• Title/Summary/Keyword: Knee surgery

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Ligament Injuries of Knee in the Recreational Skiers (스키에 의한 슬관절 인대 손상)

  • Lee Dong Chul;Ko Jin Hyeok;Kim Dong Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.37-43
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    • 2003
  • Purpose: This study is to analyse the injury patterns of knee ligament and the factors influencing ligament injuries of knee, and to evaluate the changes of knee function and activity after ski injury. Materials and Methods: Thirty cases of ligament injuries of knee were studied with a questionaire, stress radiographs, magnetic resolution imaging, and physical examination. Mean age was 28.6 years old and mean follow up was 29.6 months. Clinical evaluation of Lysholm knee scoring scale was used for knee function and Tegner activity score was used for activity change after ski injury. Results: The anterior cruciate ligament (ACL) injury accompanied with medial collateral ligament(MCL) injury was most in 11 cases and isolated MCL injury was the next in 9 cases. The common types of injury mechanism were Phantom foot phenomenon (13 cases, 43$\%$) and valgus external rotation injury (12 cases, 40$\%$), which constitute 83$\%$ of all case. At the last follow up, the mean Lysholm score was 93.4 and mean Tegner activity score was 4.2. The reduced Tegner activity score after injury was 1.9. Among several injury groups, the evaluation of knee function and activity was best in the isolated MCL injury group and worst in the ACL injury accompanied with MCL injury group. The factors to influence ski injury were participation to ski class, release of binding, and skiing long time more than 2 hours. Conclusions: Lysholm score at last follow up revealed good grading, but sports activity after ski injury was reduced when compared with pre-injury state. It seems to need a active, systemic sports rehabilitation program after sports injury.

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Treatment of Articular Cartilage Defects of The Knee with Microfracture (미세 천공술을 이용한 슬관절 관절 연골 손상의 치료)

  • Shin, Sung-Il;Song, Kyoung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Lae;Hyun, Yoon-Suk;Seo, Eun-Ho
    • 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.

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A Ganglion Cyst in the Anterior Cruciate Ligament Accompanying with Discoid Lateral Meniscus - A Case Report - (원판형 외측 반월상 연골과 동반된 전방 십자 인대의 결절종 - 증례보고 -)

  • Kang, Chung-Nam;Kim, Dong-Wook;Kim, Jong-Oh;Choi, Chang-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.64-67
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    • 1998
  • A ganglion cyst is a soft tissue mass that is surrounded by a dense connective-tissue capsule. The capsule is filled with a viscous fluid that is rich in hyaluronic acid and other mucopolysaccharides. But, Ganglion cysts in the knee joint are rare. There are very few case reports of ganglion cysts related to the surface of the anterior cruciate ligament, Posterior cruciate ligament and medial meniscus. We are reporting a case of a ganglion cyst in the anterior aspect of the anterior cruciate ligament accompanying with discoid lateral meniscus in the right knee of a 46-year-old woman without any history of trauma. The cyst and discoid lateral meniscus were treated successfully with arthroscopic excision and partial meniscectomy.

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Observation of Lateral Compartment through Posteromedial Trans-posterior Septal Portal in Knee Joints (슬관절 후내측 후격막 통과 도달법을 이용한 외측 구획의 관찰)

  • Lee, Ghun-Shik;Park, Han-Sung;Kim, Sang-Hyo
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.56-59
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    • 2005
  • Trans-posterior septal posterior arthroscopic portals are useful in performing arthroscopic diagnosis and treatment of the lesions located in posterior aspect of knee joints. Except inferior surface of posterior horn of lateral meniscus, we easily observed entire lateral compartment, especially inferior surface of anterior horn and lateral tibial condyle by figure of 4 position through posteromedial trans-posterior septal arthroscopic portal. And it was possible to obtain visual field from posterior aspect and we could use anteromedial and anterolateral portals for instrumentation without clouding. So, this procedure may be useful in performing surgery of lateral compartment especially, anterior aspect in the knee joints.

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Intra-Articular Synovial Lipoma of the Knee Joint - A Case Report - (슬관절내에 발생한 윤활막 지방종 - 증례 보고 -)

  • Kim, Kwang-Yeol;Hwang, Yeon-Su;Lee, Ji-Hoon;Yoon, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.47-51
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    • 2012
  • Although lipoma is the most common soft-tissue tumor, accounting for up to one half of all soft-tissue tumors, intra-articular synovial lipomas are rarely seen. Occasional cases of intra-articular lipoma arborescens have been reported. However, true intra-articular synovial lipomas should be differentiated from other similar lipomatoid conditions such as lipoma arborescens, which are different pathologic entities and show different clinical presentations. This article presents the case of a patient who had an intra-articular synovial lipoma of the knee joint.

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A Comparative Study of Use of Cephalosporins in Total Knee Replacement Surgery in Terms of Economic Efficiency (슬관절치환술 환자의 Cephalosporin계 항생제 사용에 대한 경제효율성 비교연구)

  • Cho, Dong-Sun;Song, Hyun-Ju;Park, Sung-Uk;Sohn, Uy-Dong
    • YAKHAK HOEJI
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    • v.52 no.2
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    • pp.101-110
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    • 2008
  • Total Knee Replacement (TKR) surgery is one of the invasive procedures for patients with late-stage knee joint disorders. In the present study, economic efficiency was compared between uses of the 2nd and 3rd generation cephalosporins for the prophylaxis before and after the surgery using frequency analysis in terms of various factors such as medication costs, the number of days of antibiotic use and hospitalization due to TKR surgery. The results showed that the 3rd generation cephalosporins did not reduce the infection rate and total medication costs, but rather raised antibiotic cost in comparison with the 2nd ones. A frequent use of the 3rd ones is closely related to emergence of resistant bacterial strains. Therefore, we suggest that unnecessary prescriptions for the broad spectrum antibiotics should be avoided.

A Patient with Multiple Unfavorable Reconstruction Options: What Is the Best Choice?

  • Park, Hyun June;Son, Kyung Min;Choi, Woo Young;Cheon, Ji Seon
    • Archives of Reconstructive Microsurgery
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    • v.25 no.2
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    • pp.75-78
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    • 2016
  • The method of lower limb reconstruction surgery is selected based on a patient's underlying conditions, general conditions, and wound status, and it usually varies from direct closure to skin graft and flap coverage. Herein, we describe a patient with Duchenne muscular dystrophy who developed critical limb ischemia after femoral cannulation for extracorporeal membrane oxygenation was used during knee disarticulation, which was followed by reconstruction of the defect around the knee using a pedicled anterolateral thigh flap and skin graft.

Lengthening of the Above-knee Amputation Stump - Reports of 2 cases - (소아 슬관절 상부 절단단 연장 성형술 - 증례 보고 2례 -)

  • Kim, Tai-Seung;Kim, Jong-Koo;Whang, Kuhn-Sung
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.1
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    • pp.53-58
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    • 1998
  • Limb-salvage surgery has become more popular than amputation for the treatment of malignant bone tumor because no differences in local recurrence and the 5-year survival rate have been found. However for young patients with sarcoma, skeletal immaturity may be a contraindication to limb-salvage surgery due to the expected leg length discrepancy. If limb-sparing procedure should be impossible for skeletally immature patients, amputation has to be given first consideration. To minimize the functional difficulty from short amputation stump of above knee amputation, we performed lengthening of the amputation stump using ipsilateral tibia. One patient was lengthened 17cm using ipsilateral tibia and the other, 12cm. Two patients and their families were satisfied both clinically and psychologically.

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Clinical Results of Medial Unicompartmental Knee Arthroplasty in Elderly Patients Older than 70 Years of Age (70세 이상의 고령 환자에서 시행한 내측 슬관절 단일구획치환술의 임상 결과)

  • Kim, Kyung Tae;Lee, Song;Kim, Jin Hak;Lee, Ho Young;Kim, Myung Jin
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.34-41
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    • 2021
  • Purpose: To evaluate the long-term clinical results and survivorship of unicompartmental knee arthroplasty (UKA) in elderly patients older than 70 years by analyzing cases that have been implanted for >10 years ago. Materials and Methods: The long-term follow-up results were evaluated in 39 patients (46 cases) who underwent medial UKA from March 2002 to February 2004. The mean age of the patients at the time of surgery was 74.0 years, and the preoperative diagnosis was degenerative arthritis of the knee in all cases. Results: Of the 46 cases, reoperation occurred due to the complications in four cases. In 22 cases without 14 cases of death and six cases of follow-up loss, follow-up more than 10 years was possible. The mean Knee Society knee and function scores improved significantly from 53.0 and 52.5 points pre-operatively to 89.4 and 80.9 points at the last follow-up, respectively (p<0.001). The mean range of motion of the knee recovered to 132.5°, and the mean tibiofemoral angle changed to 5.9° of valgus at the last follow-up. Complications following the UKA occurred in four cases; the most prevalent complication was mobile bearing dislocation (n=2). One case of failure occurred due to aseptic loosening and degenerative arthritis of the lateral compartment, respectively. The cumulative survival rate of the implants was 95.0% at 10 years and 85.7% at 15 years. Of the 40 cases, excluding six cases of follow-up loss, 36 cases (90.0%) could be used without reoperation until death or at the last follow-up after surgery. Conclusion: These results showed the outstanding functions of the knee and satisfactory long-term survivorship after UKA. Therefore, UKA could be a useful method for the treatment of osteoarthritis of the knee in elderly patients older than 70 years of age.

Relationship between Knee Function at 1 Year Postoperation and Gap Difference (90° Flexion Gap-Extension Gap) in Total Knee Replacement (간격 차이(90° 굴곡 간격-신전 간격)와 슬관절 전 치환술 1년 후의 무릎 기능과의 관계)

  • Cho, Myung-Rae;Do, Jung-Suk;Kim, Kyung-Tae;Choi, Won-Kee
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.254-260
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    • 2019
  • Purpose: To evaluate the relationship between the knee function at 1 year postoperation and the gap difference (90° flexion gap-extension gap) in total knee replacement. Materials and Methods: Eighty-two consecutive osteoarthritis knees that underwent primary total knee replacement using navigation from March 2017 June 2017 were evaluated prospectively. The gap was measured using navigation after reducing the patella with towel clips. After checking the average values of the medial and lateral gaps at extension and 90° flexion knee, the gap difference (90° flexion gap-extension gap) was calculated. The knees were divided into three groups according to the gap difference (gap difference<0 mm, 0 mm≤gap difference<2 mm, 2 mm≤gap difference). The Knee Society score (KSS) and maximal knee flexion were compared at 1 year postoperation among three groups. Results: The numbers of knees according to groups were 37, 29, and 16 knees in regular order. The average of the KSS knee, KSS function, and maximal knee flexion at the 1-year follow-up were 81.21±8.31, 71.34±9.84, and 126.48°±7.28°, respectively. No statistically significant difference in KSS was observed among the 3 groups. The third group (2 mm≤gap difference) showed a larger maximal knee flexion than the other groups in the Mann-Whitney test. Conclusion: The group of total knee replacement (2 mm≤90° flexion gap-extension gap) showed larger maximal knee flexion than the other groups at the 1-year follow-up in statistics.