• Title/Summary/Keyword: arthroscopic treatment

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Arthroscopic treatment of Pigmented Villonodular Synovitis with combined Rotator Cuff Tear - 3 Case Reports - (견관절에서 회전근 개 파열이 동반된 색소성 융모성 활액막염의 관절경적 치료 - 증례보고 3예 -)

  • Ji, Jong-Hun;Kim, Weon-Yoo;Han, Chang-Hwan;Kim, Young-Yel;Kim, Seung-Jun;Kim, Ji-Chang
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.111-118
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    • 2006
  • Most pigmented villonodular synovitis (PVNS) is occurred in knee joint and finger of hand. PVNS is rarely occurred in shoulder joint. In English and French literatures, less than 30 cases were reported. We report 3 PVNS cases with rotator cuff tears, which was treated by arthroscoic extensive synovectomy, debridement and rotator cuff repair. The PVNS with rotator cuff tear in shoulder joint was rarely reported in the Korean literature.

Ankle Arthrodesis for Severe Arthritis Induced by Diffuse-Type Pigmented Villonodular Synovitis: A Case Report (미만성 색소 융모 결절성 활액막염에 의해 발생한 고도의 발목 관절염에 대한 관절 유합술: 증례 보고)

  • Kim, Young Kyu;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.173-176
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    • 2018
  • Pigmented villonodular synovitis (PVNS) is a proliferative disease that affects the synovial joint, tendon and bursa. PVNS can form a nodular structure in any joint, but it most commonly affects the knee joint and is rare in the foot and ankle joint. PVNS is divided into two types. Localized-type PVNS exhibits focal involvement with a nodular mass, while diffuse-type PVNS involves the entire synovium. Synovitis of the affected joint can also destroy cartilage and bone. Diffuse type accounts for 75% of PVNS and has a reported recurrence rate of 12.2% to 46%; aggressive synovectomy is recommended as the most effective treatment. In localized-type PVNS, only arthroscopic partial synovectomy is effective with a lower recurrence rate. We report a patient with severe ankle joint arthritis induced by diffusetype PVNS. The patient was treated by lateral malleolar ostectomy and ankle arthrodesis with a plate and screws via a lateral approach.

Total elbow arthroplasty for active primary tuberculosis of the elbow: a curious case of misdiagnosis

  • Pattu, Radhakrishnan;Chellamuthu, Girinivasan;Sellappan, Kumar;Chendrayan, Kamalanathan
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.158-162
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    • 2022
  • The incidence of musculoskeletal tuberculosis (TB) is on the rise due to the current Acquired Immunodeficiency Syndrome (AIDS) pandemic. Spine is the most common osseous site, followed by other joints. TB identified in the elbow accounts for 2%-5% of skeletal TB cases, which are secondary to pulmonary TB. Primary elbow TB is rare. We report a case of primary TB of the elbow which had a negative synovial biopsy. A 46-year-old right-hand dominant female patient with chronic pain and disability of the right elbow was diagnosed with chronic non-specific arthritis based on an arthroscopic synovial biopsy. The case was diagnosed retrospectively as active TB from bone cuts post total elbow arthroplasty. Anti-tuberculosis treatment (ATT) was given postoperatively for 12 months. The patient reported good functional outcomes at 3 years of follow-up. Such atypical presentations of osteoarticular TB are challenging to diagnose. Therefore, particularly in endemic areas, clinicians should be careful before excluding such a diagnosis even after a negative biopsy. Further research should investigate whether active TB of small joints such as the elbow can be treated with ATT, and early arthroplasty should be a focus of this research.

Application of Giungoroen-Therapy through a Postoperative Delirium Case (수술 후 섬망 치험 1례를 통해 본 지언고론요법의 활용)

  • Kang, Dong Hoon;Kim, Ju Yeon;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.3
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    • pp.339-349
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    • 2022
  • Objectives: The purpose of this study was to report the effectiveness of the combination of Giungoroen-therapy, as well as other Korean medicine therapy on postoperative delirium. Methods: The patient was diagnosed with postoperative delirium, that occurred after arthroscopic debridement two months before hospitalization. The patient received Giungoroen-therapy in addition to conventional Korean Medicine treatment, including acupuncture, herbal medicine, and moxibustion. The evaluation variables to check the effectiveness of the interventions, were the Korean Nursing Delirium Screening Scale (Korean Nu-DESC) and the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98). Results: During the hospitalization period, the Korean Nu-DESC score decreased from 5 to 1, and the K-DRS-R-98 score decreased from 36 to 23. The subjective expression of anxiety had been reduced. Conclusions: The combination of Giungoroen-therapy, as well as other Korean medicine therapy including acupuncture, moxibustion, and herbal medicine may be useful in alleviating postoperative delirium.

Operative Treatment of Symptomatic Os Acromiale (견봉 골의 수술적 치료)

  • Ji, Jong-Hun;Kim, Weon-Yoo;Park, Sang-Eun;Kim, Young-Yul;Moon, Chang-Yun
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.123-130
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    • 2008
  • Os acromiale is the rare shoulder disease and its treatment is controversial. Despite conservative treatments for 6 months include medication, exercise, physical therapy and subacromial steroid injections, operative treatment for uncontrolled symptomatic Os acromiale is considered the treatment of choice. Operative treatment includes excision, arthroscopic or open reduction and internal fixation with a bone graft. Open reduction with tension band wiring and a bone graft is now the preferred treatment. We experienced 8 patients with symptomatic Os acromiale from March, 2001 to March, 2006. The average patient's age was 45 years and the man and women ratio were 2: 6. All 8 cases of symptomatic Os acromiale of the mesoacromion were treated with open reduction and internal fixation using tension-band wiring. The preoperative ASES($47.3\pm24.4$) and UCLA ($16.6\pm5.8$)scores were improved to $88.8\pm7.3$ and $31.5\pm1.9$, respectively, at the 2 year follow up. The overall UCLA score showed 1 excellent result and 7 good results. We think that symptomatic Os acromiale is a specific disease entity, and open reduction and internal fixation using tension-band wiring with K-wire is a good treatment modality.

Meniscoid-type SuperrJior Labrum Associated with Internal Derangement of Shoulder Joint (견관절내 병변과 동반된 상부관절순의 반월상변형)

  • Choi Chang-Hyuk;Kwun Koing-Woo;Kim Shin-Kun;Lee Sang-Wook;Park Bum-Jin
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.41-46
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    • 1999
  • Glenoid labrum acts as one of static stabilizer of the glenohumeral joint. It deepens the glenoid socket and may also serve as a chock, acting as a wedge in preventing glenohumeral translation. Two types of variations in labral anatomy were noted by Detrisac and Johnson. Type A has a superior labrum that is detached centrally but well attached peripherally. The type B labrum is well attached centrally and peripherally at all sites. A meniscoid-type labrum is thought to be normal unless there are splits or fragmentation of the overlying labral tissue. Meniscoid type labrum is different from SLAP II lesion in that it has a firm anchoring on the superior labrum. We observed four cases that had a meniscoid variant superior labrum, which covered the superior glenoid unusually larger than normal in the arthroscopic treatment of shoulder pathology including instability and rotator cuff diseases. We did arthroscopic reshaping and debridement of meniscoid variant superior labrum combined with pathologic change of the glenohumeral joint. Further study would be required for understanding the mechanism of the development of meniscoid variant labrum and its clinical significance.

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Arthroscopic Repair of Type II SLAP Lesion with Bioabsorbable Knotless Suture Anchor: Surgical Technique and Clinical Results (제 2형 SLAP병변에서 생체흡수성 봉합나사못을 이용한 관절경 봉함; 수술 술기와 임상 결과)

  • Lee, Chae-Chil;Kim, Sung-Jae;Hwang, Chang-Ho;Seo, Dong-Kyo;Ko, Sang-Hun
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.59-64
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    • 2007
  • Purpose: The purpose of this study was to evaluate the results of bioabsorbable knotless suture anchoring for isolated type II SLAP. Materials and Methods: Fourteen patients with isolated type II SLAP underwent a surgical repair with bioabsorbable knotless anchor arthroscopically. Instability, rotator cuff tears or simple subacromial decompression were excluded. The UCLA and pain of VAS (Visual Analogue Scale), ADL (Activity of Daily Living, from the American Shoulder and Elbow Society) were evaluated and patients underwent a thorough shoulder examination at a minimum follow-up period of 2 years postoperatively. Results: At a mean of 27.1 months follow-up. The mean UCLA score improved from 14.4 pre-operatively to 31.2 on last follow-up. The mean VAS for pain was 4.9 and on last follow-up 1.0. The mean VAS for instability was 2.6 and on last follow-up 0.5. The mean ADL was 10.4 and on last follow-up 25.0. 12 patients reported their satisfaction as good to excellent and 10 of the 14 patients returned to their pre-injury level of activity (athletics) (P<0.05). Conclusion: Arthroscopic repair with bioabsorbable knotless suture anchors is an effective surgical technique for the treatment of an isolated unstable type II SLAP lesion. Overall satisfaction was only 85.7%. 1 patient had severe stiffness and 1 patient had shoulder pain.

Transpatellar Cannulated Screw Fixation of Displaced Tibial Intercondylar Eminence Fractures (전위성 경골 과간 융기부 골절의 슬개골 하단을 통한 삽관 나사못 고정술)

  • Nha Koung Wook;Jung Byung Hyun;Suh Jin Soo;Suk Seung Yeub;Park Gyu Won;Chae Dong Ju
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.25-30
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    • 2002
  • Purpose : To evaluate the clinical results of displaced tibial intercondylar eminence fractures which were treated with transpatellar cannulated screw fixation. Materials and Methods : Ten patients with displaced tibial intercondylar eminence fractures were treated between December 1998 and May 2001 and then followed up for more than one year. They were treated arthroscopic reduction and fixation of fracture site by cannulated screw through the hole of nonarticular surface of inferior patella. They were prospectively evaluated with regard to their clinical and radiologic results. Results : Radiologic unions occurred at an average of 9.2 weeks. Average anterior displacements were 1.8 mm in stress x-rays and 1.1 mm in KT-2000 arthrometer. Average loss of extension was $4.1^{\circ}$. Functional results were excellent in 7 cases and good in 3 cases. Conclusion : Arthroscopic transpatellar cannulated screw fixation is one of the useful methods for the treatment of displaced tibial intercondylar eminence fractures.

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Appearance of Meniscus Tear Associated with ACL Rupture - Analysis of Location and Type of Meniscus Tear - (전방 십자인대 파열과 동반된 반월상 연골 파열 양상 - 파열부위 및 형태의 분석 -)

  • Lee, Yeong-Hyun;Nam, Il-Hyun;Moon, Gi-Hyuk;Yun, Ho-Hyun;Kim, Jae-Cheol;Ahn, Gil-Yeong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.45-49
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    • 2007
  • Purpose: We analyzed the location and type of meniscus tear associated with ACL rupture in order to estimate and prepare whether the meniscus tear is in a repairable location. Materials and Methods: We reviewed 78 cases who had ACL reconstructive surgery due to ACL rupture. We set the period of acute injury on the basis of under 12 months after trauma. The location and type of meniscus tear was analyzed in accordance with MRI findings and arthroscopic findings. Results: The 50 cases of meniscus tear were detected out of the 78 ACL rupture;32 cases were lateral meniscus tears, 24 were medial meniscus tears and 6 cases were both menisci tears. From a total of 56 meniscus tears, 30 cases were longitudinal tears, 22 cases were red-red zone tears and 35 cases(62%) were posterior horn tears. Conclusion: The most common type of meniscus tear associated with ACL rupture war longitudinal tear at the red-red zone or meniscosynovial junction. Majority of the tears located at that place can be healed with conservative treatment, arthroscopic meniscus suture.

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The Modified $Brostr{\ddot{o}}m$ Procedure for Chronic Lateral Ankle Instability (만성 족관절 외측 불안정성에 대한 $Brostr{\ddot{o}}m$ 변형 술식)

  • Song, Ha-Heon;Shim, Dae-Moo;Lee, Byoung-Chang;Kim, Dong-Churl;Cho, Yong-Woo;Yang, Jung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.81-85
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    • 2004
  • Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

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