• Title/Summary/Keyword: Arthroscopic treatment

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Arthroscopic Treatment of Rotator Cuff Lesion

  • Rhee Yong Girl
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1998.03a
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    • pp.15-19
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    • 1998
  • The arthroscopic treatment may prove to be the desirable method, but this arthroscopic technique cannot be appliable to all surgeons and all patients, It should be determined on the base of type of lesion, effectiveness of arthroscopic procedure, and the surgeon's skill. The Key to an excellent result in arthroscopic treatment of rotator cuff lesion is doing a proper diagnosis, well-established arthroscopic technique and following through a well-designed rehabilitation program.

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Arthroscopic Repair versus Non-operative Treatment of First-time Traumatic Anterior Shoulder Dislocations: A Numbers-needed-to-treat Analysis for Prevention of Recurrent Dislocations

  • Park, Jihong;Cosby, Nicole L.
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.110-116
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    • 2016
  • Background: Arthroscopic surgical repair is a better intervention than non-operative (conservative) treatment for patients with shoulder dislocations. This systematic review determined the numbers-needed-to-treat (NNT) and relative risk reduction (RRR) associated with arthroscopic surgical repair versus non-operative treatment in reducing recurrence rates among patients with first-time traumatic anterior shoulder dislocations. Methods: We searched Google Scholar, MEDLINE, SPORTDiscus, and CINAHL from inception in 2015. All articles had to compare arthroscopic surgical repair and non-operative treatment and be written in English. We used the total number of subjects and the number of recurrent dislocations within each treatment to calculate the NNT and RRR for each study and the pooled data. Results: Six articles were selected and all clearly demonstrated that the arthroscopic surgical repair was more effective than non-operative treatment in reducing the recurrence episodes. The pooled NNT was 1.76 (95% confidence interval [CI]=NNT to benefit 1.50-2.13) and the pooled RRR was 86.0% (95% CI=77.0%-92.0%) among individuals who underwent arthroscopic repair. The average follow-up time was 56 months. Conclusions: A Strength of Recommendation Taxonomy level of evidence of 1 with a grade A recommendation supports the use of arthroscopic surgical repair over non-operative treatment in prevention of first-time traumatic anterior shoulder dislocations. We suggest that sports medicine practitioners consider the patients' age, occupation, and physical activity level when making a clinical decision.

Arthroscopic Treatment of Chronic Calcific Tendinitis of the Shoulder (견관절 만성 석회화 건염의 관절경적 치료)

  • Kim Jin Sub;Yoo Jung Han;Yoo Sun Oh
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.6-11
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    • 1998
  • Shoulder is a common site for calcific deposit and is frequently asymptomatic. There is a general agreement that calcific tendinitis should be initially treated nonoperatively and excision reserved for cases unresponsive to the conservative measures. There are several reports that arthroscopic excision of symptomatic calcific deposit is proved to be efficient in the calcific tendinitis refractory to nonoperative management. The results of arthroscopic treatment of chronic resistant calcific tendinitis of the shoulder in eleven patients were evaluated. Each patient had shoulder pain for more than one year prior to the arthroscopic surgery. The average age of the patients was 48 years(range 35-70). Arthroscopic calcium removal and subacromial bursectomy was performed in all patients. Arthroscopic acromioplasty was additionally done in four patients. The results turned out to be good in nine patients with full range of motion and complete pain relief. One patient with full motion and occcasional episodes of pain was satisfactory. One patient with persistent pain was unsatisfactory which converted to satisfactory six months later after subacromial injection. So we conclude that the arthroscopic treatment is a reasonable alternative in treatment of the chronic calcific tendinitis resistant to conservative treatment.

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Arthroscopic Treatment in Multidirectional Instability of the Shoulder Joint (다방향성 불안정 견관절의 관절경을 이용한 치료)

  • Rhee Kwang-Jin;Byun Ki-Yong;Kwon Soon-Tae;Kim Sang-Bum
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.40-45
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    • 1998
  • Multidirectional instability of the shoulder joint is an unusual entity which is not yet well understood. Traditionally recommended treatment is non-operative, but recently arthroscopic treatment has been performed. This is a retrospective review of 20 patients who had multidirectional instability, who had been treated with arthroscopic capsular shift(7 cases), and arthroscopic treatment using Ho:YAG laser(l3 cases) at Department of Orthopaedic Surgery, Chungnam National University Hospital from July, 1988to February, 1997. Results of this study were as follows: 1. In five patients who were treated with arthroscopic anterior capsular shift only, all cases had redislocation of the shoulder joint. But there was no redislocation in two patients who were treated with arthroscopic anterior and posterior capsular shift. 2. ln three patients who were treated with laser-assisted capsular shift only, all cases had redislocation of the shoulder joint. But there was only one redislocation in ten patients treated with laser-assisted capsular shrinkage and capsular plication. Ho: Y AG laser has been found to be a safe and efficacious adjunct to many arthroscopic shoulder procedures. We had satisfactory results by combining a transglenoid capsular shift with laser-assisted capsular shrinkage. Arthroscopic laser-assisted capsular shrinkage and capsular plication is a one of recommendable treatment options in multidirectional instability of the shoulder joint.

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Current Concepts in Arthroscopic Treatment of Anterior Shoulder Instability (견관절 전방 불안정에 대한 관절경적 최신 치료 경향)

  • Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.13-27
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    • 2003
  • In the past, the report of shoulder instability undergoing open shoulder stabilization had satisfactory outcomes of greater than 90%. However, the functional loss of open procedure is severe in abduction and external rotation especially. Current arthroscopic techniques for shoulder instability result in success rate equal to open surgical procedure when the labrum is properly fixed to the glenoid rim using suture anchors, the capsule is tightened, and associated bony and soft tissue pathology is addressed. The arthroscopic surgery facilitates the view within shoulder joint for more accurate diagnosis, reduces operating time, minimises postoperative pain, reduces operative morbidity, improves shoulder function, and provides the possibility to perform other procedure simultaneously. However, to accomplish a successful arthroscopic stabilization procedure and to prevent complications, numerous advanced arthroscopic skill must be mastered. Although the arthroscope provides means to visualize new lesions, the pathomechanism and biomechanical explanation is not clear yet. Further studies are necessary to develop for shoulder reconstruction.

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Arthroscopic Procedure in the Treatment of Chronic Lateral Ankle Instability (만성 발목 불안정증의 치료에서 관절경 수술)

  • Lee, Ho Jin;Jeong, Bi O
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.25-31
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    • 2021
  • The open Broström procedure is considered the surgery of choice for treating chronic lateral ankle instability. The role of arthroscopy has gained popularity in the surgical treatment of chronic lateral ankle instability, partly for the ability to manage the intra-articular pathology combined with ankle instability. Arthroscopic techniques can be divided broadly into the arthroscopic-assisted Broström technique and arthroscopic all-inside ligament repair. The clinical results of these arthroscopic techniques are similar to open procedures. The arthroscopic technique may be an excellent alternative to the open Broström procedure in treating chronic lateral ankle instability when applying the appropriate indications.

Clinical Results of Arthroscopic Treatment for Infection after Total Knee Arthroplasty (슬관절 전치환술 후 발생한 감염에 시행한 관절경적 치료의 임상 결과)

  • Kim, Kyung Tae;Lee, Song;Kim, Jee Hyoung;Kim, Dae Geun;Shin, Won Shik
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.38-43
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    • 2013
  • Purpose: To evaluate the efficiency of arthroscopic treatment for infected total knee arthroplasty (TKA), and to investigate the factors affecting the outcomes. Materials and Methods: We analyzed 17 cases which underwent arthroscopic treatment to treat infection after TKA. After confirming infection by hematologic examination and analysis of joint fluid, we performed arthroscopic debridement, synovectomy and irrigation with normal saline mixed with antibiotics. Through routine examination after operation, we checked failure of treatment or recurrence of infection. If there is no recurrence until 2 years after the operation, we considered it as a success of treatment. Results: Of the 17 cases taken arthroscopic treatment, 13 cases were treated successfully with primary arthroscopic treatment only, but 4 cases had to undergo re-operation because of persistence or recurrence of infection. Analyzing the factors affecting the results, we found that symptom duration of the re-operation group is longer than the treated group after arthroscopy (p<0.05). Conclusion: Arthroscopic treatment can be effective when we performed appropriate selection of patients, careful and extensive arthroscopic irrigation and debridement, and suitable use of antibiotics. However, we have to do early arthroscopic surgery as soon as possible when infection after TKA is suspected.

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Arthroscopic Treatment of Calcific Tendinitis of Subscapularis Tendon - A Case Report - (견갑하근 건에 발생한 석회화 건염의 관절경적 치료 - 증례 보고 -)

  • Yi, Woo-Jin;Lee, Kwan-Hee;Jang, Won-Hee
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.56-60
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    • 2013
  • Calcific tendinitis of rotator cuff is a common disease which could be the cause of shoulder pain, and frequently occurs in supraspinatus, infraspinatus and teres minor in descending order. Calcific tendinitis of subscapularis is rare and arthroscopic treatment of that has also been rarely reported. So, we report a case of arthroscopic treatment of calcific tendinitis of subscapularis with excellent result.

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Arthroscopic Treatment of Elbow Osteoarthritis and Arthroscopic Ulnar Nerve Decompression

  • Chung, Seok Won
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.256-263
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    • 2016
  • Although arthroscopic surgery has been used conventionally, it has not been widely adopted yet due to the risks of complications, including nerve damage, technical difficulties, and limited indications. As shown in other joints, however, the use of an arthroscope will gradually increased in the elbow joint ('Arthroscopy always wins'). Herein, arthroscopic treatments and arthroscopic ulnar nerve decompression will be discussed in cases of elbow osteoarthritis.

Intra-articular Avulsion Fractures of the Malleolus in Chronic Ankle Pain (만성 족관절 동통에서의 관절 내 과단부 견열 골절)

  • Han, Seung-Hwan;Lee, Jin-Woo;Kim, Sung-Hwan;Kang, Eung-Shick;Kim, Sung-Jae
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.167-172
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    • 2005
  • Purpose: We report our results of arthroscopic treatment of symptomatic avulsion fracture of the malleolus in chronic ankle pain, and also analyzed the clinical and radiological features for evaluating the good candidate for arthroscopic treatment. Materials and Methods: Fourteen patients who were diagnosed with intra-articular avulsion fractures of the malleolus received arthroscopic surgery and were followed up for at least a year. The clinical and radiological characters including MRI and arthroscopic findings were reviewed. Clinical assessments were done according to the AOFAS score system. Results: There was a history of inversion type of the injury in most cases and local tenderness of lesion site was a unique. MRI study showed thickened anterior talofibular ligament (ATFL) in 8 cases (57%) and discontinued ATFL in 3 cases (21%). Enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 12 cases (86%). Preoperative score of all patients were $74.0{\pm}5.5$, which improved to $89.3{\pm}6.7$ at the follow-up after the treatment (P<0.001). Conclusion: Most patients had history of injury and localized tenderness in the area coinciding with radiological findings. Thickened ATFL and contrast enhancement around the ossicle were frequently found. Symptomatic avulsion fractures of the malleolus associated with the clinical and radiological findings above could be a good candidate for arthroscopic treatment.

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