• Title/Summary/Keyword: Knee surgery

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The Natural History of Anterior Cruciate Ligament Deficient Knee (전방십자인대 손상 슬관절의 자연적 병의 경과)

  • Kim, Hyoung-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.41-46
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    • 1997
  • The natural history of the anterior cruciate ligament(ACL)-deficient knee remains controversial. although numerous investigation have tried to ascertain the course that the knee would follow once the ACL has lost functional integrity. An extensive review of the literature performed according to symptoms. physical examinations, associated surrounding tissue injuries. returns to activity level and radiological changes in the knee joint. An active individual with a non-functioning ACL was susceptible to injury to the menisci and deteriorate the articular cartilage, followed radiographic changes. An activity levels in general also changed after injury. The most common symptom was pain. But instability varied in these individuals. Conclusively we believe that all these factors will eventually, if not initially, result in a symptomatic knee. which will result in significant limitations to the individual's desired level. So we recommend an aggressive approach in person who desired to return to a relatively active life style in young person as well as in middle aged individuals who have significant symptomatic ACL deficient knee.

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Usefulness of Anteromedial Portal for Femoral Tunneling in Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술시 대퇴골 터널에 있어 전내측 삽입구의 유용성)

  • Kang, Min-Soo;Kim, In-Bo;Kim, Kyung-Taek
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.118-124
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    • 2008
  • Purpose: Recent development and advances in the arthroscopic surgical techniques for anterior cruciate ligament(ACL) reconstruction have led to the ideal location for more oblique anatomic point of the femur from 10 to 10:30 o'clock(in the right knee) and from 2 to 1:30 o'clock(in the left knee) in the frontal plane. This study was performed to compare the operative methods and the radiologic results of the femoral tunnels made through the tibial tunnel(trans-tibial approach) and the anteromedial portal. Materials and Methods: From January 2003 to May 2004, on hundred reconstructions of ACL were performed. Group I(the femoral tunnel made through the tibial tunnel) consisted of 50 cases and group I(the femoral tunnel made through the anteromedial portal) consisted of 50 cases. The operative methods and the radiographic results of the femoral tunnels were compared. Results: Femoral tunnel was made more easily at more oblique anatomic point in group II than in group I. In group II, better visual field was achieved at the angle of 100? flexion of the knee joint, the risks of the posterior cortical breakage and the tunnel-graft mismatching were reduced more, and the divergence of femoral interference screw from the radiograph decreased more than in group I(p<0.05). The angle between the femoral tunnel and the longitudinal axis of ACL increased in group II. Conclusion: Anteromedial portal technique was useful for femoral tunneling toward 10 to 10:30 o'clock(in the right knee) and 2 to 1:30 o'clock(in the left knee) in ACL reconstruction. Level of Evidence:Level III, case-control study.

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Arthroscopic Removal of Loose Bodies from the Knee (관절경을 이용한 슬관절 유리체 제거술)

  • Ahn, Jin Hwan;Ha, Chul Won;Hwang, Tae Kyu
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.155-158
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    • 1998
  • The purpose of this study is to evaluate the cause, size, number, nature and locaton of loose bodies in the knee joint and to describe the proper arthroscopic technique to remae the loose bodies according to the location of them. We retrospectively analysed thirty-three operations of arthroscopic removal of loose bodies from the knee. Eleven males and 22 females were included with average age of 38(range 7-71). Total number of removed loose bodies were more than sixty. The loose bodies were found most commonly at anterior intercondylar notch area. The most common associated pathology was degenerative arthritis. The most common size of loose bodies was in the range of 5mm to 10mm in diameter. The most common nature of loose bodies was osteochondral. The loose bodies located in suprapatellar pouch, medial gutter, lateral gutter. anterior intercondylar notch or posterior intercondylar notch were removed using standard portals such as anteromedial, anterolateral, superomedial and posteromedial portals. The removal of loose bodies located in upper portion of posteromedial or posterolateral compartment were greatly enhanced using posterior trans-septal portal. The proper portals for the visualization and removal of loose bodies were identified according to the location of loose bodies in the knee joint. More skill in the use of the arthroscope is required for the removal of loose bodies than for simple diagnostic arthroscopy.

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Clinical and radiologic study of total knee replacement arthroplasty using Doujet GF bone cement (liquid-powder bone cement containing gentamicin) (Doujet GF 골 시멘트를 사용한 인공 슬관절치환술의 임상적, 방사선적 고찰)

  • Sungwook Choi;Seong-meen Yoon;Joseph Y. Rho;In-seok Son
    • Journal of Medicine and Life Science
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    • v.20 no.2
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    • pp.60-66
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    • 2023
  • Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.

The Patients' Satisfaction Degree to Arthroscopic ACL Reconstruction (관절경하 전방십자인대 재건술에 대한 환자의 만족도)

  • Chung, Hyun Kee;Choi, Choong Hyeok;Kim, Jong Heon;Song, Sang Jun
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.129-134
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    • 1998
  • The arthroscopic ACL reconstruction using the bone-patellar tendon-bone has been considered as the gold standard in the treatment of the ACL insufficiency. There are many reports about the good functional outcome and the restored stability of the knee joint. But there are a few reports showing whether this surgery has good results in the patients' satisfaction. The purpose of this study is to evaluate the patients' satisfaction in this surgery. Authors analysed 32 cases who had taken the ACL reconstruction from Jannuary, 1989 to June, 1997. The average follow-up was 40 months. At the last follow-up, 32 patients reported the patients' satisfaction degrees(four degrees; very satisfied, generally satisfied, improved, no change or aggravated), KT-1000 arthrometer test, Vastus atrophy(thigh circumference), and three kinds of the knee scores(Lysholm, HSS, IKDC). Among the 32 cases, 12 cases (37.5%) were very satisfied, 17 cases(53.1%) were generally satisfied and 3 cases(9.4%) were improved. No case showed no change or aggravated. The satisfaction degree in this surgery had little relation with the age, operation time, follow-up period, combination of meniscectomy, but had significant relations with anteroposterior stability evaluated by KT-1000, thigh circumference measurements and the functional scoring of the knee(Lysholm, HSS, IKDC scores).

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Revision Anterior Cruciate Ligament Surgery Using Hamstring Autograft (슬괵건을 이용한 전방 십자 인대 재 재건술)

  • In Yong;Bahk Won-Jong;Kwon Oh-Soo;Suh Young-Wan;Im Dong-Sun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.183-188
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    • 2003
  • Purpose : The purpose of this study is to evaluate the results of revision surgery for failed anterior cruciate ligament (ACL) reconstruction using quadruple hamstring tendon autograft. Materials and Methods : From May 2000 to July 2002, six patients received ACL revision surgery using quadruple hamstring autograft for failed ACL reconstruction. Femoral tunnels were made 40 mm in depth and fixed with a cross pin and a bioabsorbable interference screw to fill the bone defect. In tibial tunnels, the grafts were fixed with Intrafix(Mitek, Norwood, MA). In case of tibial tunnel widening, additional screw-washer fixation was done. Follow up was at least 12 months postoperatively. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee(IKDC) evaluation form and manual maximal side to side difference using KT-2000 arthrometer. Results : The average Lysholm knee score improved from 77.2 preoperatively to 87.7 postoperatively. At the final IKDC evaluation, 1 case was graded as normal, 4 nearly normal, 1 abnormal. Mean side to side difference of manual maximum anterior displacement using the KT-2000 arthrometer was 1.8mm. The success rate was $83\%$. Conclusion : ACL revision surgery using quadruple hamstring autograft with double fixation is considered good procedure with successful results.

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Porocarcinoma Arising in a Ganglion Cyst: A Case Report and Review of the Literature

  • Park, Ie Hyon;Kim, Tae Hoon;Kwon, Sung Tack;Park, Ji Ung
    • Archives of Reconstructive Microsurgery
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    • v.25 no.2
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    • pp.56-59
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    • 2016
  • Eccrine porocarcinoma is a rare malignant neoplasm of the eccrine sweat gland that often occurs in the lower extremities, and usually affects elderly individuals. Most cases of eccrine porocarcinoma arise de novo. We encountered a case of a large porocarcinoma arising in a pre-existing ganglion cyst in the knee. The malignant tumor was excised widely, and the defect was reconstructed using a free anterolateral thigh flap.

A single injection of saphenous nerve block reduces postoperative bleeding after total knee arthroplasty (무릎전치환술 환자에서 일회성 복재신경차단술이 수술 후 출혈량 감소에 미치는 영향)

  • Choi, Yun Suk;Yun, So Hui;Cho, Seung Yeon;Song, Seung Eun;Kim, Sang Rim
    • Journal of Medicine and Life Science
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    • v.18 no.1
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    • pp.11-15
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    • 2021
  • In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.

Bilateral Lipoma Arborescens of the Knee in an Adolescent Patient (청소년에서 양측 슬관절에 발생한 수지상 지방종)

  • Kim, Hee-June;Kim, Jeong-Woo;Lee, Hyun-Joo;Kyung, Hee-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.354-358
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    • 2020
  • Lipoma arborescens (LA) is a rare lesion that causes joint effusion and pain. LA usually presents as a unilateral knee lesion, and bilateral lesions are extremely rare. LA among adolescent patients is also extremely rare with the disorder having a much higher incidence among adults. This paper reports a 14-year-old boy who was treated for bilateral knee LA. X-rays revealed the characteristic features of LA in both knees, and arthroscopic synovectomy was performed to resect the lesions. Postoperative recovery progressed smoothly, and the patient was eventually relieved of pain and swelling. LA should be considered when adolescent patients present with bilateral pain and swelling, even though this condition is rare in this age group. Furthermore, surgical synovectomy for a complete resection is an appropriate treatment option.