• Title/Summary/Keyword: Second look arthroscopy

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Natural History of Spontaneous Healing of a Traumatic Radial Tear of the Lateral Meniscus: A Case Report (외측 반월상 연골에서 발생한 외상성 완전 방사상 파열 자가 치유의 자연 경과: 증례 보고)

  • Sim, Jae Ang;Yoon, Yong-Cheol;Lee, Sheen Woo;Lee, Beom Koo
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.21-26
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    • 2015
  • Complete radial tears of the lateral meniscus are relatively rare. Once torn, the injury can be debilitating due to disruption of the circumferential fibers of the meniscus. We experienced a case of a lateral meniscus with a complete radial tear at the midbody, where the two torn ends were displaced more than 1 cm and could not be approximated during arthroscopy. Thirteen months after surgery, follow-up MRI and second-look arthroscopic findings showed that the complete radial tear has healed spontaneously. However, twenty nine months after the second-look arthroscopy, the patient complained of severe knee pain during exercise. On follow-up MRI, increased sclerosis and newly developed bone marrow edema were observed in the lateral femoral condyle, compared with previous MR images. Finally, we performed meniscal allograft transplantation due to the defective properties of the completely healed lateral meniscus.

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Second-look Arthroscopic Findings after ACL Reconstruction - The Changes around Graft - (전방 십자 인대 재건술후 2차 관절경 검사 소견 - 이식건 주위의 변화 -)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Hwang Hoon;Ko Dong-Oh;Kwon Gi-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.13-16
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    • 2001
  • Purpose : To evaluate the types of the fibrous scar formation around graft after ACL reconstruction. Materials and Methods : Between Nov 1997 and Jun. 1999, the second look arthroscopy was performed on 15 knees of 14 patients. We evaluated the changes around graft and measured the tunnel position that the tibial tunnel position as a percentage along the length of the tibial plateau from the anterior-to-posterior as seen on a lateral radiograph and the femoral tunnel position as a percentage along Blumensaat's line from anterior-to-posterior as seen on a lateral radiograph. Results : The tibial tunnel position was from $27\%\;to\;58\%(mean\;41\%)$ and the femoral tunnel position was from $58\%\;to\;83\%(mean\;76\%)$, so the tunnel position was ideal in almost cases. By arthroscopic findings, the grafts were not impinged in all cases and tile fibrous scar was formed between intercondylar notch and graft in almost cases except 3 cases. The types of fibrous scar formation were 6 cases of fibrillated fiber and 5 cases of fibrous nodule and 1 case of fibrous band. Conclusion : There was no impingement on graft in all cases and various types of fibrous scars were formed around grafts.

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Arthroscopic Evaluation of Allogenic Meniscal Transplantation (반월상 연골 동종 이식술 후 이차 관절경 소견)

  • Choi Jeong-Ki;Son Il-Jin;Lee Chun-Tek;Kim Sung-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.147-152
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    • 2003
  • Purpose : The purpose of this study was to evaluate the arthroscopic findings of the transplanted human allogenic meniscus including MRI changes at follow up. Materials and Methods : From Oct. 1999 to Jun. 2002, nine patients underwent arthroscopic evaluation at follow-up. We used nonirradiated cryopreserved meniscus allograft for 6 cases and fresh-frozen for 3 cases. We used bone-plug method for medial meniscus and bone-bridge method for lateral meniscus to fix the transplanted meniscus. The average follow-up time was 13 months. We evaluated the result by lysholm score, MRI and second-look arthroscopic finding. Results : The second-look arthroscopy after allogenic meniscal transplantation revealed that grafts were well incorporated with surrounding capsular tissue. But one case showed wear on the post horn and the other case which was operated at other local clinic showed tear of the anterior hem due to non-anatomic placement of bone bridge. There was improvement of average Lysholm score form 64 to 87. Conclusion : Second-look arthroscopy revealed excellent incorporation of the allograft with firm attachment and early clinical results are satisfactory. But further studies are necessary to assess whether meniscal transplantation can prevent progressive degenerative changes.

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The Effect of a Tibial Remnant Preservation Technique on the Synovialization of the Graft Tendon in Anterior Cruciate Ligament Reconstruction - Based on the Second Look Arthroscopic Findings - (전방십자인대 재건술시 잔류 조직 보존술이 이식 인대의 활막화(synovialization)에 미치는 영향 - 2차 관절경 소견을 중심으로 -)

  • Ahn, Gil Yeong;Nam, Il Hyun;Moon, Gi Hyuk;Lee, Yeong Hyun;Choi, Seong Pil;Yoo, Jong Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.11-17
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    • 2013
  • Purpose: The purpose of this study is to evaluate the effect of preservation of the tibial remnant on the synovialization of graft tendon after the reconstruction of anterior cruciate ligament (ACL) based on the second look arthroscopic findings. Materials and Methods: From May 2005 to May 2012, among sixty three patients having ACL reconstruction with the four-strand hamstring using a bioabsorbable cross pin (RigidFix$^{(R)}$) for the femoral tunnel, nineteen patients who had second look arthroscopy were analyzed. We classified them into three groups according to the tibial remnant of the torn ACL for arthroscopic findings. Group 1 had less than 5 mm of a remnant tissue, Group 2 had from 6 mm to 10 mm of it, and Group 3 had more than 11 mm. We estimated the percentage of synovial coverage on the graft tendon during second look arthroscopy. We evaluated Lysholm score and Tegner activity score preoperatively and in the last follow-up. Results: At the time of ACL reconstruction, the mean length of preserved tibial remnant of torn ACL was 2.3 mm in Group 1, 7.4 mm in Group 2, and 13.7 mm in Group 3. In the second look arthroscopy, the average percentage of synovial coverage was 55.4% in Group 1, and 77.9% in Group 2, and 89.7% in Group 3. Lysholm score and Tegner activity score improved from 74.2 and 7.3 preoperatively to 94.1 and 8.5 in the last follow-up. Conclusion: The preservation of tibial remnant of torn ACL influenced the synovial coverage of the graft tendon and the volume of preserved remnant in accordance with the surface of synovial coverage. It would have a good effect on graft healing and preservation of proprioceptive function.

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Results of the Reconstruction of Anterior Cruciate Ligament with Freshfrozen Achilles Allograft and of the Second-look Arthroscopy (신선 동결 동종 아킬레스건을 이용한 전방 십자인대 재건술 후 2차 관절경소견)

  • Yoo, Jae-Doo;Kim, Sung-Il
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.111-116
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    • 2007
  • Purpose: To assess the clinical results of ACL reconstruction with a fresh frozen Achilles allograft, retrospectively and the findings of the graft in second look arthroscopy. Materials and Methods: Twenty-eight ACL reconstructions using fresh frozen Achilles tendon allograft were included in this study between March 1999 and February 2003. The average age was 31.2 years old and the average follow-up was 16.6 months(range: 12-26 months). The clinical evaluation was done by KT-1000 arthrometer, Lysholm knee score, range of motion, Lachman and pivot-shift test. Results: In the last follow-up of Lachman test, 21 cases showed normal, 5 cases grade 1, 2 cases grade 2 and 1 case grade1. The results of pivot-shift test data, 23 cases(82.1%) were normal, 4 cases(14.3%) grade 1, 1 case(3.6%) grade 2. The mean maximum side-to-side difference was improved from 6.75mm preoperatively to 2.46mm in the last follow-up. Lysholm knee score was improved from 73.5 preoperatively to 91.6 in last follow-up. Re-rupture of the ACL graft was found in one case and one case of wound infection in the tibial incision was found. The 6 cases showed the good synovialization of the ACL graft. Conclusion: The anterior stability was restored with ACL reconstruction using fresh frozen Achilles allografts and the good synovialization was found in the second-look arthroscopy

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Second look arthroscopic findings after microfracture surgery in osteoarthritic knee (퇴행성 슬관절염에서 미세천공술 후 이차 관절경 소견)

  • Bae, Dae Kyung;Kim, Jin Moon;Lee, Jeong Heui;Park, Yong Koo
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.85-90
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    • 1999
  • Purpose : The purpose of this study is to evaluate the clinical and histological results of the osteoarthritic patients who had second look arthroscopy after microfracture surgery. Materials and Methods : From Oct. 1997 to Dec. 1998, 46 patients, 48 knees were treated by microfracture technique. In the 22 patients, 24 knees, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture. Three patients were men and 19 patients were women. Average age of the patients were 58 years (range, 40-75 years). The average follow up period was 12 months(7-20 months). We analysed clinical results according to the nine-point scale. Also we observed type II collagen formation with immunohistochemical staining. Results : Clinical results were excellent in 83% and good in 17%. Among the 24 knees, more than 80% areas of chondral defect were covered with regenerated cartilage in 21 knees. Histologically, the regenerated tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. Regenerated cartilage contains variable amount of type II collagen with immunohistochemical staining. Conclusion : Most of the patients had significant improvement clinically. 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissue. Microfracture in the full thickness chondral defect provides and enriched environment for cartilaginous tissue regeneration.

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Arthroscopic Treatment of Osteochondritis Dissecans of the Talus (거골 박리성 골 연골염의 관절경적 치료)

  • Choi, Chong-Hyuk;Cheon, Yong-Min
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.161-170
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    • 2002
  • Purpose : To investigate arthroscopic simple excision for the treatment of osteochondritis dissecans of the talus and to examine gross change and histological evaluation of the defect through second look arthroscopy. Materials and Methods : This study included twenty-two patients who had osteochondritis dissecans of the talus that was treated with excision of arthroscopic loose body and necrotic bone tissue, leaving bleeding bed. In 7 cases, we performed second look arthroscopic examination for the evaluation of gross change of defects and histologic findings. Final results were evaluated with two clinical and functional protocols. Average follow up period was 42 months from 14 months to 8 years. Results : Ankle-hindfoot score (100 point) was improved significantly (p<0.003). Subjective and functional scores (100 points) averaged 82 points. The defect of lesion had a tendency of filling with fibrous tissue and fibrocartilage. Although the defect was filled with fibrocartilage, specific secondary lesion was not detected through second look arthroscopic examination. Conclusion : Arthroscopic debridement was an effective method for the treatment of osteochondritis dissecans of the talus without progression of secondary lesion even though the defect was filled with fibrocartilage.

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