• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.35-39
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• 1999

The authors introduce an operative technique which is simple and effective for the treatment of the large prepatellar bursitis, avoiding problems by the conventional open technique such as tender scar, infection and recurrence. We treated three cases of the large refractory prepatellar bursitis caused by acute direct trauma. Bursectomies were performed by using an arthroscope and percutaneous multiple sutures were applied to the overlying skin with mattress fashion. There were no complications after treatment over one year follow-up. We suggest that this technique is very useful, greatly minimizes the chance of recurrence and reduces the possibility of post-operative infection.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.98-103
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• 2012

The repair technique of rotator cuff tear has been markedly developed in recent years. When the natural history of rotator cuff tear was followed, the size of rotator cuff tear increased with time. The fatty infiltration which would come at the later period of rotator cuff tear and the rotator cuff tear arthropathy which would be occurred after massive rotator cuff tear may be the important factors in predicting the prognosis of rotator cuff tear or determining the timing of surgery. Because moderate supraspinatus fatty infiltration appeared an average of 3 years after onset of symptoms, the repair of rotator cuff tear was recommended to be performed before that. And if there was massive rotator cuff tear with cuff tear arthropathy, it was recommended that the rotator cuff repair should be performed before the occurrence of the narrowing of acromiohumeral interval. The techniques of arthroscopic rotator cuff repair were mainly the single row repair and the double row repair. The former is good in view of time consuming and cost, but the latter is superior in view of biomechanics. To maintain the benefit in biomechanics of double row technique and reduce the time of surgery, the suture-bridge technique was invented and widely used recently. There are several modified techniques in arthroscopic suture-bridge technique according to the characteristics of rotator cuff tear.

• Journal of the Korean Orthopaedic Association
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• v.54 no.6
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• pp.574-578
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• 2019

For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.340-349
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• 2007

Free flap transplantation with microvascular anastomosis has been successfully performed by development of surgical technique, materials and postoperative monitoring equipments of flap. But success rate of microvascular anastomosis is influenced by various factors, and failure rate is about 5-10%. The most influential factor for success rate is surgical technique and other factors that influence failure of microvascular anastomosis are ischemic time of free flap, thrombus formation of anastomosis region and vascular spasm. In this study, vascular patency and thrombus formation in experimental micro-venous anastomosis, and endothelial repair were observed with histologic analysis, scanning electron microscopy, transmission electron microscopic examination. The results were obtained as follows: 1. In vascular patency test in 30 minute and 7 days after micro-venous anastomosis with heparin irrigation, all of 12 anastomosis site were good vascular patency. 2. In thrombus formation in 2 weeks group(Experimental I), 2 site of 6 cases were observed thrombus, and in 4 weeks group(Experimental II), 1 site of 6 cases were observed thrombus. 3. In histologic examination, normal vein(Control Group) showed continued internal elastic lamina, well formed thick smooth muscle layer and connective tissue. The group of 2 weeks after microvenous anastomosis(Experimental I) showd locally recovered internal lamina, discontinued internal lamina, disorganized smooth muscle cells and granulation tissue around suture silk. In the group of 4 weeks after micro-venous anastomosis(Experimental II), anastomosis site showed almostly continued internal lamina, disorganized smooth muscle cells and cicartrized tissue around suture silk. 4. In scanning electron microscope examination in 2 weeks(Experimental I) after micro-venous anastomosis, mesh fibrin formation showed near to endothelial cells, and in 4 weeks after micro-venous anastomosis(EXperimental II), numerous blood cells and fibrin mesh formation was seen associated with irregular endothelial cell arrangement. 5. In transmission electron microscope examination in 2 weeks after micro-venous anastomosis(Experimental I), irregular arrangement of smooth muscle cells was seen adjacent to collagenized tissue around suture silk. In 4 weeks after micro-venous anastomosis(Experimental II), denuded venous wall composed of relatively well arranged smooth muscle cells was covered by endothelial cells, but fibroblast cells and foreign body giant cells near to suture silk was remained. From the results obtained in this study, results of good vascular patiency and anti-thrombotic effect of heparin were obtained as a local irrigation solution, and repair of venous endothelial cell was observed in 2 weeks after micro-venous anastomosis.

• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.70-76
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• 2005

Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.157-169
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• 1999

Eighty-nine shoulders in eighty-eight patients with traumatic unilateral anterior shoulder instability were evaluated for Rowe and UCLA scores, recurrence, return to activity, and range of motion by an independent examiner at an average of 39 months after either arthroscopic or open Bankart repair using suture anchors. The arthroscopic technique included a minimum of 3 anchors, and a routine incorporation of capsular plication and proximal shift. Twenty­six shoulders(86.6%) out of thirty in the open Bankart repair group had excellent or good results while fifty­four(91.5%) of the fifty-nine shoulders with arthroscopic Bankart repair had excellent or good results. The arthroscopic group revealed significantly better results in the Rowe(p=.041) and UCLA scores(p=.026). Two shoulders in each group developed redislocation. There were no significant differences in the loss of external rotation and return to prior activity between the two groups(p>.05). The residual instability occurred more frequently in the group of patients with lesser anchors. Arthroscopic suture anchor capsulorraphy has results equal to or better than the open Bankart procedure.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.6
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• pp.239-246
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• 2014

Many kinds of membrane have been used for the guided bone regeneration (GBR) technique. However, most membranes do not fulfill all requirements for the ideal membrane for the GBR technique. Among them, collagen membrane has been most widely used. However, its high price and weak tensile strength in wet condition are limitations for wide clinical application. Synthetic polymers have also been used for the GBR technique. Recently, silk based membrane has been considered as a membrane for the GBR technique. Despite many promising preclinical data for use of a silk membrane, clinical data regarding the silk membrane has been limited. However, silk based material has been used clinically as vessel-tie material and an electrospun silk membrane was applied successfully to patients. No adverse effect related to the silk suture has been reported. Considering that silk membrane can be provided to patients at a cheap price, its clinical application should be encouraged.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.3
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• pp.197-203
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• 2017

Once a submasseteric space infection is diagnosed, the key to resolving the infection is via surgical intervention to evacuate the pus. Although it is possible and occasionally practical to drain the submasseteric space via an intraoral approach, an extraoral approach may sometimes be required. Surgeons have encountered complications such as facial nerve damage during extraoral incision and drainage procedures, and they have felt that extraoral dissection was very difficult. As such, an easier and simpler technique is needed. Our department recently modified various drainage techniques for submasseteric space abscesses. Damage to the marginal branch of the facial nerve did not occur, and this technique was very simple and rapid, such that a novice physician could perform this procedure. This modified technique was possible with trismus and under local anesthesia. After intraorally checking the position of the drain, the intraoral wound is closed with an absorbable suture and the drain is fixed to the extraoral skin. When a masseteric space infection is diagnosed, multiple space involvement is ruled out, and dependent drainage is required, this modified drainage technique can be useful.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.84-93
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• 2013

Purpose: The purpose of this study was to evaluate the repair integrity and clinical outcomes of delaminated tears following arthroscopic layered suture bridge rotator cuff repair in a prospective fashion. Materials and Methods: A consecutive series of 67 patients with delaminated rotator cuff tears who underwent surgery using the arthroscopic Layered Suture Bridge Technique were followed prospectively. Of 67 shoulders, 26 patients were male and 40 patients were female (one patient had bilateral tears); the mean age was 58.8(40~76) years. The clinical evaluation was performed according to ASES, UCLA, and KSS (Korea Shoulder Scoring System) scores with an average follow up period of 33 months. Repair integrity was estimated using MRI, which was performed six months postoperatively. Results: The average clinical outcome in ASES, UCLA, and KSS scores showed significant improvement at the time of the final follow-up compared to preoperatively, from 50.2 to 92.3, 15 to 31.3, and 54.4 to 90.7, respectively (p<0.001 for all scores). Follow up by MRI showed that 16 shoulders had a type-I; 14, a type-II; five, a type-III; two, a type-IV; one, a type-V re-tear. The overall rate of re-tear (types IV and V) was 7.9%. Conclusion: Use of the Arthroscopic Layered Suture Bridge Technique can result in improved functional and structural outcome in cases of delaminated rotator cuff tear.

• Journal of Veterinary Clinics
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• v.37 no.2
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• pp.75-81
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• 2020

The objective of the present study was to evaluate the effectiveness of autoligation techniques for castrating healthy male small breed dogs. Forty dogs were divided into four groups, with 10 in each group, based on maturity and the surgical technique used: 1) immature dogs aged less than 1 year, with autoligation of the spermatic cord via a scrotal approach (SAL) as the surgical technique (SAL-IM); 2) mature dogs aged 1 year or older, with the same SAL surgical technique (SAL-M); 3) immature dogs aged less than 1 year, with double ligation of the spermatic cord with an absorbable suture via a prescrotal approach (PDL) as the surgical technique (PDL-IM); and 4) mature dogs aged 1 year or older, with the same PDL surgical technique (PDL-M). The effectiveness of the surgical technique was evaluated by comparing the operating time and complications between these four groups. The significant decreases in operating times were found in SAL-IM and SAL-M compared with those of PDL-IM and PDL-M (p < 0.01 and p < 0.01). Regardless of maturity, the SAL surgical technique reduced operating time by approximately 69.5% compared with the PDL surgical technique. When the complication severities were scored, the results showed no significant differences among the four group. The autoligation technique for castration in healthy male small breed dogs is considered to be effective because the operating time consuming is less than conventional techniques.