• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.32-37
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• 2000

Purpose : We performed routinely arthroscopy to diagnose and treat intra-articular soft tissue pathology and tibial condylar fractures. The purpose of this study was to evaluate clinical value of arthroscopy in the tibial condylar fractures. Materials and Methods : The 31 tibial condylar fractures was examed by routine arthroscopy, 9 treated by conservative method and 22 treated by surgery at least follow up of 12 months. The authors analysed to the cause, classification, soft tissue injuries such as ligaments and menisci, treatment and results. Results : The most common type was Schatzker classification type I in 15 cases$(18\%)$ and intra-articular lesions and associated ligament injury were in 21 cases$(67\%)$. Most common lesion was meniscal tear in 16 cases and most common type of meniscal lesions was peripheral detachment in 7 cases$(44\%)$. Schatzker I, II fracture patterns were associated with the highest frequency of soft tissue injuries, especially medial collateral ligament and meniscal injuries. Conclusion : Arthroscopic examination is useful method to evaluate the intra-articular pathology and to treat the tibial condylar fractures.

• Journal of Korean Foot and Ankle Society
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• v.22 no.2
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• pp.55-61
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• 2018

Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified $Brostr{\ddot{o}}m$ operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.2
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• pp.94-100
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• 2013

Musculoskeletal ultrasound has unique advantages that may be free from exposure to radiation, low price compared to MRI, outpatient procedure that can be easily accessible, and better accuracy combined with physical examination. Dynamic ultrasound performed with stress tests are known to be useful for detecting the hidden lesions in the tendons, ligaments, nerves. Ultrasound in the elbow can be used easily in the outpatient for evaluation of the joint surface and synovial space; diagnosis for tendon diseases such as lateral epicondylitis, medial epicondylitis and morbidity of peripheral nerves; guide for anterior-posterior bursal and intra-articular injections.

• Journal of Korean Dental Science
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• v.17 no.1
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• pp.14-35
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• 2024

The temporomandibular joint (TMJ) is one of the most unique joints in the human body that orchestrates complex movements across different orthogonal planes and multiple axes of rotation. Comprising the articular eminence of the temporal bone and the condylar process of the mandible, the TMJ integrates five major ligaments, retrodiscal tissues, nerves, and blood and lymph systems to facilitate its function. Cooperation between the contralateral TMJ and masticatory muscles is essential for coordinated serial dynamic functions. During mouth opening, the TMJ exhibits a hinge movement, followed by gliding. The health of the masticatory system, which is intricately linked to chewing, energy intake, and communication, has become increasingly crucial with advancing age, exerting an impact on oral and systemic health and overall quality of life. For individuals to lead a healthy and pain-free life, a comprehensive understanding of the basic anatomy and functional aspects of the TMJ and masticatory muscles is imperative. Temporomandibular disorders (TMDs) encompass a spectrum of diseases and disorders associated with changes in the structure, function, or physiology of the TMJ and masticatory system. Functional and pathological alterations in the TMJ and masticatory muscles can be visualized using various imaging modalities, such as cone-beam computed tomography, magnetic resonance imaging, and bone scans. An exploration of potential pathophysiological mechanisms related to the TMJ anatomy contributes to a comprehensive understanding of TMD and informs targeted treatment strategies. Hence, this narrative review presents insights into the fundamental functional anatomy of the TMJ and pathological changes that evolve with TMD progression.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.387-394
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• 2008

Purpose : The purpose of this study was to verify the usefulness and feasibility of ultrasonographic imaging for the detection of the disorders of the surrounding supporting structure such as articular capsule, retrodiscal tissue and related ligaments, osteoarthritic evidence and associated disc displacement at the temporomandibular joint(TMJ) Materials and Methods : 20 patients(40 joints) with periodic lock and crepitations were investigated prospectively using 12 MHz array transducer. Ultrasonographic Imagings were assessed for osteoarthritic surface changes of condyle, extent of disc displacement and disorders of surrounding structures. Ultrasonographic images were compared with clinical investigations, conventional radiography and Dental Computed Tomographic scans. Results : In clinical and conventional radiography, osteoarthritic changes were diagnosed in 8 joints. Ultrasonographically 7 of the 8 osteoarthritic changes were diagnosed correctly. Sensitivity, specificity, and accuracy of ultrasonography in the osteoarthritic detections were 87.5%, 62.5%, and 67.5% respectively. About the detection of disc displacement, disc displacement were diagnosed in 21 joints clinically. Ultrasonographically 19 of the 21 disc displacements were diagnosed correctly. Sensitivity, specificity, and accuracy of ultrasonography in the osteoarthritic detections were 95%, 90%, and 92.5% respectively. when the disorders of supportive structure were figured out, the disorders of supportive structure were diagnosed in 18 joints clinically. Ultrasonographically 1 of the 18 the disorders of supportive structure were diagnosed correctly. Sensitivity, specificity, and accuracy of ultrasonography in the osteoarthritic detections were 5.5%, 4.5%, and 55% respectively. Conclusion : Ultrasonography is an relatively reliable diagnostic tool for the detection of disc displacement and some of osteoarthritic changes. But it's not an insufficient imaging technique for the detection of the disorders of the surrounding structure.

• Journal of Biomedical Engineering Research
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• v.23 no.3
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• pp.171-179
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• 2002

It is well known that the geometry of the articular surface plays a major role in the kinematic and kinetic analysis to understand human knee joint function during motion. The functionality of the knee joint cannot be accurately modeled without considering the effects of sliding and lolling motions. We Present a 3-D human knee joint model considering sliding and rotting motion and major ligaments. We employ more realistic articular geometry using two cam profiles obtained from the extrusion of the sagittal Plain view of the representative Computerized Tomography image of the knee joint compared to the previously reported model. Our model shows good agreement with the already reported experimental results on Prediction of the lines of force through the human joint during gait. The contact point between femur and tibia moves toward the Posterior direction as the knee undergoes flexion, reflecting the coupling of anterior and Posterior motion with flexion/extension. The anterior/posterior displacement of the contact Point on the tibia plateau during one gait cycle is about 16 mm. for the lateral condyle and 25 mm. for the medial condyle using the employed model Also. the femur motion on the tibia undergoes lateral/medial movement about 7 mm. and 10 mm. during one gait cycle for the lateral condyle and medial condyle. respectively. The developed computational model maybe Potentially employed to identify the joint degeneration.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.286-292
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• 2010

Purpose: Stability of joints and maintenance of range of motion are needed for optimum function. The most common complaint about the elbow joint is joint stiffness. Recent articles have reported good outcomes in the treatment of stiff elbow joints. However, deciding which procedure to use is always difficult. Materials and Methods: Morrey et al. reported that the functional range of motion of the elbow joint is $30-130^{\circ}$ of flexion-extension and $50^{\circ}C$ of supination and pronation. About 90% of daily activities are done using this range of motion. Stiff elbow joints can be classified according to the traumatic events that caused the problem or the location of the main pathology. Intraarticular pathology includes severe articular mismatch, intraarticular adhesions, loss of articular cartilage, mechanical blockade by osteophytes, loose bodies, and hypertrophied synovium. Extraarticular pathology includes severe capsular adhesion due to the trauma or to dislocation, contracture of the collateral ligaments or muscles, bony bridge. Results and Conclusions: The main pathology underlying the loss of extension is the fibrous contracture of the anterior capsule. In this pathology, an anterior capsulectomy would be helpful. The main pathology underlying the loss of flexion is the contracture of the posterior band of medial collateral ligament.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.458-465
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• 2018

Background Volar plate avulsion fracture of the proximal interphalangeal (PIP) joint is one of the most common hand injuries. In this study, we divided patients into two groups: patients with pure volar plate avulsion fracture, and patients with volar plate avulsion fracture concomitant with collateral ligament rupture. The purpose of this study was to compare long-term surgical outcomes between the two groups. As a secondary measure, the Mitek bone anchoring and polydioxanone (PDS) bone suturing techniques were compared. Methods A single-institutional retrospective review of the surgical treatment of volar plate avulsion fracture was performed. The cases were divided into those with pure volar plate avulsion fracture (group A, n=15) and those with volar plate avulsion fracture concomitant with collateral ligament rupture (group B, n=15). Both groups underwent volar plate reattachment using Mitek bone anchoring or PDS bone suturing followed by 2 weeks of immobilization in a dorsal protective splint. Results The average range of motion of the PIP joint and extension lag were significantly more favorable in group A (P<0.05). Differences in age; follow-up period; flexion function; visual analog scale scores; disabilities of the arm, shoulder, and hand scores; and the grip strength ratio between the two groups were non-significant. No significant differences were found in the surgical outcomes of Mitek bone anchoring and PDS bone suturing in group A. Conclusions Overall, the surgical outcomes of volar plate reattachment were successful irrespective of whether the collateral ligaments were torn. However, greater extension lag was observed in cases of collateral ligament injury.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.127-136
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• 2003

Posterolateral instability of the knee occurs more commonly in association with an injury to anterior and posterior cruciate ligament and combined injuries are severe injuries that result in significant functional instability and articular cartilage degeneration. Reconstruction of the anterior and posterior cruciate ligament without an appropriate treatment of posterolateral corner injury result in failure of the reconstructed cruciate ligaments. Meticulous physical examinations, imaging studies, lower limb alignment and gait pattern should be evaluated. Acute grade III isolated or combined injury of the posterolateral corner is best treated within three weeks by direct repair, or augumentation, or reconstruction. The appropriate surgical method or combined methods are selected among the several methods of posterior and posterolateal reconstruction, and all injuried posterolateral and cruciate ligament structures are anatomically reconstructed simultaneously or by stages. If a varus alignment and varus thrust is disclosed in chronic posterolateral instability of knee, soft tissue reconstructions laterally are highly unlikely to be able to correct tile problem. It is appropriate that valgus osteotomy should be done before soft tissue reconstruction and reevaluate the posterolateral instability about 6 months later.

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.22-27
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• 2011

The modified Brostrom procedure is first considered for the treatment of chronic ankle instability (CAI). Recently, ankle arthroscopy is also recommended for the treatment of concomitant intra-articular lesions during the open repair of the lateral ligaments. We arthroscopically repaired the anterior talofibular ligament with a use of bio suture anchor for CAI as well as performing the multiple drilling procedure for combined osteochondral lesion of talus. We report the cases with a review of the literature.