• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.164-167
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• 1998

The purpose of this study is to evaluate the significance of arthroscopic examination in patients with chronic ankle pain. Eighty eight arthroscopic procedures were conducted due to symptoms of chronic ankle pain. The pathology of the 88 ankles could be categorized into four groups ; 22 anterior impingement syndrome, 20 anterolateal impingement syndrome, 22 instability and 20 osteochondral lesion, 59 of patients(67.0%) had trauma history and 14(15.9%) of patients had injured chronic repetitive microtrauma. During the arthroscopic procedure, we found unexpected chondral lesions of high incidence(39.1%). These lesions were not detected both by the physical examination and radiologic examinantion. These pathologies were treated during the course of arthroscopic procedure. We concluded that ankle arthroscopy may be a very useful and therapeutic tool in the patients who have not reponded to the conservative treatment. And due to high incidence of intra-articular pathology in patients with chronic ankle pain, arthroscopic examination should be performed prior to final decision.

• 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.

• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.48-54
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• 2020

Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. Various terms are used to describe this clinical entity, including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Several treatment options are available; the choice of treatment is based on the type and size of the defect and the treating clinician's preference. Arthroscopic microfracture (a bone marrow stimulation technique) is a common and effective surgical strategy in patients with small lesions or in those in whom non-operative treatment has failed. This study had the following aims: 1) to review the historical background, etiology, and classification systems of OLT; 2) to describe a systematic approach to arthroscopic bone marrow stimulation for OLT; and 3) to determine the characteristics that are useful for assessing osteochondral lesions, including age, size, type (chondral, subchondral, cystic), stability, displacement, location, and containment of the lesion.

• Journal of Korean Foot and Ankle Society
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• v.27 no.4
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• pp.148-153
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• 2023

Traditionally, arthroscopic microfracture and autologous osteochondral autograft transplantation have been the primary surgical treatments for osteochondral lesions of the talus. On the other hand, recent advancements have introduced alternative approaches, such as autologous chondrocyte transplantation, matrix-derived autologous chondrocyte transplantation, intra-articular injection of concentrated bone marrow aspirate concentrate, and the use of fibrin glue to address chondral defects. Furthermore, some studies have explored a combination of bone marrow aspirate and matrix-derived chondrogenesis. In light of these developments, this report presents a case study of a young male patient in his early twenties with a relatively large osteochondral lesion exceeding 1.5 cm² on the medial talar dome. Instead of removing the osteochondral lesion, a surgical approach was employed to retain the lesion while addressing the unstable cartilage in the affected area. This approach involved a combination of bone marrow aspirate concentrate and matrix-derived chondrogenesis. The treatment yielded favorable clinical outcomes and ultimately successfully induced the bony union of osteochondral lesions. This paper reports the author's experience with this innovative approach with a review of the relevant literature.

• Journal of Korean Foot and Ankle Society
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• v.16 no.1
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• pp.9-18
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• 2012

Osteochondral lesions of the talus are isolated cartilage and/or bone lesions that are known cause of chronic ankle pain. They can occur as the result of a single acute ankle injury or from repetitive loading of the talus. Technical development in radiologic imaging and ankle arthroscopy have improved diagnostic capabilities for detecting osteochondral lesions. Characteristics which are important in assessing an osteochondral lesions include: the size, the type (chondral, subchondral, cystic), the stability, the displacement, the location, and the containment of lesion. Nonoperative treatment involving period of casting and non-weight-bearing is recommended for acute, non-displaced osteochondral lesions in select pediatric and adolescent patients. Operative treatment is recommended for unstable lesions or failed conservative management. Marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autograft or allograft, autologous chondrocyte implantation, are frequently employed. The purpose of this article is to review the historical background, etiology, classification systems, diagnostic strategies, and to describe a systematic approach to management of osteochondral lesions of the talus.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.205-210
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• 2008

Purpose: To evaluate the clinical results after microfracture surgery for full-thickness chondral lesion of the knee. Materials and Methods: Thrity-seven patients, who had underwent microfracture surgery for full-thickness chondral lesion of the knee between January 1999 and December 2005, were reviewed. Their mean age at the time of operation was 31 years (range, 21~38 years) and mean follow up period was 2.7 years. All patients were reviewd every 6 months after operation. Clinical outcomes were evaluated by activity of daily living (ADL), Tegner activity scale, International Knee Documentation Committee (IKDC) knee examination form, Lysholm score and satisfaction of treatment. Results: ADL and Tegner activity score improved in 83% of patients during first 18 months, but decreased during next 6months. IKDC score improved from 58 points at operation time to 86 points after 12 months, but decreased to 79 points and 68 points at 18 and 24 months after operation, respectively. Also, Lysholm score improved from 61 points at operation time to 89 points after 12 months, to 92 points after 18 months, but 73 points after 24 months. At the last follow-up, 22 patients were excellent or good in satisfaction of treatment, whereas 12 patients were fair, 3 patients were poor. Conclusion: Microfracture surgery for full-thickness chondral lesion of the knee has a good functional improvement for first 12 months after operation, but its effectiveness has decreased over time.

• Clinics in Shoulder and Elbow
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• v.16 no.1
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• pp.40-46
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• 2013

Benign intraosseous osteolytic lesions of the glenoid are very rare. The present study reports on three cases of symptomatic intraosseous osteolytic lesions of the glenoid in which surgical interventions were made. Of the three, two cases presented with intraosseous ganglion and one case with fibrous dysplasia. In all the cases, the lesion was located at the posteroinferior portion of the glenoid, and it seems to be related to posterior shoulder pain. If intraosseous osteolytic lesions have symptoms or the risk for chondral defects or cortical breakage, surgical intervention is needed and bone curettage with or without bone grafting will be a useful treatment option.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.2
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• pp.390-396
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• 2008

Osteoarthritis(OA) diseases are characterized by joint pain, tenderness, limitation of movement, crepitus, occasional effusion, and variable degrees of inflammation without systemic effects. We investigated the effects of Achyrantis radixs cream treatment and low intensity ultrasound in monosodium iodoacetate(MIA) induced experimental osteoarthritis rat. Sprague-Dawley 40 rats of 7-8 weeks, weight $250\;{\pm}\;50$ g were divided into four groups including the control group and ostoarthritis group(30 rats). Histopathological examination, Mankin's score, and immunohistochemical were performed. Histological findings in control group that are similar to those observed in human osteoarthritis, such as disorganization of chondrocytes, erosion and fibrillation of cartilage surface, and subchondral bone exposure. Safranin O-fast green staining revealed that marked diffuse reduction of proteoglycans and chondrocyte treated with MIA. The Mankin's score were closely correlated to the grade of histological findings. The level of Bax and caspase-3 expression decreased experimental groups. This study shows that a Acyranthes Radix cream treatment and low intensity ultrasound exerts a beneficial influence on the severity of chondral lesion in osteoarthritis rats. This treatments could related to a reduced level of chondrocyte apoptosis through anti-apoptotoc capacities of MIA-induced apoptotic protein overexpression.

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.6-11
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• 2005

Injury of articular cartilage can be classified into acute injury and chronic degenerative osteoarthritis Acute mechanical trauma on articular cartilage causes injuries that are divided into three distinct types based on the depth of injury: microdamage, chondral fracture, osteochondral fracture and each type has different potential of healing response and long-term prognosis. Articular cartilage undergoes degradation in response to a number of stimuli and eventually degenerative osteoarthritic changes will progress. The extent of initial injury to the articular cartilage is the most important factor affecting the long-term outcome of the healing response and other variables such as the size of lesion, site, age, activity level, obesity, limb alignment are also important factors. In this review, the pathophysiology that occurs within articular cartilage after different injuries and the effect of nonsurgical treatment mainly in physicochemical aspect and biological aspect will be discussed.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.7-12
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• 2010

Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.