• Title/Summary/Keyword: Ligament injuryArthroscopy

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Treatment of Lateral Meniscus Injury (외측 반월상 연골손상의 치료)

  • Bae, Dae-Kyung;Kwon, Oh-Soo;Lim, Chan-Teak
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.92-98
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    • 2001
  • Purpose : To analyze the clinical results of isolated lateral meniscus injury according to discoid versus non-discoid, athletes versus non-athletes and repaired cases versus cases treated with meniscectomy. Materials and Methods : Between January 1997 and June 2000, arthroscopic lateral meniscus surgery was performed in 329 cases. We reviewed 80 cases of isolated lateral meniscus injury without associated ligament injury or other pathologic condition retrospectively. The study population was composed of 54 males and 26 females with average age of 30.2 years(range, $17\~40$ years). Average follow up period was 15 months(range, $12\~39$ months). Eighty cases were classified into three categories; discoid group versus non-discoid group, athletes versus non-athletes, repaired cases versus cases treated with meniscectomy. Clinical evaluation was performed using Lysholm knee score and Tegner activity. Results : Non-discoid group had higher incidence of longitudinal tear than discoid group. Athletes group had higher incidence of repaired cases than non-athletes group. The repaired group had better clinical result than patient treated with meniscectomy group. Conclusion : Although lateral meniscus has some special features including anatomic mobility which can cause instability after meniscectomy and technical difficulties in repairing, it is recommended repairing meniscus tear not only longitudinal but also horizontal and complex tear to obtain better clinical results.

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Patterns of Meniscus Injury with Acute Anterior Cruciate Ligament Tears (급성 전방 십자 인대 파열과 동반된 반월상 연골 손상의 양상)

  • Cho Sung-Do;Ko Sang-Hoon;Hwang Soo-Yeon;Kim Moon-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.58-62
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    • 2003
  • Purpose : The purpose of this study was to investigate the incidence, location, type and treatment of meniscal injury associated with acute anterior cruciate ligament (ACL) tears Material and Methods: From Mar. 1997 to Feb. 2002, we reviewed 73 cases of acute ACL tear. There were 66 males and 7 females. The average age at the time of surgery was 33 year old (range, 16-62 years). The common causes of meniscal injury were sports injuries (45 cases) and traffic accidents (19 cases). In 45 sports injuries, thirty four cases were soccer injuries. All patients had undergone arthroscopic evaluation. We analyzed incidence, type, location, and treatment of meniscal injuries, especially those of soccer injuries. Results : Foully eight (57 sites) out of 73 had meniscal tears : Of these injuries, tears of lateral meniscus (26 cases, $54.2\%$) were more common than medial meniscus. Posterior horn of the meniscus was the most common location (52 cases, $91.2\%$) and radial tears were the most common type (15 cases, $26.3\%$). Thirty eight cases $(66.7\%)$ were treated by partial menisectomy. In soccer injuries, twenty eight (33 sites) out of 34 had meniscal tears. and tears of lateral meniscus (17 cases, $60.7\%$) were more common. Posterior horn of the meniscus was the most common location (30 cases, $90.9\%$) and radial tears were the most common type (9 cases, $27.3\%$). Twenty two cases $(66.7\%)$ were treated by partial menisectomy. Conclusions : Lateral meniscal tears in the setting of an acute ACL insufficiency are more common than medial meniscal tears. The findings in the this study would be helpful in clinical diagnosis and subsequent treatment decisions in patients with an acute ACL tears.

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Anatomic Localization of Neurovascular Bundle at the Level of the Korean Knee Joint: A Magnetic Resonance Imaging Study (한국인의 슬관절에 위치한 신경-혈관 다발의 해부학적 위치: 자기공명영상 연구)

  • Kim, Yeung-Jin;Kim, Tae-Kyun;Yang, Hwan-Deok;Kim, Hyoung-Joon;Shim, Sung-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.102-106
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    • 2008
  • Purpose: To evaluate the anatomical localization of neurovascular bundle at the level of the korean knee joint using a magnetic resonance imaging study and minimize the risk of neurovascular injury from arthroscopy surgery. Materials and Methods: The transverse and central axes were described on axial MRI scans of 100 korean knee joints. The distance between the neurovascular bundle and central axis was measured. The differences in neurovascular bundle localization according to sex and side were analyzed. The results were evaluated with SPSS(ver. 10.1). The influence of sex was evaluated by t-test. The difference between right and left side was evaluated by paired t-test. Significance was considered as p<0.05. Results: Whereas neurovascular bundle localization was lateral to the central axis in 94 cases(94%), it was on central axis in 6 cases(6%). There was no statistically significant difference of sex and side(P>0.05). Conclusion: Preoperative evaluation of neurovascular bundle with MR axial scans may prevent neurovascular injury when performing arthroscopic posterior cruciate ligament reconstruction and interventions on the posterior horns of menisci.

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A Comparison of Accuracy between MRI and Arthroscopic Finding in the Diagnosis of Acute ACL Tear (급성 전방십자인대 손상의 진단에 있어 관절경 소견과의 비교분석을 통한 자기공명영상의 유용성)

  • Choi, Chong-Hyuk;Yoon, Han-Kook;Kim, Bo-Ram;Yoon, Choon-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.46-50
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    • 2005
  • Purpose: The purpose of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of acute anterior cruciate ligament (ACL) injury and its tear pattern in comparison with arthroscopic finding. Materials and Methods: Sixty consecutive patients with acute ACL injury were taken NRI followed by arthroscopic examination between January 2002 and June 2004. MRI findings were reviewed according to the presence of ACL discontinuity, diffuse swelling or thickening, focal edema, collapse on distal end, and any combined tear. The pathologic findings were then confirmed arthroscopically. The diagnostic accuracy of MRI on ACL tear pattern was analyzed by obtaining its positive predictive value. Results: All fifty two cases with presence of discontinuity on MRI showed ACL rupture arthroscopically. The location of ACL tear, diffuse swelling and focal edema on MRI also corresponded with arthroscopic findings respectively. However, the diagnostic accuracy of MRI was relatively lower in the presence of other ACL patterns such as collapses and combined tear. Conclusion: Preoperative MRI findings seem to be in accordance with arthroscopic findings and is significantly accurate in detection of location and diffuse swelling and focal edema of ACL tear.

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PCL Reconstruction using Arthroscopic Posterior Transseptal technique (관절경하 후격막 통과 도달법을 이용한 후방 십자 인대의 재건술)

  • Kim, Jin-Goo;Kang, Yeong-Hun;Kang, Kyoung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.111-116
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    • 2000
  • Purpose : We reviewed the results of arthroscopic posterior cruciate ligament reconstruction using Achilles tendon allograft, and the efficacy of the surgical technique using gradual tibial tunneling and posterior transseptal technique. Materials and Methods : From september 1997 to September 1999, 8 patients with complete PCL injury were treated by arthroscopic PCL reconstruction using Achilles tendon allograft. Mean follow-up period was 21.7 months. Mean preoperative posterior laxity was 14mm. The clinical outcome was assessed by Telos stress test, Lysholm knee score and IKDC score. Result : There was no complication such as infection and neurovascular injury. Posterior translation using Telos device was less than 5mm in 6 cases$(75\%)$, and between 6 to 10mm in 2 cases$(25\%)$. The mean Lysholm knee score was 45 preoperatively and improved to 87 postoperatively. In IKDC system, 2 of 8 patients were group A and 6 were group B. Conclusion : Arthroscopic PCL reconstruction using achilles tendon allograft and posterior transseptal technique shows reliable stability, short operative time and minimizing donor site morbidity but needs more long term follow-up.

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Simultaneous Bucket-handle Tears of both Medial and Lateral Meniscus - A Case Report - (내측 및 외측 반월상 연골에 동시 발생한 양동이 손잡이형 파열 - 증례 보고 -)

  • Yoon, Jung-Ro;Kim, Taik-Sun;Yang, Jai-Hyuk;Kang, Kyu-Bok;Kim, Young-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.25-28
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    • 2010
  • Most of bucket handle meniscal tears are associated with anterior cruciate ligament (ACL) deficiency. Lateral meniscus lesions are more common with acute ACL deficiency, where medial meniscus lesions are more associated with chronic ACL deficiency. We reported an ACL deficient knee with bucket handle tears of medial and lateral meniscus of the same knee. The report suggests the need for increased awareness of the possible presence of this. Additionally, we discuss injury mechanism, clinical symptoms, specific signs on Magnetic Resonance Imaging (MRI), and treatment options.

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Endoscopic-Assisted Curettage of Brodie Abscess in Proximal Tibia - A Case Report - (경골 근위부에 발생한 Brodie 농양에서 내시경을 이용한 소파술 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Park, Man-Jun;Choi, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.134-138
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    • 2007
  • Brodie abscess is a localized form of subacute or chronic osteomyelitis which is common in children but may also occur in adulthood. When Brodie abscess is located in the posterior metaphysis of the proximal tibia, open biopsy and curettage have a difficulty in approach to the lesion and can cause neurovascular injury or soft tissue contamination. We report a case wherein a novel surgical technique was used to treat a Brodie abscess in the posterior proximal tibial metaphysis in 48 year-old-male with endoscopic-assisted curettage by commercial anterior cruciate ligament targeting device(Rigid Fix; Mitek, Johnson & Johnson, Norwood, MA). Two portals were created toward the abscess site and, through each portal interchangeably, the granulation tissue and sclerotic bone could be excised. We believe that endoscopic-assisted curettage presents safe technique, decreased morbidity, accurate assessment of the extent of the abscess and possible improvement in long-term outcomes.

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Arthroscopic Reduction and Internal Fixation of Intra-articular Fractures of Lateral Tibial Plateau (관절면을 침범한 경골 외과 골절의 관절경적 정복 및 내고정술)

  • Lee, Kwang-Won;Lee, Hang-Ho;Yang, Dong-Hyun;Choy, Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.53-60
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    • 2006
  • Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

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The Benefit of KT-2000 Knee Ligament Arthrometer in Diagnosis of Anterior Cruciate Ligament Injury (슬관절 전방 십자 인대 파열의 진단에 있어서 KT-2000 기기의 유용성)

  • Park, Jai-Hyung;Kim, Hyoung-Soo;Jung, Kwang-Gyu;Yoo, Jeong-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.82-88
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    • 2004
  • Purpose: In this study, we intended to ascertain the benefit of KT-2000 Knee arthrometer(KT-2000) in the diagnosis of ACL(Anterior cruciate ligament) injury by comparing the anterior displacement of normal knee with that of ACL deficient knee. Materials and Methods: We designated two examiners to measure the anterior displacement of the knee joint of 30 healthy individuals, using KT-2000, at 30$^{\circ}$ flexion setting of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation and analyzed these results according to the variables and measured the preoperative anterior displacement of the ACL injured knee in the 30 patients who have gone through an arthroscopic ACL reconstruction later. Results: The results of examiner 1 are 6.5${\pm}$1.5 mm, 2.5${\pm}$0.9 mm, 4.8${\pm}$1.2 mm, 6.4${\pm}$1.3 mm in right knee and 5.6${\pm}$1.3 mm, 2.1${\pm}$0.8 mm, 4.5${\pm}$1.2 mm, 5.2${\pm}$1.3 mm in left knee, in order of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation. The results of examiner 2 are 6.9${\pm}$1.2mm, 2.9${\pm}$1.1mm, 5.6${\pm}$1.6mm, 6.9${\pm}$1.5mm in right, 5.5${\pm}$1.7 mm,1.9${\pm}$0.9 mm, 5.1${\pm}$1.9 mm, 5.7${\pm}$1.6 mm in left knee, The side to side difference of examiner 1 in the setting of muscle relaxation is 0.9${\pm}$1.0 mm. The anterior displaement of ACL injured knee is average 11${\pm}$2.93 mm and difference of average 6.5${\pm}$2.31 mm form that of normal. In comparison between the right and left knees of healthy individuals, the both results of two examiners showed the statistical difference in the setting of muscle full relaxation but, the results showed the side to side difference below 2 mm in 25case(83%), 21case(70%) respectively and above 3 mm in just 1 case. In the comparison between the normal and ACL injured knees, the results show the statistical difference of the side to side difference in the setting of muscle relaxation(p<0.05). Conclusion: The KT-2000 result is affected by relaxation of muscles around knee, flexion angle of knee joint, rotation of tibia, the strength of displacing force, time of the test and physical factors as height and weight. However, the Accuracy of diagnosis of ACL injury by KT-2000 will increase if the examiner is skillful and the tests are made on the exact position of knee joint.

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Shoulder Injuries in Throwing Athletes (Throwing athletes에서 어깨 관절의 손상)

  • Lee Kwang-Won
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.119-126
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    • 2003
  • The shoulder is a complex joint and, by virtue of having a large range of motion, is inherently unstable, relying on the surrounding soft tissue structures for stability. The bony joint consists of the glenoid, acromion, and humoral head, while the soft tissues include the glenoid labrum, the glenohumeral ligaments. and coracoacromial ligament as well as the muscles of the rotator cuff, the long head of the biceps, and the scapulothoracic muscles. Dysfunction in any one of these components can cause shoulder problems. The throwing motion involves a series of phases that stress to their limits the dynamic and static restraints of the glenohumeral and scapulothoracic joints. . Therefore, maintaining a balance of proper biomechanical forces is essential to avoiding shoulder injuries in throwing athletes. Over the last decade, signficant advances have been made in the study and understanding of the shoulder mechanics, and pathophysiology of injury. Additionally, advances in surgical techniques, particularly arthroscopy , have aided in the diagnosis of and the developement of less invasive surgical treatments for injuries that do not respond to nonoperative measures. In this article, we reviewed the pathophysiology of injuries , diagnostic techniques, and surgical management of shoulder injuries in throwing athletes .

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