• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.21-29
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• 2003

Purpose: The purpose of this study is to review clinical and radiologic changes after arthroscopic operation without bone graft for osteochondral lesion with subchondral cyst on the talus. And we compared the results with those without cyst. Radiologic changes were also observed. Materials and Methods: Arthroscopic microfrature or abrasion arthroplasty was performed on 10 caeses of osteochondral lesions with subchondral cyst and 20 cases without cysts. Preoperative and postoperative symptoms were evaluated by Ankle-Hind foot scale of AOFAS and the score of two groups were compared(t-Test : Paired Two Test for Means). Radiologic evaluation was performed after operation on patients with osteochondral lesion with cyst. Results: On patients of osteochondral lesion with subchondral cyst on talus, there was clinical improvement compared to the preoperative status and compared to patients without cysts(P=0.01) after arthroscopic operation. We could get increase of density and decrease of size of cystic lesion on plain film with time passage. Conclusion: We report 10 cases with osteochondral lesion with subchondral cyst on talus which resulted in clinical and radiological improvement after arthroscopic microfracture or abrasion arthroplasty without bone graft.

• Journal of Korean Foot and Ankle Society
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• v.24 no.4
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• pp.174-174
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• 2020

• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.69-74
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• 2020

Osteochondral lesions of the talus (OLT) can heal and remain asymptomatic, or they can progress to deep ankle pain on weight bearing and the formation of subchondral cysts. Treatment varies from nonoperative treatment to open and arthroscopic procedures. Operative procedures include marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autografts or allografts, and autologous chondrocyte implantation. Among these treatments, arthroscopic marrow stimulation techniques have been the preferred initial surgical treatment for most OLT. Despite these treatments, many patients complain of persistent pain even after surgery, and many surgeons face the challenge of determining a second line of treatments. This requires a thorough re-evaluation of the patient's symptoms as well as radiological measures. If the primary surgical treatment has failed, multiple operative treatments are available, and relatively more invasive methods can be administered. On the other hand, it is inappropriate to draw a firm conclusion in which methods are superior.

• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.32-32
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• 2008

• 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.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.164-168
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• 2013

It is easy to overlook osteochondral lesions (OCLs) of the ankle in patients with chronic lower limb pain, such as complex regional pain syndrome (CRPS) or thromboangiitis obliterans (TAO, Buerger's disease). A 57-year-old woman diagnosed with type 1 CRPS, and a 58-year-old man, diagnosed with TAO, complained of tactile and cold allodynia in their lower legs. After neurolytic lumbar sympathethic ganglion block and titration of medications for neuropathic pain, each subject could walk without the aid of crutches. However, they both complained of constant pain on the left ankle during walking. Focal tenderness was noted; subsequent imaging studies revealed OCLs of her talus and his distal tibia, respectively. Immediately after percutaneous osteoplasties, the patients could walk without ankle pain. It is important to consider the presence of a hidden OCL in chronic pain patients that develop weight-bearing pain and complain of localized tenderness on the ankle.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.190-193
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• 2010

Both os trigonum syndrome and osteochondral lesion of talus (OLT) are common causes of ankle pain and usually affect ballet dancers or athletes. Lateral osteochondral lesions, which usually result from traumatic event, are mostly located anterolateral talar dome but rare central or posterolateral. Moreover, there are technical difficulties such as position of patient or additional posterior portal to address posterolateral lesion by arthroscopy. Meanwhile, treatment of os trigonum syndrome using arthroscopic approach has been reported in many literatures recently. However, it has not been reported to diagnose both os trigonum syndrome and posterolateral OLT together and treat arthroscopically at one stage. The authors report a case of male patient who was diagnosed as os trigonum syndrome with posterolateral OLT and treated simultaneously by hindfoot arthroscopy. Symptom was improved immediately after the operation, and radiological findings at postoperative 16 months verified remarkable healing.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.183-188
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• 2021

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.19-22
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• 2009

Purpose: This retrospective study was designed to determine the type and frequency of associated lesions in patients with chronic lateral ankle instability who had modified Brostrom lateral ankle ligament reconstruction. Materials and Methods: Between 2004 and 2007, 60 cases of 60 patients were enrolled in this study. A retrospective review of the magnetic resonance images of the affected ankle was conducted by two orthopedic surgeons who did not get any information about intraoperative findings and the lesions were admitted when two doctors were coincident. Results: The overall incidence of associated lesions found in this study was about 83%. Peroneal tenosynovitis was the highest frequency (32%), followed by osteochondral lesion of talus (28%), anterolateral impingement (15%), Os subfibula (13%), Os trigonum (12%), ankle synovitis (12%), anterior tibiofibular ligament tear (15%), anterior bony spur (7%). Another findings were loose bodies (5%), flexor tendon tenosynovitis (5%), medial osteophyte (3%). Conclusion: Identifying these associated lesions will be helpful in treating chronic lateral ankle instability especially when the surgeon have a plan to operate the instability. We suggest that the better results can be obtained when the associated lesions are corrected simultaneously.

• Journal of Korean Foot and Ankle Society
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• v.5 no.2
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• pp.103-111
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• 2001

Purpose: The purpose of this study was to evaluate prognostic factors of ankle arthroscopy and the effectiveness of high anteromedial and anterolateral portals in diagnosis and treatment for various disease entities. Materials and Methods: The results of ankle arthroscopy were evaluated between March 1992 and January 2000 by one surgeon. Total 169 patients who were followed for a minimum of 12 months, were included in this study. Using high anteromedial and high anterolateral portals, all procedures were done with accessory portals if necessary. A functional evaluation was performed using the Karlsson score and questionnaire subjectively. Results: Fifty-six synovial impingement, 48 osteochondral lesion on talus, 10 impingement exostosis, 8 loose body, 27 osteoarthritis and chondromalacia, 10 postfracture fibrosis, 3 lateral plica, and 1 pigmented villonodular synivitis(PVNS) among 169 patients were diagnosed. Patients with the former four groups had satisfactory results and the latter four groups had not. Remaining 6 patients underwent arthroscopic arthrodesis, and 5 had satisfactory results. Conclusion: Using high anteromedial and anterolateral portals, we could get better visualization of talar dome and posterior chamber of ankle. For better clinical results, in ankle arthroscopy, not only operative skill but also proper indications are important. In case of synovial impingement after trauma, arthroscopy should be considered within one year after initial trauma. There were little correlation between the radiographic findings and arthroscopic findings of articular cartilage in osteochondral lesion of talus, and it is better to determine treatment modality based on the arthroscopic or MRI findings. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.