• Title/Summary/Keyword: Arthroscopic removal

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Clinical Outcome and Arthroscopic Evaluation of Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술의 임상적 결과 및 이차적 관절경 소견)

  • Song, Eun-Kyoo;Seon, Jong-Keun;Lee, Kyoung-Jai;Kim, Hyung-Soon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.28-34
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    • 2010
  • Purpose: The aim of this study was to evaluate short-term clinical results and second-look arthroscopic findings after double-bundle anterior cruciate ligament (DB ACL) reconstruction. Materials and Methods: Forty-nine patients, who were followed up for at least 24 months after DB ACL reconstruction, were included. Clinical results, such as, Lysholm knee and Tegner activity scores, and manual laxity and instrumented anterior laxity test results were evaluated. In fifteen patients (15 knees), second-look arthroscopy with staple removal was performed. At second-look arthroscopy, the authors assessed about reconstructed ACL rupture, subjective graft tension and extent of synovial coverage. Results: Lysholm knee scores significantly improved from 67.4 preoperatively to 96.1 at last follow-up (p<0.01). Tegner activity scale improved from 2.0 to 6.1. The Lachman test, at last follow-up, showed normal laxity in 39 (of 49) patients, and the pivot-shift test showed normal laxity in 36 (of 49) patients. Mean side-to-side differences improved significantly from 10.8 mm to 3.3 mm (p<0.01). Second-look arthroscopic findings showed that all patients had a normal or a near normal anteromedial bundle. However, 8 patients (53.3%) were found to have partial or complete posterolateral bundle rupture. Conclusion: Even though double-bundle ACL reconstruction was clinically effective means of restoring knee rotational and anteroposterior stabilities, there were some ruptured posterolateral bundles observed in cases under arthroscopy after double-bundle ACL reconstruction.

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Arthroscopic Management for the Treatment of Ankle Gutter Syndrome (족 관절 구 증후군에 시행한 관절경적 치료)

  • Choi Chong Hyuk;Park Jin-Oh;Ogilvie-Harris D. J.
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.54-60
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    • 2000
  • Purpose : The purpose of this study was to evaluate the gutter pathologies and the clinical results of arthroscopic treatment for ankle gutter syndrome. Materials and Methods : Seventy six patients(77 ankles) who had lesions in the ankle gutter were treated by arthroscopy. The gutter pathology could be divided into 3 categories; hypertrophic scar tissue, loose bodies and bone spurs. Fifty two patients were evaluated subjectively and functionally with authors' criteria. The follow-up period averaged 44 months(range, 2.9 year-8.5 year). Results : The incidence of the gutter lesion was $21\%$(77 ankles) among 366 ankles undergoing arthroscopy. The most common pathology was hypertrophic scar tissue. In 31 ankles$(40\%)$, the lesions were found only in gutter, and 46 ankles$(60\%)$ were associated with pathologies in other areas. All of parameters for subjective and functional evaluation were improved with statistical significance(p<0.001). Seventeen patients$(33\%)$ could returned to competitive or contact sports activity with same level of premorbid period. Conclusion : Ankle gutter is an important site of pathologies which cause chronic ankle pain, and should be explored in ankle arthroscopy. The ankle arthroscopy is a very effective treatment method fur the removal of pathologies in ankle gutter syndrome.

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Arthroscopic Management in Chronic Osteomyelitis (만성 골수염의 내시경적 처치 - 증례 보고 2예 -)

  • Lee Beom Koo;Eom Gi Serk;Ki Yong Chul;Cho Hyun Yee
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.192-194
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    • 2002
  • The goal of surgery of chronic osteomyelitis is removal of dead bone and achieving a viable and vascular environment. During saucerization, the sequestrum could be checked and resected completely. But it can causes vascular injury by massive soft tissue dissection in saucerization of chronic osteomyelitis. Recently, we experienced medulloscopy in the treatment of chronic osteomyelitis and it is possible for us to visualize the sequestrum, to do complete resection of dead bone and to reduce vascular injury during operation.

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Shoulder Impingement Caused by Superiorly Displaced Glenoid Fracture Fragment at a Boy - A Case Report - (소아에서 생긴 견갑골 관절와 골절편의 상방 전위에 의한 견관절 충돌 운동 장애 - 증례 보고 -)

  • Jeong, Kyoung-Il;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Choi, Hun-Sik;Park, Gee-Kang
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.231-234
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    • 2006
  • We experienced a case of impingement caused by a bone fragment which was impacted between acromion and humeral head in a child. The bone fragment came from antero-inferior glenoid fracture. Satisfactory clinical results and stability were obtained by arthroscopic bone fragment removal. In case that bone fragment is located in the upper shoulder joint and results in impingement, We must consider not only greater tubercle fracture but also glenoid fracture. Magnetic resonance imaging can assist in the preoperative diagnosis.

Notchplasty for Treatment of Impingement of the Cranial Cruciate Ligament on Osteophyte in a Cat

  • Hong, Youngchae;Park, Jiyoung;Choi, Ho-Jung;Lee, Young-Won;Jeong, Seong Mok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.459-462
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    • 2017
  • A 3-year-old, 5.6 kg, castrated, male, British short hair cat presented with subtle weight-bearing lameness of the right hindlimb when walking suddenly after rest. On physical examination, the patient experienced pain when the right stifle joint was hyperextended. There was no clinical improvement of lameness or pain of the right hindlimb, despite the administration of analgesic drugs for one week. During diagnostic arthroscopy of right stifle, mild synovitis and cranial cruciate ligament (CCL) impingement on osteophyte of the intercondylar notch (ICN) was observed. Computed tomography was applied to determine an accurate surgical plan. Arthroscopy-assisted notchplasty, including removal of the osteophyte, was performed using chisel and arthroscopic burr. At 4 weeks postoperatively, the frequency of subtle weight-bearing lameness of the right hindlimb was significantly reduced. At 6 months postoperatively, the patient exhibited normal ambulation without recurrence of lameness. Impingement of CCL may cause subtle lameness and pain. Arthroscopy can be a good diagnostic tool for early-stage CCL disease. Notchplasty can be recommended for osteophyte-induced CCL disease.

Secondary contouring of flaps

  • Kim, Tae Gon;Choi, Man Ki
    • Archives of Plastic Surgery
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    • v.45 no.4
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    • pp.319-324
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    • 2018
  • Perforator flaps are becoming increasingly common, and as primary thinning techniques are being developed, the need for secondary contouring of flaps is decreasing. However, many reconstructive flap procedures still incorporate secondary debulking to improve the functional and aesthetic outcomes. Direct excision, liposuction, tissue shaving with an arthroscopic cartilage shaver, and skin grafting are the four major methods used for secondary debulking. Direct excision is primarily applied in flaps where the skin is redundant, even though the volume is not excessive. However, due to the limited range of excision, performing a staged excision is recommended. Liposuction can reduce the amount of subcutaneous tissue of the flap and protect the vascular pedicles. However, the main drawback of this method is its limited ability to remove fibrotic tissues, for which the use of a shaver may be more convenient. The main drawback of using a shaver is that it is difficult to simultaneously remove excess skin. Skin grafting enables the removal of sufficient excess tissue to recover the contour of the normal limb and to improve the color match, facilitating excellent aesthetic results.

Multiple Rice Bodies in Subacromial Space - A Case Report - (견봉하 공간의 다발성 미립체 - 증례 보고 -)

  • Min, Kyoung-Dae;Ryu, Ki-Hoon;Lee, Jae-Sang;Lee, Byung-Ill
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.232-235
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    • 2007
  • Multiple rice bodies are a rare disorder that is most commonly observed in chronic rheumatoid arthritis patients and as a complication of chronic inflammation in the bursa. However, it can occur in the absence of an underlying systemic disorder. Although it resembles synovial chondromatosis clinically and on imaging, the condition can be discriminated by an analysis of the radiographic and MR appearances. We encountered a case of multiple rice body formation with subacromial bursitis on the shoulder of a 37-year old man suffering from pain and motion limitation. The patient was treated by arthroscopic removal of the multiple rice bodies and a subacromial bursectomy. We present this case with a review of the relevant literature.

Arthroscopically-Assisted Reduction and Internal Fixation of Intra-Articular Fractures of the Lateral Tibial Plateau (관절면을 침범한 경골 외측 고평부 골절에 대한 관절경을 이용한 정복 및 내고정술)

  • Kim, Juhan;Kim, Dong Hwi;Lim, Jae-Hwan;Jang, Hyunwoong;Kim, Young Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.227-236
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    • 2019
  • Purpose: To evaluate the results of tibial lateral plateau fractures using arthroscopic-assisted reduction and internal fixation without cortical window or bone grafts. Materials and Methods: From March 2009 to March 2017, 27 patients with Schatzker type II tibial plateau fractures with articular depression and displacement over 5 mm on a computed tomography (CT) scan, who were treated with arthroscopic reduction and internal fixation and followed-up for at least 18 months, were enrolled in this study. Under arthroscopic guidance, the depressed fracture fragment was reduced using a freer and fixed with 5.0 or 6.5 mm cannulated screws through the inframeniscal portal without a cortical window or bone graft. The clinical and radiological results were evaluated using a Rasmussen system. Second look arthroscopy was performed in thirteen patients during the implant removal operation. Results: All fractures healed completely with a mean union time of 8.7 weeks (range from 8 to 12 weeks). Twenty four patients had good to excellent clinical results and 25 patients had good to excellent radiological results according to the Rasmussen classification. A well-healed articular surface with fibrocartilage was also found in 13 cases with second look arthroscopy. The 8 cases on CT scan at outpatient department follow-up showed bone union without bone grafting. Conclusion: Arthroscopic-assisted fixation of tibial lateral plateau fractures is a useful method without a cortical window or bone graft that produces good clinical results.

Arthroscopy for the Diagnosis and Treatment of Failed Trochleoplasty in a Dog (활차구 성형술이 실패한 개에서 관절경을 이용한 진단과 치료)

  • Hwang, Junho;Heo, Suyoung;Kim, Bumseok;Lee, Sanghoon;Jeong, Seongmok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.251-254
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    • 2015
  • A 3-year-old castrated male Spitz dog (8.4 kg) was referred for hindlimb lameness. The dog had undergone corrective surgery for bilateral medial patellar luxation 6 weeks prior to presentation. Intermittent lameness of both hind limbs was evident on general inspection. Physical examination revealed moderate pain and crepitus upon flexion and extension of the stifle joints. Radiography revealed features consistent with distal deviation of the cartilage flaps and effusion in both stifle joints. Detachment and deviation of both osteochondral blocks were suspected based on the physical and radiographic findings. Arthroscopy confirmed failed osteochondral blocks (right $1.5cm{\times}0.9cm{\times}0.2cm$, left $1.3cm{\times}0.9cm{\times}0.1cm$), which were removed. After removal of the osteochondral blocks, the stepped trochlear grooves were located and debrided using an arthroscopic burr, to prevent patellar tracking disorder. The dog resumed normal ambulation without medial patellar luxation 2 weeks postoperatively, and there were no complications. Arthroscopy is an effective surgical modality for the diagnosis and treatment of canine joint disorders. It offers a magnified view of the joint, which allows accurate evaluation of intra-articular structures. In addition, arthroscopic surgery can reduce the postoperative complications associated with surgical wound.

A Suture Bridge Transosseous-Equivalent Technique for Bankart Lesions with Deficient Bony Stability - Technical Note - (골안정성 결손을 가진 Bankart 병변에 대한 경 골-유사 교량형 봉합술식 - 술기 보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Chae, Sung-Bum
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.179-182
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    • 2009
  • Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

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