• Title/Summary/Keyword: Arthroscopic removal

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Arthroscopic Capsular Repair without Relaying Sutures: 'Simple Sewing Technique'

  • Kim, Hyungsuk;Song, Hyun Seok;Kang, Seung Gu;Han, Sung Bin
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.146-148
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    • 2019
  • We report a simple technique for repairing capsular tear, using only a hook-like, cannulated instrument and braided sutures without relaying steps. A No. 2 braided suture is passed through the lumen of the instrument. Under direct arthroscopic view, the tip of the instrument is passed through the side of the capsule that has previously been separated with the probe. One end of the suture is retrieved with a grasper through a separate portal. The tip is moved back without withdrawing through the skin, and reinserted into the other side of the capsule. Holding the end retrieved earlier, the other end of the suture is retrieved with a suture retriever. After complete removal of the instrument, the suture is tied through a cannula using the standard knot tying techniques. The same procedures are repeated for other required knots.

Results of Arthroscopic-assisted Minimally Invasive Removal of a Lateral Periarticular Plate used for the Treatment of AO Type-C Distal Femoral Fractures (AO C-형 원위 대퇴골 골절의 치료로 삽입된 관외측 금속판의 절경 보조하 최소 침습적 제거의 결과)

  • Kim, Young-Mo;Lee, June-Kyu;Yang, Jae-Hoon;Kim, Bo-Kun;Lee, Won-Gu
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.46-52
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    • 2009
  • Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

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Exploratory Arthroscopic Treatment to Diagnose and Treat Osteochondritis Dissecans of the Shoulder Joint in a Dog (개의 어깨 관절에서 박리성 골연골염의 진단과 치료를 위한 탐색적 관절내시경의 적용)

  • Kim, Choong-Sup;Lee, Hae-Beom;Choi, Ul Soo
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.146-149
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    • 2013
  • A 6-month-old, intact male Great Pyrenees (35 kg) was referred with 2 weeks continuous left forelimb lameness to the Chonbuk Animal Medical Center, College of Veterinary medicine, Chonbuk National University. The lameness became worse three days before being referred to the hospital. Upon the physical examination, the patient had pain when the left shoulder joint was palpated, and the lameness was visible in the left forelimb during ambulation on gait examination. There were no remarkable findings on radiological and neurological examination. Osteochondritis dissecans (OCD) was suspected based on medical history and gait tests. As a definitive diagnosis could not be made, exploratory arthroscopic surgery was performed to examine the inside of the shoulder joint. During the operation, mild bicipital tenosynovitis, synovitis and OCD which was located on the caudal medial area of humeral head were revealed. Arthroscopic procedures were used for the treating OCD, including the removal of the OCD flap and debriding of the subchondral defect until hemorrhaging by use of an electrical burr. The patient was discharged a day after surgery. After 2 weeks, the patient again presented at the hospital due to complications, including inflammation of the surgical lesion because of licking and seroma within the subcutaneous tissue. Antibiotics were administered and an aseptic bandage was applied. And simple surgical operations were performed for the removal of the cyst and seroma. Eleven weeks following arthroscopy, the lameness was completely resolved. Arthroscopy has the advantage of allowing gross examination inside the joint capsule. Due to this advantage, arthroscopy is one of the best advanced options for diagnosis in dogs with undiagnosed joint pain.

Arthroscopic Cannulated Screw Fixation Technique for Avulsion Fracture of the Intercondylar Eminence of the Tibia (삽관 나사못(Cannulated screw)을 사용한 경골 과간 융기부 견열 골절의 관절경적 치료 기법)

  • Lee, Kee-Byoung;Chang, Ho-Guen;Lee, Seok-Beom;Moon, Young-Wan;Kang, Ki-Hoon;Lee, Wook-Hyung
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.127-131
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    • 1999
  • Avulsion fractures of the intercondylar eminence of the tibia are not uncommon. In the displaced avulsion fracture, anatomical reduction and firm fixation of fracture fragments are needed but the most of the conventional operative techniques including arthroscopic technique are relatively complex and need. The results were not always satisfactory due to the risk of postoperative complications such as wound infection, premature epiphyseal closure and loss of fixation after early motion etc. So we describe a simple and safe modified method of arthroscopic reduction and fixation for avulsion fractures of the intercondylar eminence of the tibia. In our thirteen cases, we achieved anatomical reduction and secure fixation using cannulated screw through the three arthroscopic portals (anterolateral, medial mid-patellar and central). Postoperatively, immediate limited range of motion of the knee and partial weight bearing were possible. Additional use of the washer afforded safe fixation of comminuted avulsion fracture. The advantage of this technique includes its technical simplicity, easy removal of hardware, ability to treat comminuted type IV fracture with washer, no additional skin incision, no damage to growing plate in growth children and less morbidity.

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Arthroscopic Treatment of Acute Acromioclavicular Dislocation using $TightRope^{(R)}$ ($TightRope^{(R)}$를 이용한 관절경적 급성 견봉쇄골 관절 탈구의 치료)

  • Kim, In-Bo;Shon, Myung-Hwan;Kim, Moon-Chan;Kim, Dong-Jun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.13-18
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    • 2011
  • Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

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Arthscopic Treatment of Osteochondritis Dissecans in Femoral Condyle (관절경을 이용한 대퇴골과 박리성 골연골염에 대한 치료)

  • Kim Sung-Jung;Kyung Hee-Soo;Ihn Joo-Chul;Lee Seong-Man
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.138-143
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    • 2000
  • Purpose : We analyzed clinical and radiological results of the treatment of osteochondritis dissecans in the femoral condyle under arthroscopic guidance. Materials and Methods : The study group consists 19 cases in 17 patients. Average follow up period was 34 months and average age was 16 years. The cases were classified by 4 different groups, using the fellowing system: Group 1-stable lesion and no specific treatment after arthroscopic examination; Group 2-early separation and multiple drilling; Croup 3-unstable lesion and Herbert screw fixation; Croup 4-loose body removal and/or crater curettage. The results were analyzed by the criteria of Hughston which including clinical and radiologic outcomes. Results : There were 14 cases$(74\%)$ of good and excellent results in 19 knees in which, $75\%$(3/4) in Group 1, $75\%$(3/4) in Group 2, $86\%$(7/8) in Group 3 and $33\%$(1/3) in Group 4. The result of Herbert screw fixation group was better than that of other groups with statistically significant differences. Conclusion : In the treatment of osteochondritis dissecans of skekletally immature patients, arthroscopic finding was reliable guidance in decision of treatment method and active fixation was recommended in patients with large, unstable lesion.

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Arthroscopic Treatment for Residual Pain after Ankle Fracture (족근관절 골절 치료후 발생한 동통에 대한 관절경의 이용)

  • Lee Beom Koo;Park Hong Kee;Seong In Ho;Kim Keon Beom;Jang Young hun;Choi Jang Seok
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.61-66
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    • 2000
  • Purpose : The diagnosis of the causes of residual pain after ankle fractures and the treatment is not simple. The authors analyzed the clinical results of the patients with residual pain after ankle fracture fur whom ankle arthroscopy was undertaken, for the purpose of evaluating the efficacy of arthroscopic diagnosis and treatment. Materials and Methods : From January 1997 to June 1998, ankle arthroscopy was done for the seventeen patients suffering from residual ankle pain and limitation of motion after ankle fracture. Their symptoms were not improved despite conservative treatment. There were sixteen men and one woman, and their mean age was 37.4 years. Result : Radiological examination revealed loose bodies in two patients, and osteophytes at the anterior rim of the tibia in fourteen patients. By the classification of osteoarthritic change, three ankles were assigned to grade 0, eight to grade I, six to grade II, and none to grade III. On arthroscopic examination, soft tissue impingement was found In thirteen cases, loose bodies in five cases, and osteochondral lesions in four cases. For arthroscopic treatments, removal of soft tissue, abrasion of osteophytes, cartilage shaving and removal of loose bodies were done. Clinical results were evaluated using Evanski and Waugh score. Preoperative overall score of 58.7 points jumped to 74.6 points after the operation, and in fourteen patients$(82\%)$ the symptoms were improved. Conclusion : Ankle arthroscopy is considered to be a very useful diagnostic and treatment method fer the patients with residual complaints after ankle fracture.

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Synovial Chondromatosis of the Glenohumeral Joint Presenting as Impingement Syndrome - Case Report - (충돌증후군 증상을 유발한 견관절의 활막 연골종증 - 증례 보고 -)

  • Lee, Dong-Hun;Noh, Young-Min;Chang, Jun-Dong
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.202-206
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    • 2006
  • Synovial chondromatosis is an uncommon condition and involvement of the glenohumeral joint is rare comparing its involvement of knee and hip. We report a case of synovial chondromatosis with its radiography, MRI and microscopic findings and treatment by arthroscopic synovectomy & loose body removal which have been developed in right shoulder of a 46 year-old-female and presented as impingement syndrome.

Atypically Large Calcific Tendinitis of the Shoulder: A Case Report

  • Kim, Jin Wan;Moon, Kyu Pill;Kim, Kyung Taek;Hwang, Youn Soo;Park, Won Seok
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.241-244
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    • 2016
  • Calcific tendinitis of the shoulder joint is common disease causing acute pain, mainly involving the supraspinatus or infraspinatus muscle, and less frequently the teres minor or subscapularis muscle. This study reports on the satisfactory arthroscopic removal of calcium deposits as well as infraspinatus and supraspinatus muscle repair without relapse via minimal incision using suture anchors. This was a case of atypically extensive calcific tendinitis involving the infraspinatus muscle, with a bursal side partial rupture of the supraspinatus muscle in a 61-year-old female whose chief complaint was chronic pain of the right shoulder exacerbated by limited movement.

Osteochondral Fracture on the Articular Surface of the Medial Malleolus of the Tibia - A Case Report - (경골 원위부 내과 관절면에 발생한 골연골 골절 - 1례 보고 -)

  • Kang, Jae-Do;Kim, Hyung-Chun;Kyoung, Chi-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.1
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    • pp.35-38
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    • 2000
  • Osteochondral fracture is common in adolescent and usually occurs in the knee and ankle. Many authors have written concerning osteochondral fracture of the ankle joint, however, many of these pertain only to the talus. The author has found an osteochondral fracture of the articular surface of the medial malleolus within the ankle joint not previously described. We report a case of this lesion that was treated by arthroscopic osteochondral fragment removal.

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