrence seems to be affected by dominance, frequency, and patient's activity. The size of Bank art lesion might be also considered as a contributing factor. Conclusion: Either open or arthroscopic Bankart procedures are safe and effective methods with acceptable results if an adequate patient's selection, precise surgical technique and proper postoperative care are done. And arthroscopic surgery could be considered if the anterior instability is non-dominant, non-athlete, traumatic unidirectional and Bankart lesion has minimal erosion of the glenoid and it has thick and mobile labrum.

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