• Title/Summary/Keyword: Arthrotomy

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Comparison of Various Joint Decompression Techniques in Septic Arthritis of the Hip in Children: A Systematic Review and Meta-Analysis

  • Sitanshu Barik;Vikash Raj;Sant Guru Prasad;Richa;Varun Garg;Vivek Singh
    • Hip & pelvis
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    • v.35 no.2
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    • pp.73-87
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    • 2023
  • The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multi-centric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.

Results of Autologous Osteochondral Transplantation of the Ostochondral Lesion on the Talus: A Comparison Study between Medial Malleolar Osteotomy Approach and Anterior Arthrotomy Approach (거골의 골연골 병변에 대한 자가 골연골 이식술의 결과: 내과 절골 도달법과 전방 관절낭 절개 도달법의 비교)

  • Lee, Yong-Sik;Ahn, Gil-Yeong;Nam, Il-Hyun;Lee, Yeong-Hyun;Lee, Tae-Hun;Kim, Dae-Geun;Lee, Dong-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.139-143
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    • 2017
  • Purpose: Osteochondral lesion of the talus (OLT) has traditionally been treated using an autologous osteochondral graft via the medial malleolar approach. Here, we compare the traditional method with the anterior arthrotomy approach. Materials and Methods: Between January 2005 and June 2015, 24 cases of patients who received autologus osteochondral graft for OLT and with at least 2 years of follow-up were evaluated. They were divided into two groups; one group receiving autologous osteochondral graft via the medial malleolar osteotomy approach (group 1, n=9) and another group via the anterior arthrotomy approach (group 2, n=15). The clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results: In all cases, the size of the subchondral cyst of the talus decreased, if not disappeared on the final follow-up radiograph. All osteochondral grafts were united. The mean AOFAS score increased from 61.5 preoperatively to 84.9 at the final follow-up. The mean AOFAS score of group 1 increased from 60.3 preoperatively to 78.0 (p=0.007) at the final follow-up, and the mean AOFAS score of group 2 also increased from 62.2 to 89.1 (p=0.006). The AOFAS score was statistically better in group 2 than in group 1 (p=0.034) at the final follow-up. Conclusion: Autologous osteochondral graft of the OLT yields satisfactory radiologic and clinical outcomes. Especially, better clinical outcome was observed in the group using the anterior arthrotomy approach (group 2) than in the group using the medial malleolar osteotomy approach (group 1).

Arthroscopic Findings of the Canine Stifle Joint (정상견 무릎의 관절경 검사소견)

  • 정순욱;정월순
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.300-308
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    • 1999
  • Arthroscopy is a valuable diagnostic and operative tool in equine and human orthopedics. The arthroscope is a difficult instrument to use and requires patience, practice, and persistence in order to obtain good results. This technique was found to be less traumatic than arthrotomy, invasiveness, rapid recovery and the feasibility of surgically correcting many arthropathies. The use of the arthroscope in the dog provides a new dimension in the study and diagnosis of joint derangements. The purpose of this report is to introduce the use of the arthroscope in the dog-more specifically, in the stifle of the dog. A diameter 2.7 mm fore-oblique viewing arthroscope, cold light source, video and video printer are used. With the fore-oblique viewing type it is possible to view directly as well as slightly to the side and the range of viewing can be increased by rotating the arthroscope around the object The scope is connected with a cold light source by means of a fiber-optic light guide. The stifle joint was flexed to 20~30$^{\circ}$. The joint were lavaged with lactated Ringer's solution during arthroscopic examination. Arthroscopy of the stifle was performed prior to arthrotomy in 1 dead dog and 4 healthy dogs, and other 3 dogs was performed only arthroscopic examination. In this study only the conventional approaches were used and in most cases it was possible to view all the intra-articular structures via the lateral infrapatellar approach. In the stifle joint, endoscopic observation was performed to find lateral femoral condyle, patella, medial femoral condyle, trochlear groove, tibia, fat, cranial cruciate ligament, caudal cruciate ligament lateral meniscus, tendon of long digital extensor muscle, medial meniscus, and medial collateral ligament Post-arthroscopic examination, the lameness had disappeared within 12~24 hours. Pain and swelling in the stifle joint had disappeared within 24~36 hours. Post-arthroscopic secondary infection was never encountered in the dogs. In conclusion, arthroscopic insertion technique in canine stifle joint using a diameter 2.7 mm 30$^{\circ}$ arthroscope was established and arthroscopical views of all anatomical structures in the normal stilfe joint were obtained through lateral infrapatellar portal.

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Autogenous Osteochondral Graft for Freiberg's Disease (A Case Report) (자가 골연골 이식술을 이용한 Freiberg 병의 치료(1예 보고))

  • Kim, Hyong-Nyun;Eom, Sang-Wha;Suh, Dong-Hyun;Park, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.223-226
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    • 2009
  • Freiberg disease is a osteochondrosis of the lesser metatarsal heads. Various surgical treatment have been recommanded including joint debridement and metatarsal head reshaping, metatarsal dorsal wedge osteotomy, metatarsal head excision and joint arthroplasty. Autogenous osteochondral graft for the treatment of Freiberg disease is an effective restorative procedure that provides early range of motion exercise, weight bearing, and reduces other morbidity. We report a case of late stage Freiberg disease treated with arthrotomy, removal of loose body and autogenous osteochondral graft.

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Operative Treatment for Osteochondral Lesions of the Talus: Bone Marrow Aspirate Concentrate and Matrix-induced Chondrogenesis (거골 골연골병변에 대한 수술적 치료: 골수 흡인물 농축액 및 기질 유래 연골 형성)

  • Kim, Bom Soo;Na, Yeop;Kwon, Won-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.61-68
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    • 2020
  • Bone marrow aspirate concentrate and matrix-induced chondrogenesis (BMIC) is an interesting treatment option for osteochondral lesions of the talus with promising short- to mid-term results. The various terminologies used to describe this surgical method need to be addressed. These include bone marrow-derived cell transplantation, matrix-induced bone marrow aspirate concentrate, and matrix-associated stem cell transplantation. BMIC is a one-stage, minimally invasive surgery performed arthroscopically or using a mini-open arthrotomy approach without a malleolar osteotomy in most cases. The lesion is replaced with hyaline-like cartilage, and treatmentrelated complications are rare. BMIC is a safe and effective treatment option and should be considered in large lesions or lesions with a prior treatment history.

A Case Report of Surgical Treatment in a Lamed Hunting Dog with Cranial Cruciate Ligament Rupture and Medial Meniscal Injury (사낭견에서 내측반월판 손상을 수반한 전방십자인대단열의 외과적 치유예)

  • 정순욱;김영대;박수현;정월순;이충헌;신영규
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.497-500
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    • 1999
  • A 4 years old male mixed breed dog, which weighed 25.5 kg, referred to Veterinary Teaching Hospital at College of Veterinary Medicine in Chonnam National University, because of chronic hindleg lameness. Click sound by flexion and extension of stifle joint, positive reaction by cranial drawer movement, fat pad sign and tibial position in cranial drawer position on the lateral radiographic view, medial patellar luxation (grade II), and lameness score 2.5 at standing and 2 at walking in right hindleg were showed. Under general anesthesia with enflurane, after medial arthrotomy, it was performed to remove remnants of cranial cruciate ligament and torn medial menisci and joint closed. In modified retinacular imbrication technique, one lateral fabellar/tuberosity suture, one medial fabellar/tuberosity suture, and one imbrication suture adjacent to the patella were placed. At 9 days after operation, lameness score 0 was observed and general condition was excellent.

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Septic arthritis of the temporomandibular joint: a case report

  • Yang, Sung-Won;Cho, Jin-Yong;Kim, Hyeon-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.4
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    • pp.227-230
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    • 2016
  • Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.

Fragmented Medial Coronoid Process in a Korean Jindo (진도개에 발생한 주관절 내측갈고리돌기 단열)

  • Kim Sangki
    • Journal of Veterinary Clinics
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    • v.21 no.4
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    • pp.416-419
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    • 2004
  • A 9-month-old castrated male Korean Jindo was presented for evaluation of a progressive left forelimb lameness of 4 weeks' duration. On physical examination, the dog showed moderate weight bearing lameness on the left forelimb. Firm and mild swelling was palpated, and range of motion was decreased in the left elbow. Signs of pain were elicited by gentle flection and hyperextension of the left elbow. On radiographs, fragmentation of the medial coronoid process with moderate secondary degenerative joint disease was found. The bone fragments could be seen more clearly on stress radiograph of the left elbow joint which was taken while flexing the elbow and inwardly rotating the antebrachium. A medial elbow arthrotomy was performed, and the loose fragments were removed from the coronoid region. Left forelimb lameness improved markedly after surgery.

Medial impingement syndrome of the ankle associated with large anteromedial osteophyte of talus - A case report - (거골의 전내측에 큰 골극이 동반된 족관절의 내측 충돌증후군)

  • Yu, Sun-O;Kim, Jong-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.124-128
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    • 2002
  • After a severe ankle sprain, the incidence of residual complaints, particularly on the medial side of the joint, is high. We experienced a case of medial impingement between medial malleolus and anteromedial osteophyte of talus, specially in the dorsiflexion of the right ankle. Twenty five-year-old male was complained tenderness and chronic pain over the medial side of the right anklel for 3 years after an inversion sprain of the ankle. The plain radiography revealed a bony osteophyte on the anteromedial side of talus. The patient was treated by the open arthrotomy of the ankle. At surgery, impingement between articular surface of medial malleolus and osteophyte of the talus was observed when ankle dorsiflexion was done. Chondral lesion of medial malleolus and chondromalacic degeneration on anteromedial talus was viewed. Surgical removal of osteophyte on talus and debridement and multiple drilling of chondral lesion on medial malleolus was done. The symptom was improved. After postoperative 1 year, recurrence was not.

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Treatment of Freiberg Disease with Metatarsophalangeal Arthroscopy - A Case Report- (중족지 관절경을 이용한 Freiberg 병의 치료 -1예 보고-)

  • Ahn, Jae-Hoon;Lee, Seung-Hun;Lee, Kwang-Won;Choy, Won-Sik;Kam, Byoung-Sup
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.59-62
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    • 2007
  • Freiberg disease is a relatively rare osteochondrosis of metatarsal head, which usually involves the 2nd metatarsal of adolescent females. Various open surgical treatments have been recommended; arthrotomy and removal of loose body, dorsiflexion osteotomy and resection of the metatarsal head. Arthroscopic treatment for Freiberg disease has a merit of shortening the recovery period and reducing the postoperative stiffness. We report a case of early stage Freiberg disease treated with metatarsophalangeal arthroscopic excision of loose body and debridement of the 2nd metatarsophalangeal joint.

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