• Title/Summary/Keyword: notchplasty

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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.

Design of Femoral Tunnel Entrance to Operate Notchplasty (Notchplasty 시술을 위한 대퇴골 터널 입구 형상 설계)

  • Chung G.Y.;Kim K.T.;Lee T.H.;Ahn J.Y.;Han J.S.
    • Journal of Biomedical Engineering Research
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    • v.21 no.3 s.61
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    • pp.279-283
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    • 2000
  • After ACL reconstruction. abrasion or wear of graft appeared frequently because of contact stresses between femoral tunnel and ACL. To minimize these problems. optimal shape of femoral tunnel is necessary. In this study. we evaluate friction force by degree of wear due to abrasion of soft tissue and develop 3-dimensional FEM model using ANSYS 5.5.1 version to analyze stress growths between femoral tunnel and ACL, We conclude that femoral tunnel angle must be slacked parallel to tunnel direction to minimize contact stress.

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Arthroscopic ACL Reconstruction - How can I do well with notchplasty -

  • 최남용
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.7-9
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    • 2003
  • 전방십자인대 재건술시 이식건의 과간 절흔에 대한 충돌을 예방하기 위하여 어느 절도의 절흔 성형을 시행 할 것인가에 대하여는 아직까지 논란이 있으며 수술시 절흔의 형태, 골극 형성 유무, 이식건의 크기 경골 터널의 위치를 고려하여 시행하여야 한다. 절흔 후방의 골 제거가 과도하게 시행 될 경우에는 대퇴골 부착부가 외측으로 전위되어 슬관절의 생역학적 변화를 가져올 수 있고, 주변 관절 연골의 조기 퇴행성 변화를 초래할 수 있으므로 세심한 주의를 기울여야 하며 절흔 성형은 가능한 한 최소화 하는 것이 출혈, 동통 및 부종 등의 술후 합병증을 줄일 수 있다.

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Complications of Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술의 합병증)

  • Song Eun-Kyoo;Kim Jong-Seok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.15-19
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    • 2003
  • Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

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Arthroscopically Assited Reconstruction of the Anterior Cruciate Ligament using the Flexible Reamer (유연성 연마기를 이용한 관절경적 전방 십자 인대 재건술)

  • Lee Seoung-Joon;Park Jung-Ho;Chae In-Jung
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.176-182
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    • 2003
  • Purpose : The purpose of this study is to describe the surgical technique of ACL reconstruction with the flexible reamer and evaluate the clinical results of this method. Materials and Methods : Twenty four patients who followed for 12 months were included. The results were evaluated by Lachman test, KT-2000 arthrometer, Lysholm score, and postoperative roentgenogram of the knee. Results : The range of motion of the affected knee was acceptable except one case(10 to 90 degree) and at the last follow up, two cases were positive in Lachman test. Mean Lysholm knee scoring scale was 63.7 point preoperatively and 91.4 point at the last follow up. The results of KT-2000 arthrometer was 6.6mm preoperatively and 1.5mm at the last follow up. In operative time, there were decrease of mean 13.5 minute than ACL reconstruction without the flexible reamer, Conclusion : ACL reconstruction with the flexible reamer achieves the ideal isometric point of tibia and femur with no difficulty, proper notchplasty preventing from the impingement, and lessens the operative time.

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Hypertrophy of the Anterior Cruciate Ligament of the Knee (슬관절의 전방 십자 인대의 비후)

  • Cho Sung-Do;Park Tae-Woo;Cho Yong-Sun;Kim Bum-Soo;Lew Sogu;Yang Seoung-Oh;Kim Sung-Sook;Hwang Su-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.63-68
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    • 2001
  • Purpose : To propose the diagnosis, 'hypertrophy of the anterior cruciate ligament(ACL)', and its clinical, radiological and pathological characteristics. Materials & Method : Since Dec. 1995, we have experienced 10 patients(12 knees) with hypertrophy of the ACL. There were 2 males and 8 females, and the age of the patients ranged from 35 to 67 years. Characteristics of clinical, radiological and pathological findings were analysed. Results : The chief complaint was insidious onset of dull pain on the knee which became worse with activity. The constant physical finding was painful limitation of full extension of the knee. Sagittal MR images showed diffuse swelling of the ACL, similar finding that could be seen in acute ACL tear. Arthroscopically, noted was a marked enlargement of the ACL causing notch impingement. Biopsies of the hypertrophied ACL showed increased collagenous tissue with variable degree of myxoid degeneration. With partial excision of the hypertrophied ACL with or without notchplasty, the symptoms improved in all. Conclusion : Hypertrophy of the ACL, a newly proposed diagnosis, should be considered be determining the cause of the painful knee, and further study should be done about its pathogenesis.

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A Prospective Randomized Study of Anterior Cruciate Ligament Reconstruction Comparing Single-Bundle and Double-Bundle Techniques (단일다발 및 이중다발 전방십자인대 재건술의 전향적 무작위적 비교 연구)

  • Park, Sang-Eun;Lim, Moo-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.13-19
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    • 2010
  • Purpose: To evaluate and compare the postoperative knee stability and functional scores between single- and double- bundle anterior cruciate ligament (ACL) reconstruction at a minimum 2 years follow-up. Materials and Methods: 56 patients (group T) with ACL injury in one knee were recruited with 27 allocated to the double bundle ACL reconstruction group (group D) and 29 to the single bundle ACL reconstruction group (group S). Clinical outcomes including Lysholm knee scores, Tegner activity scores, Lachman and pivot shift test results, and radiographic stabilities were also compared between two groups. Results: Clinical outcomes including Lysholm knee and Tegner activity scores were similar in the two groups at 2 years follow-up. Furthermore, stability results of Lachman test, pivot shift test, and radiological findings failed to reveal any significant inter-group differences. Conclusion: Double bundle ACL reconstruction does not produce better in clinical outcomes and postoperative stabilities.

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Anterior Cruciate Ligament Double Bundle Reconstruction with Hamstring Tendon Autografts - Technical Notes (자가 슬괵건을 이용한 전방 십자 인대 이준 다발 재건술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Ahn, Hyung-Kwon;Kang, Hong-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.222-231
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    • 2005
  • Purpose: This article describes a double-bundle ACL reconstruction technique using a five-strand hamstring tendon autograft with conventional anteromedial bundle reconstruction and additional posterolateral bundle reconstruction. Operative technique: For the tibial tunnel, the conventional single tunnel technique is performed and for the femoral tunnel, the double tunnel technique is performed with the anteromedial and posterolateral bundle. After minimal notchplasty, the anteromedial femoral tunnel is prepared with leaving one milimeter of posterior femoral cortex within the over-the-top, which if positioned at the 11-o'clock orientation for the right knee or at the 1-o'clock position for the left knee. The posterolateral femoral tunnel that is located 5 to 7 mm superior to the inner margin of the lateral meniscus anterior horn at $90^{\circ}$ of flexion is prepared with tile outside-in technique using a 4.5 cannulated reamer. The graft material for the double bundle reconstruction is made of the conventional four-strand hamstring autograft in the anteromedial bundle and of a single-strand semitendinosus tendon in the posterolateral bundle. The anteromedial bundle is fixed with using a rigid fix system on the femoral side and the posterolateral bundle is fixed to tie with the miniplate from the outside femur. Then, with the knee in $10^{\circ}\;to\;20^{\circ}$ of flexion, a bioabsorbable screw is simultaneously applied to achieve tibial fixation with tensioning of both bundles. Conclusion: A double bundle reconstruction with five-strand hamstring autograft, which is designed with a favorable conventional anteromedial bundle and an additional posterolateral bundle to restore rotation stability, seems to be a very effective method for the treatment for ACL instabilities.

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The Follow-up Results of Anterior Cruciate Ligament Reconstruction Using The Flexible Reamer (유연성 연마기를 이용한 관절경적 전방 십자 인대 재건술의 추시 결과)

  • Chae, In-Jung;Wang, Joon-Ho;Choi, Gi-Won;Song, Dong-Ik
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.18-23
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    • 2008
  • Purpose: The purpose of this study is to evaluate the clinical results of the function and stability of ACL reconstruction using the flexible reamer. Materials and Methods: We reviewed 98 patients who taken ACL reconstruction using the flexible reamer from March, 1999 to May, 2004. And the follow-up period was more than 12 months in all cases. We used the subjective tests including Lysholm knee score and 2000 International Knee Documentation Committee(IKDC) subjective knee score, and the objective tests such as anterior drawer test, Lachman test, pivot shift test, and KT-2000 arthrometer to evaluate the clinical results. Results: In the range of motion of the affected knee, the extension deficit more than 5 degree was 8 cases preoperatively and 1 case postoperatively. The flexion deficit more than 5 degree was 12 cases preoperatively and 2 cases postoperatively. The mean Lysholm knee score was 61.3 point(${\pm}3.5$ SD) preoperatively and 87.7 point(${\pm}2.0$ SD) postoperatively. The mean 2000 International Knee Documentation Committee(IKDC) subjective knee score was 49 point(${\pm}3.3$ SD) preoperatively and 84 point (${\pm}2.2$ SD) postoperatively. 93 cases were more than grade II in Lachman test preoperatively and 5 cases postoperatively. 71 cases were more than grade II in pivot shift test preoperatively but 89 cases were negative postoperatively. The mean maximal manual difference by KT-2000 arthrometer was 6.8 mm(${\pm}1.9$ SD) preoperatively and 1.8 mm(${\pm}0.8$ SD) postoperatively. Conclusion: ACL reconstruction using the flexible reamer achieved the ideal isometric point of femur and anatomic graft placement, so we could obtain good results, especially in rotational stability.

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