• Title/Summary/Keyword: intercondylar notch

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Arthroscopic Removal of Loose Bodies from the Knee (관절경을 이용한 슬관절 유리체 제거술)

  • Ahn, Jin Hwan;Ha, Chul Won;Hwang, Tae Kyu
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.155-158
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    • 1998
  • The purpose of this study is to evaluate the cause, size, number, nature and locaton of loose bodies in the knee joint and to describe the proper arthroscopic technique to remae the loose bodies according to the location of them. We retrospectively analysed thirty-three operations of arthroscopic removal of loose bodies from the knee. Eleven males and 22 females were included with average age of 38(range 7-71). Total number of removed loose bodies were more than sixty. The loose bodies were found most commonly at anterior intercondylar notch area. The most common associated pathology was degenerative arthritis. The most common size of loose bodies was in the range of 5mm to 10mm in diameter. The most common nature of loose bodies was osteochondral. The loose bodies located in suprapatellar pouch, medial gutter, lateral gutter. anterior intercondylar notch or posterior intercondylar notch were removed using standard portals such as anteromedial, anterolateral, superomedial and posteromedial portals. The removal of loose bodies located in upper portion of posteromedial or posterolateral compartment were greatly enhanced using posterior trans-septal portal. The proper portals for the visualization and removal of loose bodies were identified according to the location of loose bodies in the knee joint. More skill in the use of the arthroscope is required for the removal of loose bodies than for simple diagnostic arthroscopy.

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Notchplasty for Treatment of Impingement of the Cranial Cruciate Ligament on Osteophyte in a Cat

  • Hong, Youngchae;Park, Jiyoung;Choi, Ho-Jung;Lee, Young-Won;Jeong, Seong Mok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.459-462
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    • 2017
  • A 3-year-old, 5.6 kg, castrated, male, British short hair cat presented with subtle weight-bearing lameness of the right hindlimb when walking suddenly after rest. On physical examination, the patient experienced pain when the right stifle joint was hyperextended. There was no clinical improvement of lameness or pain of the right hindlimb, despite the administration of analgesic drugs for one week. During diagnostic arthroscopy of right stifle, mild synovitis and cranial cruciate ligament (CCL) impingement on osteophyte of the intercondylar notch (ICN) was observed. Computed tomography was applied to determine an accurate surgical plan. Arthroscopy-assisted notchplasty, including removal of the osteophyte, was performed using chisel and arthroscopic burr. At 4 weeks postoperatively, the frequency of subtle weight-bearing lameness of the right hindlimb was significantly reduced. At 6 months postoperatively, the patient exhibited normal ambulation without recurrence of lameness. Impingement of CCL may cause subtle lameness and pain. Arthroscopy can be a good diagnostic tool for early-stage CCL disease. Notchplasty can be recommended for osteophyte-induced CCL disease.

Geometry of Resident's ridge with Multidetector-Row Computed Tomograph Image (다중검출기 컴퓨터 단층 영상 분석을 이용한 Resident's ridge의 형태학적 연구)

  • Roh, Jeong-Ho;Min, Byoung-Hyun;Park, Jeong-Wook;Ahn, Byung-Moon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.40-44
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    • 2008
  • Purpose: The purpose of this study was to report the real geometry of Resident's ridge doing in anterior cruciate ligament reconstruction Materials and Methods: From Jan 2007 to Aug 2007, 48 cases which had normal distal femoral condyle analyzed with Multidetector-Row Computed Tomography. Resident's ridge was defined as change of height above 1 mm in lateral wall of intercondylar notch. Anterior-posterior length of intercondylar notch, length and height of Resident's ridge, distance of Resident's ridge from posterior cortex were estimated with 3-D reconstruction using $Lucion^{(R)}$ program. Results: Cases were $59{\pm}16$ years olds and male was 16 cases, female was 32 cases. 9 cases had no Resident's ridge, anterior-posterior length of intercondylar notch was $25.4{\pm}3.5$ mm, average of length and height of the Resident's ridge was $8.2{\pm}2.6,\;3.5{\pm}1.5$ mm. Distance of the Resident's ridge from posterior cortex was $7.6{\pm}2.6$ mm. Conclusion: Resident's ridge was used as landmark in anterior cruciate ligament reconstruction, which presented in many cases and which had distinct length and height.

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Arthroscopic Reduction of Irreducible Posterolateral Knee Dislocation with Interposition of the Vastus Medialis: A Case Report

  • Sim, Jae-Ang;Kim, Byung-Kag;Lee, Beom-Koo;Yoon, Yong-Cheol;Choi, Eun-Suk
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.167-171
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    • 2016
  • Irreducible traumatic knee dislocation is rare. The knee dislocation is classified depending on the incarcerated structures. Complete reduction is achieved by extracting the incarcerated structure. Several reports introduce the reduction of irreducible traumatic knee dislocation by open surgery or arthroscopy. This case describes irreducible posterolateral knee dislocation with interposition of the vastus medialis. Closed reduction failed in the emergency room, and complete reduction was attained by arthroscopically sectioning the muscle and fascia of the vastus medialis in the intercondylar notch.

Stiff Knee Following Anterior Cruciate Ligament Reconstruction - Cause Analysis and Treatment - (전방 십자 인대 수술 후 합병된 슬관절 강직 - 원인분석 및 치료 -)

  • Choi, Nam Yong;Lee, In Ju;Choi, Moon Ku;Ko, Hae Sok;Kim, Seung Ki;Park, Sung Jin;Han, Suk Koo;Kang, Young Mok
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.72-76
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    • 1998
  • Between March 1992 and December 1995 at St. Paul's, Holy Family, St. Vincent and Eui Jung Bu St. Mary Hospitals Catholic University, two hundred and eighty patients underwent arthroscopic anterior cruciate ligament(ACL) reconstruction using central one-third bone-patellar tendon-bone autograft. Nine of these patients had limitation of motion(LOM) defined as a knee flexion contracture greater than 10o or less than 125o of passive knee flexion. This study analyzes the causes of LOM after ACL reconstruction as well as the results after passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM. The results are as follows: 1. Out of nine patients, initially three had isolated ACL injuries and six had combined injuries. Seven of nine cases were perfomed by ACL reconstruction within four weeks and two were performed after four weeks following injury. 2. Treatment for LOM after ACL reconstruction was done after 5.5 months on average. 3. Arthroscopic adhesiolysis was done in 5 cases. There were fibrous adhesions at suprapatellar pouch and femoral intercondylar notch in all cases, respectively, infrapatellar fat pad in 3 cases and medial para patellar gutter in 2 cases. Two patients had a fibrous nodule, "cyclops" lesion, which formed anterior to the ACL graft. 4. Range of motion and Lysholm knee score were much improved following passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM.

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Symptomatic Abnormal Insertion of the Anterior Horn of Medial Meniscus - A Case Report - (증상을 유발하는 내측 반월상 연골 전각부의 비정상적 삽입 - 1예 보고 -)

  • Yoo, Jae-Doo;Shin, Sang-Jin;Kim, Tae-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.45-49
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    • 2007
  • We report a case of a girl with a symptomatic anomaly of medial meniscus. The complaint of the patient was pain and snapping of the knee. The anterior horn of medial meniscus has anomalous insertion which was extended to the intercondylar notch of the femur on the surface of the anterior cruciate ligament, it attached to lateral wall of medial femoral condyle. This anomalous band was not detected in MRI of knee but found during the operation. After resection of anomalous band, the symptoms completely disappeared.

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Anatomical Studies on the Skeleton of Pelvic Limb of Korean Native Goat (한국재래산양의 후지골격에 관한 해부학적 연구)

  • Kim, Jin-sang;Lee, Heung-shik S.;Lee, In-se;Yoon, Yeo-sung
    • Korean Journal of Veterinary Research
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    • v.28 no.1
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    • pp.1-16
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    • 1988
  • The anatomical structure of pelvic limb, of thirty-one adult Korean native goats (Body weight: 14~17kg) was observed after skeletal preparation, and the osteometry was performed in each bone. The results were as follows: 1. The pelvic limb of the Korean native goat was composed of the hip bone, femur, patella, tibia, fibula, tarsal bones, metatarsal bone, phalanges and sesamoid bones. 2. The hip bone consisted of the ilium, ischium and pubis which fused each other, The gluteal surface of the ilium was directed dorsolaterally. The tuber sacrale and tuber coxae were formed at the dorsal apex and ventrolateral part of the iliac wing, respectively. The lesser ischiatic notch was deeper than the greater one. The ischiatic tubercles were triangular form and consisted of the dorsal, lateral and caudal ischiatic tubercles. The left and right hip bone indexes were 67.08, 66.20, the acetabular indexes were 93.78 and 92.10 and the obturator foramen. indexes were 53.84 and 54.77, respectively. 3. In femur, both of the greater and lesser trochanter were well developed but the third trochanter was not observed. The left and right femur indexes were 26.55 and 26.14, head indexes were 81.66 and 81.49 and the trochlear-epicondyle indexes were 42.47 and 41.63, respectively. 4. The patella was observed as an isosceles triangle with base lying proximal and the cranial surface was more convex. 5. The tibial shaft was sigmoid form and the popliteal notch was deep. There was a large nutrient foramen at the cranial aspect of the cranial intercondylar area. The tibial indexes were 22.09 in left and 21.10 in right. 6. The proximal extremity of the fibula was fused with the lateral condyle of the tibia but the distal one was observed independently as the malleolar bone. 7. The tarsal bones were five in number; the talus, calcaneus, centroquartal tarsal bone, first tarsal bone, and second-third tarsal bone. 8. The metatarsal bone was composed of a large metatarsal bone. resulted from the fusion of the third and fourth metatarsal bones, The structure of metatarsal bone was similar to the metacarpal bone but longer about 7mm. 9. The phalanges and sesamoid bones were similar to these of the thoratic limb. 10. The ratios of the lengths among the hip bone, femur, tibia and metafarsal bone were 1.71 : 1.54 : 1.73 : 1.00 in left and 1.68 : 1.53 : 1.72 : 1.00 in right, respectively.

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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 Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • 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.

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Ultrasonographic Diagnosis of the Patellar Clunk Syndrome after Posterior Stabilized Total Knee Arthroplasty - A Case Report - (후방 안정형 인공 관절 전치환술 후 슬개골 덜컹 증후군의 초음파적 진단 - 증례 보고 -)

  • Yoo, Jae Doo;Kim, Nam Ki;Chung, Jae Yoon
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.39-44
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    • 2014
  • The patellar clunk syndrome is one of the patellofemoral complication, caused by formation of the fibrous nodule at the suprapatellar region after total knee arthroplasty. The symptom involves painful catching, crepitus and clunk during knee extension. It has been mainly but not exclusively associated with the posterior stabilized total knee system. The fibrous nodule is entrapped in the femoral intercondylar notch of the femoral component during flexion and as the knee is extended, it displaces back to the trochlear groove abruptly and the typical symptoms occur. The risk of developing this complication is primarily related to the design of the femoral component and higher incidence was noted with earlier designs of posterior stabilized knee prosthesis. Modifications have been made to the femoral component to optimize the kinematics of the patellofemoral joint and thereby reduced the incidence of patellar clunk syndrome but did not eliminate the problem completely. Clinical examination is the gold standard of diagnosis and imaging study has been used as a possible adjunct to diagnosis. Especially ultrasonography is an imaging modality, which can be easily performed to detect the fibrous nodule on the quadriceps tendon. We report a case of patellar clunk syndrome which was diagnosed with ultrasonography.

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