• Title/Summary/Keyword: Orthopedic Surgeons

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Complications After Meniscus Allograft Transplantation (동종 반월상 연골 이식술 후 합병증)

  • Chun, Churl-Hong;Bae, Kyu-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.42-49
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    • 2011
  • Recently, meniscal allograft transplantation has been regarded as a successful procedure in terms of pain relief and functional improvement for the symptomatic patients previously underwent subtotal or total meniscectomy. However, the likelihood of a successful outcome would be reduced by various complications including graft tear, shrinkage, extrusion, infection, progressive chondral injury, and granuloma due to nonabsorbable suture material. Therefore, knee surgeons need to be all aware of the complications and to make an effort to minimize them. The purpose of this article is to review the current literatures regarding clinical results and complications after meniscus allograft transplantation.

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Classic Floating Elbow in Adults: A Case Series

  • Cho, Chul-Hyun;Min, Kyung-Keun
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.8-12
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    • 2015
  • Background: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. Methods: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. Results: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. Conclusions: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.

Significant radiologic factors related to clinical outcomes after arthroscopic rotator cuff retear repair

  • Joo, Min-Su;Kim, Jeong-Woo
    • Clinics in Shoulder and Elbow
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    • v.25 no.3
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    • pp.173-181
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    • 2022
  • Background: Healing of the tendon itself is not always related to successful clinical outcomes after rotator cuff repair. It was hypothesized that certain radiologic factors affecting clinical outcomes could exist in case of the retear after arthroscopic rotator cuff repair (ARCR) and the radiologic factors could help predict clinical process. The purpose of this study was to identify the radiologic factors associated with clinical outcomes of the retear after ARCR. Methods: Between January 2012 and December 2019, among patients with sufficient footprint coverage for ARCR, 96 patients with Sugaya classification 4 or higher retear on follow-up magnetic resonance imaging were included. The association between clinical outcomes such as American Shoulder and Elbow Surgeons (ASES) score, Constant score and range of motion and radiologic variables such as initial tear dimension, retear dimension, variance of tear dimension, critical shoulder angle, acromial index, and acromiohumeral distance was analyzed. Results: Preoperatively, the ASES and Constant scores were 59.81±17.02 and 64.30±15.27, respectively. And at the last follow-up, they improved to 81.56±16.29 and 78.62±14.16, respectively (p<0.01 and p<0.01). In multiple linear regression analysis, the variance of the mediolateral dimension of tear had statistically significant association with the ASES and Constant scores (p<0.01 and p=0.01). Conclusions: In patients with the retear after ARCR, the variance in the mediolateral dimension of tear had significantly negative association with the clinical outcomes. This could be considered to be reference as relative criteria and needed more sample and mechanical study.

Ultrasound-Guided Shoulder Injections (초음파 유도하 견관절 주사요법)

  • Moon, Young Lae;Jun, Yong Cheol;Sun, Jae Myeong
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.393-401
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    • 2019
  • The shoulder pain is one of the most common problems to orthopaedic surgeons in clinic. Among therapeutic modality used to manage this pain, joint and periarticular injection, as well as suprascapular nerve block, show good clinical outcome. Ultrasound guidance is a safe technique, increasing the safety and accuracy of the procedure and reducing complications. An accurate understanding of the surface anatomy is important in performing the ultrasound-guided shoulder injections. This article aims to describe the surface anatomy and sono anatomy of both the shoulder and the surrounding structures and also summarize different infiltration techniques and peripheral nerve blocks.

Arterialized Venous Free Flap at the Insufficient Vascular Recipient Bed in Finger Reconstruction (수지 재건시 불충분한 혈행상태의 수혜부에 시행한 동맥화 정맥 유리 피판술)

  • Lee, Young-Keun;Park, Ki-Tae;Lee, Jun-Mo;Park, Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.131-136
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    • 2012
  • Purpose: Arterialized venous flap is useful for reconstruction of the traumatic soft tissue defect in fingers, but insufficient circulation of the traumatic fingers makes surgeons annoying to use the flap. We have grafted flaps in 7 fingers with insufficient vascular bed hoping to expanded the category of the flap. Materials and Methods: Arterialized venous flap have transplanted in 7 fingers from March 2008 through February 2010 and followed up for 4 to 16 months(average 7.2 months). They were all male with a mean age at the time of surgery was 33. The main injury was crushing in 4 degloving, contact burn and saw injury was I respectively. Time interval from injury to flap transplantation was average 3.1. weeks(3 days to 6 weeks). Designed flap size ranges from $8cm{\times}3.5cm$to $4cm{\times}3cm$. Vessel type of flap was one artery with two veins were 5 cases and one artey with one vein 2. Flap type was cutaneous in 3, tendocutaneous 2, neurotendocutaneous 1 and neurocutaneous 1. The circulation state of recipient site was avascular in 2 cases, insufficiency 3 and tip avascular 2. Results: Arterialized venous flap was complete survived in 2 cases, partial necrosis(less than 10%) 3 and failed in 2. Conclusion: An arterialized venous free flap could be a useful procedure for reconstruction in soft tissue or combined defect of the finger despite an avascular or insufficient vascular beds if the recipient beds were free from infection.

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Clinical and Radiological Results of Reverse Total Shoulder Arthroplasty Using a 25-mm Glenoid Baseplate

  • Lee, Ji Min;Kim, In Bo;Jung, Dong Wook
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.242-247
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    • 2015
  • Background: The size of the baseplate used in reverse total shoulder arthroplasty (RTSA) tends to be larger than the average size of the glenoid in the Korean population. The mismatch between the sizes of the baseplate and the patient's glenoid may result in improper fixation of the glenoid baseplate. This in turn may lead to the premature loosening of the glenoid component. Thus, we evaluated the short-term results of using a 25-mm baseplate in RTSA. Methods: Seventeen patients with cuff tear arthropathy underwent RTSA with a 25-mm baseplate. The mean age of the patients was 70.1 years, and the mean follow-up period was 14.0 months. We evaluated clinical outcomes preoperatively and postoperatively: the range of shoulder motion, the American Shoulder and Elbow Surgeons (ASES) score, and the Korean Shoulder Society (KSS) score. Results: We found that the mean ASES score and KSS improved from 35.0 to 74.4 (p<0.001) and from 46.9 to 71.8 (p<0.001) with RTSA. The mean forward elevation and abduction, external rotation also improved from $78.6^{\circ}$ to $134.3^{\circ}$ (p<0.05) and from $66.6^{\circ}$ to $125.0^{\circ}$ (p<0.05), from $20.2^{\circ}$ to $28.4^{\circ}$ (p=0.43). Postoperative complications were seen in 12% of patients, but neither the loosening of the glenoid baseplate nor inferior scapular notching were observed. Conclusions: In sum, the results of using a 25-mm baseplate in RTSA were similar to those of previous reports. Even though the outcomes are those of a short-term follow-up, neither the loosening of the glenoid baseplate nor the scapular notching were observed.

Giant Cell Tumor of the Cervical Spine - Case Report - (경추에 발생한 거대 세포종 - 증례 보고 -)

  • An, Ki-Chan;Chung, Kyung-Chil;Kim, Yoon-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.57-62
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    • 2006
  • Giant cell tumors are potentially malignant tumors in vertebrae, affecting frequently difficult to diagnose and are often inoperable. So it will be treated using radiation because of their high recurrence rate and the mechanical compression of spinal cord, but many surgeons described tumors of the vertebra, and the affected vertebral body can be treated using radical or near to total excision, with anteroposterior vertebral fusion or instrumentation of the spine. we report a case of giant cell tumor affecting the third cervical vertebra which caused neck pain and destroyed the vertebra body had treated using radical excison with fusion of posterior arch using instrumentation of the spine together with a literature review.

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The Current State of Total Shoulder Arthroplasty (견관절 전치환술의 현재)

  • Oh, Joo-Han;Song, Byung-Wook
    • Clinics in Shoulder and Elbow
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    • v.14 no.2
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    • pp.253-261
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    • 2011
  • Purpose: The purpose of the present article is to help orthopedic surgeons better understand the basic principles of unconstrained total shoulder arthroplasty, and to help them perform the best surgical technique for reconstruction. Materials and Methods: In this article, we reviewed in depth current biomechanics, indications & contraindications, surgical techniques, complications and outcomes of unconstrained total shoulder arthroplasty. Additionally, we discussed current issues relevant to total shoulder arthroplasty such as whether a keeled or a pegged glenoid should be used. Results and Conclusion: A thorough understanding of the biomechanics of total shoulder arthroplasty, and the technical details and problems in implantation, are critical to provide the best functional outcome and to avoid the risk of complications.

Treatment of Displaced Intra-articular Calcaneal Fracture using Ollier Approach (전위된 관절 내 종골 골절의 Ollier 접근법을 이용한 치료)

  • Kim, Keun-Woo;Cho, Sang-Gi;Lee, Dong-Yeon
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.174-179
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    • 2008
  • Purpose: We evaluated the clinical results of the intraarticular calcaneal fractures treated using Ollier approach by inexperienced orthopaedic surgeon. Materials and Methods: Between August 2003 and May 2007, Of the total 46 cases, 12 cases (9 patients) of displaced intraarticular calcaneal fracture who underwent open reduction and internal fixation using Ollier approach were evaluated. The means of age was 50.5 years. According to the Sanders classification, there was no type I case and 8 cases of type II, 1 case of type III, and 3 cases of type IV. We evaluated the treatment result by assessing radiologic parameters ($B{\ddot{o}}hler$ angle, Gissane angle, and calcaneal height/width) and clinical outcomes (VAS and AOFAS score). Results: The means of follow-up period was 25.3 months. The means of B.hler angle was improved from $2.4^{\circ}$ to $26.1^{\circ}$. Radiologic and clinical union was achieved in all cases without additional procedures. Excellent result were noted in 2 cases, good in 5 cases, fair in 4 cases, and poor in 1 case. We experienced 2 cases of minor complications; 1 case of mild wound infection and 1 case of hypoesthesia on foot dorsum. Radiologic findings of subtalar arthritis were present in 2 cases. Conclusion: Ollier approach seems to be helpful to inexperienced orthopaedic surgeons for the treatment of intraarticular calcaneal fractures in that it enables them to achieve considerable clinical outcomes without serious complications.

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Return to Play of Elite Overhead Athletes with Superior Labral Anterior Posterior Tears only after Rehabilitation

  • Park, Jin Young;Hong, Kyung Ho;Lee, Jae Hyung;Oh, Kyung Soo;Chung, Seok Won;Jeon, Seung Hyub;Cha, Myung Joo
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.77-83
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    • 2017
  • Background: Although there have been multiple reports on surgical outcomes of superior labral anterior to posterior (SLAP) lesions in overhead athletes, only a few reports exist in the literature about the results of nonoperative treatment in elite (collegiate or professional) overhead athletes. To determine the clinical outcomes of nonoperative treatment of SLAP lesions in elite overhead athletes. Methods: Between January 2006 and December 2011, 69 patients were selected. Initial arthroscopic SLAP repair was performed in 19 patients and of the 50 patients who underwent nonsurgical treatment, such as range of motion gain and periscapular muscle strengthening, 14 patients were converted to surgical treatment; 5 patients were lost to follow-up. Medical records of 31 elite overhead athletes who underwent nonsurgical treatment were retrospectively reviewed. Four clinical outcome measures were used: visual analogue scale (VAS) for pain, VAS for satisfaction, American Shoulder and Elbow Surgeons (ASES) score, and subjective feeling of recovery. Results: The average follow-up period was 35.9 months (range, 24-62 months). The VAS for pain decreased from 6.5 to 2.2 (p<0.01) and VAS for satisfaction was 7.6. The ASES score increased from 54.1 to 85.9 (p<0.01). The overall average value of subjective feeling of recovery was 72%. Twenty-three out of 31 elite athletes (74.2%) returned to play after rehabilitation; these 23 athletes performed at the same or higher levels after rehabilitation. Conclusions: Nonsurgical treatment in elite overhead athletes with SLAP lesion should be considered as a treatment option.