• Title/Summary/Keyword: arthroscopic treatment

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Characteristics of Meniscus Tear in Tibial Plateau Fractures (경골 고평부 골절의 반월상 연골 파열 양상)

  • Lee, Dong-Hoon;Kim, Byung-Kuk;Kim, Jae-Hwa;Chung, Ju-Hwan;Lee, In-Sung;Lee, Jun-Ku;Lee, Soon-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.9-16
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    • 2012
  • Purpose: Tibial plateau fractures cause a variety of problems in the knee joint. The purpose of this study was to investigate the characteristics of the meniscus injuries in tibial plateau fracture arthroscopically. Materials and Methods: Thirty-three out of 39 consecutive patients diagnosed with tibial plateau fractures underwent arthroscopy between March 2007 and March 2010. According to Schatzker classification, there were 1 type I (3.3%), 19 type II (53.3%), 4 type III (13.3%), 2 type IV (6.6%), 2 type V (6.6%) and 5 type VI (20%) fracture patterns in 33 patients. Results: Twenty-five cases (75.8%) had lateral meniscus tears. There were 18 meniscal tears in 19 cases of Schatzker type II fractures (94.7%), 3 meniscal tears out of 4 cases of Schatzker type III fractures (75%) and 4 meniscal tears out of 5 cases of Schatzker type VI fractures (80%). The most commonly affected site (22/25) was the anterior horn of the lateral meniscus. Of the 25 documented meniscal tears, all but one were vertical longitudinal tear at meniscocapsular junction so most cases are amenable to arthroscopic repair. Conclusion: Arthroscopy for the meniscal injuries in tibial plateau fractures is a valuable diagnostic and treatment tool, we recommend arthroscopy in tibial plateau fracture.

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The Effectiveness of Arthroscopy in Complicated Knee Arthroplasty (합병증이 병발된 슬관절 치환술에 시행한 관절경술의 효용성)

  • Kim, Kyung-Tae;Lee, Song;Ko, Dong-Oh;Kim, Kwan-Soo;Kim, Tae-Woo;Park, Soon-Youl
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.39-45
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    • 2009
  • Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

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Knee Injury In Soccer Play (축구경기시의 무릎손상)

  • Lee, Dong-Chul;Bae, Sang-Keun;Shon, Oog-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.141-146
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    • 2006
  • Purpose: This study was performed to analyze the mechanism and type of knee injury during soccer game and to evaluate the functional recovery after treatment. Materials and Methods: From October 2002 to January 2005, 49 patients were treated surgically. Mean age was 28.8 (8-36) years old, mean follow-up duration was 14.9 (8-36) months. Injury was evaluated by physical examination, radiography, and arthroscopic finding. Clinical results were evaluated with Lysholm score and Tegner activity score. Results: According to classification of the ligament injury, the incidence of single ACL injury was the most frequent and 27 cases. Injuries took place, in 2nd half of the games, and in the winter. Among the mechanism of injury, turn & twisting was 20 cases and the most frequent. The preoperative Lysholm score, Tegner activity score were 45, 2 and those of last follow-up were 87.6, 6, respectively. Conclusion: The recovery of Lysholm and Tegner activity score were good, but the sports activity was clearly decreased alter injury. It was suggested that appropriate physical & psychological rehabilitation and education were inevitable.

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Acute Type V Acromioclavicular Injury Treated by the Modified Bosworth Technique (급성 제 5형 견봉쇄골관절 탈구의 치료)

  • Kim Seung-Key;Yi Sang-Hoon;Park Jong Beom;Bahk, Won-Jong;Jang Il-Seok;Chang Han
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.126-132
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    • 1999
  • Purpose : To evaluate the functional and radiographic outcome of the modified Bosworth method in the surgical treatment of acute type V acromioclavicular joint dislocation. Materials and Methods: From June 1995 to May 1998, 20 patients were operated on for acute and complete acromioclavicular dislocation(Rockwood type V). The operative technique includes fixation of the coracoclavicular joint with Bosworth screw or 6.5mm cancellous screw and imbrication of trapezius and deltoid muscles. The average age was 34 years(range, 19 to 51 years). These 20 patients with an average follow-up of 18months, were evaluated clinically using the UCLA scoring system. Additional radiographical assessment was performed with stress radiographs. Results: Excellent or good clinical results were obtained in 95%(19 cases). And the average coracoclavicular interval ratio was decreased from 3.31(2.2-6.0) to 1.13(1-1.4) in stress radiographs. There were 4 cases of hetero­topic calcification postoperatively but there was no correlation with clinical result. Posttraumatic A-C joint arthritis was developed in one case. In that case, the distal clavicular resection was done under the arthroscopic technique. Conclusion: The severe displacement observed with type V injuries is incompatible with normal shoulder function if the shoulder is left in its displaced position. In type V injuries, significant damage to the deltoid and trapezius musculature and overlying fascia occurs, therefore open reduction and good fixation must be obtained with imbrication of trapezius and deltoid muscles. In our type V acute complete acromioclavicular dislocation, the modified Bosworth technique provides excellent results with a low complication rate.

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Comparison of Superior Labral Anterior Posterior (SLAP) Lesions: Sports versus Non-sports Induced Injury (스포츠 손상과 비스포츠 손상에 의한 상부 관절와 순 전후방(SLAP) 병변의 비교)

  • Lee, Kwang-Won;Lee, Seung-Hun;Yang, Dong-Hyun;Kam, Byoung-Sup;Choy, Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.175-182
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    • 2007
  • Purpose: This study compared the SLAP lesions caused by a sports-induced injury with those caused by a non-sports-induced injury. Materials and Methods: The study was performed on 54 patients who had undergone arthroscopic surgery for a SLAP lesion. There were 21 sports-induced-injury patients (group I) and 36 non-sports-induced injury patients (group II). The mean age of the men was 36 years and that of the women was 48 years. In both groups, the frequency of a concomitant injury and the clinical outcomes at the last follow-up was evaluated using the UCLA score, Rowe score, and the ASES score. Results: According to their injury mechanism, , there were 14 cases (67%) of repeated microtrauma injury in group I and 25 cases (75%) of compression injury type in group II. As a concomitant pathology, there was 11 cases of shoulder instability and 5 cases of a rotator cuff tear in group I, and 23 cases of rotator cuff tears and 14 cases of shoulder instability in group II. At the last follow up, group I showed slightly better clinical satisfaction (P>0.05). Conclusion: The possibility of a SLAP lesion accompanying other diseases is high. Therefore, an accurate assessment of concomitant injury lesions before surgery is important for the treatment outcome.

Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.303-308
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    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

Alternative Fixation Technique for Bony Bankart Lesion with Using Suture Anchor (봉합나사와 골터널을 이용한 골성 반카르트 병변의 고정)

  • Kim, Byung-Kook;Lee, Ho-Jae;Kim, Go-Tak;Dan, Jinmyoung
    • 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.

Patterns of Meniscus Injury with Acute Anterior Cruciate Ligament Tears (급성 전방 십자 인대 파열과 동반된 반월상 연골 손상의 양상)

  • Cho Sung-Do;Ko Sang-Hoon;Hwang Soo-Yeon;Kim Moon-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.58-62
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    • 2003
  • Purpose : The purpose of this study was to investigate the incidence, location, type and treatment of meniscal injury associated with acute anterior cruciate ligament (ACL) tears Material and Methods: From Mar. 1997 to Feb. 2002, we reviewed 73 cases of acute ACL tear. There were 66 males and 7 females. The average age at the time of surgery was 33 year old (range, 16-62 years). The common causes of meniscal injury were sports injuries (45 cases) and traffic accidents (19 cases). In 45 sports injuries, thirty four cases were soccer injuries. All patients had undergone arthroscopic evaluation. We analyzed incidence, type, location, and treatment of meniscal injuries, especially those of soccer injuries. Results : Foully eight (57 sites) out of 73 had meniscal tears : Of these injuries, tears of lateral meniscus (26 cases, $54.2\%$) were more common than medial meniscus. Posterior horn of the meniscus was the most common location (52 cases, $91.2\%$) and radial tears were the most common type (15 cases, $26.3\%$). Thirty eight cases $(66.7\%)$ were treated by partial menisectomy. In soccer injuries, twenty eight (33 sites) out of 34 had meniscal tears. and tears of lateral meniscus (17 cases, $60.7\%$) were more common. Posterior horn of the meniscus was the most common location (30 cases, $90.9\%$) and radial tears were the most common type (9 cases, $27.3\%$). Twenty two cases $(66.7\%)$ were treated by partial menisectomy. Conclusions : Lateral meniscal tears in the setting of an acute ACL insufficiency are more common than medial meniscal tears. The findings in the this study would be helpful in clinical diagnosis and subsequent treatment decisions in patients with an acute ACL tears.

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Treatment of Osteochonritis Dissecans of Femoral Condyle (대퇴골과 박리성 골연골염의 치료)

  • Lee Dong-Chul;Kwon Soon;Son Wook-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.49-54
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    • 2002
  • Purpose : To analyze the clinical results of treatment for the osteochondritis dissecans of femoral condyle by age, the type of lesion and method of treatment. Methods : From March 1991 to February 2000, 17 patients (20 cases) with osteochondritis dissecans of the femoral condyle were followed up over 1 year. Three patients had bilateral lesion. There were 12 cases with trauma history (9 cases with sports injury and 3 cases with direct trauma). The initial symptoms were pain, clicking, locking, giving way in the order of frequency, pain was revealed in all cases. Clinical evaluation of IKDC and Hughston method were used for subjective and objective function. Results : The number of male patient was 12, and the mean age was 19.8 year old (11$\~$50). The location of the lesion was 14 cases in medial femoral condyle and 6 cases in lateral femoral condyle. The arthroscopic findings of the lesion in 15 cases were as follows, early separation in 6 cases, partially detachment in 4 cases, and crators and complete detachment in 5 cases. 5 cases were treated with mutiple drilling and 5 cases with Herbert screw fixation, 3 cases with Herbert screw fixation and bone graft. In early stage, 7 cases were treated with conservative method. In the grading of Hughston score, 6 cases were graded as excellent, 9 cases as good, 15 cases were graded as good to excellent. Based on the IKDC scale, 1 case was graded as normal, 6 as nearly normal, and 10 as abnormal. Conclusions : The trauma seemed to be important factor in occurrence of osteochondritis dissecans of the femoral condyle. The clinical results of juvenile period showed better than adolescence and adult period, it is necessary to detect the lesion as soon as possible. The result of subjective evaluation was worse than the Hughston evaluation. It was caused by limiting involvement of sports activity and limited activity in the adolescence.

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Radiofrequency thermal Shrinkage for Elongated Anterior Cruciate Ligament after Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술 이후 이완된 전방십자인대에 시행한 고주파 에너지 열 수축)

  • Kim, Yeung-Jin;Chun, Churl-Hong;Kim, Tae-Kyun;Yang, Hwan-Deok;Kim, Hyoung-Joon;Kim, Young-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.27-32
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    • 2008
  • Purpose: To evaluate the clinical results of the patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity after ACL reconstruction. Material and Methods: From October 1999 to March 2006, we performed 133 cases of ACL reconstruction. Among them we experienced 16 patients who had the laxity of reconstructed ACL in second look arthroscopy. Mean follow-up was 20.4 months. Mean age was 33.5 years. 12 cases were male and 4 cases were female. The elongated ACL were treated by bipolar radiofrequency energy with an output of grade II. Subjective and objective parameters were utilized in analyses, such as: the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test, IKDC score. Wilcoxon signed-rank test was used to perform the data analysis. P<0.05 was considered to be statistically significant. Results: Postoperative mean Lysholm knee score (preop: $82.2{\pm}5.2(77{\sim}85))$ (P=0.04), postop: $85.2{\pm}4.8$(82-90)) and anterior displacement by the Telos stress test (preop: $5.4{\pm}4.6(3{\sim}10)mm$, postop: $2.1{\pm}1.9(0{\sim}4)mm)$ (P=0.02), Lachman's test, and IKDC scores (P=0.04) demonstrated significant differences statistically compared to the preoperative. There were no statistical differences in mean range of motion, Tegner activity scale. Conclusions: Arthroscopic shrinkage for the ACL laxity after ACL reconstruction with radiofrequency device showed good clinical results and was applicable operative technique.

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