• Title/Summary/Keyword: orthopedic procedures

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Chronic Lateral Ankle Instability (만성 족관절 외측 불안정증)

  • Jung, Hong-Geun;Park, Jae-Yong;Park, Jong-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.73-78
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    • 2012
  • Severe ankle sprain secondarily leads to chronic lateral ankle instability in 20-30%. Many surgical procedures have been presented for reconstruction of the lateral ankle instability, but controversy still remains for the ideal surgical option. Br$\ddot{o}$strom procedure or its modifications have been widely used but they have some limitations for the instabilities for the over-weight, physically high demanding patients and especially for significantly deficient or attenuated ligaments. Moreover the tenodesis procedures using peroneus brevis tendon are non-anatomical and sacrifice important lateral stabilizing tendon. Therefore recently, many reconstructive procedures for lateral ankle instability utilizing free allograft or autograft tendon have been introduced to anatomically stabilize the lateral ligaments to various degrees.

Improving visualization in shoulder arthroscopy

  • Emily R. McDermott;David J. Tennent;Daniel J. Song
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.455-461
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    • 2023
  • Arthroscopic shoulder procedures are one of the most common procedures used to restore function through minimally invasive techniques. With the demand for shoulder arthroscopic procedures comes the need for safe, effective, and efficient surgery that maximizes patient outcomes while minimizing complications. Many variables contribute to visualization in shoulder arthroscopy including vascular anatomy, blood pressure control, arthroscopic pump systems, turbulence control, epinephrine, and tranexamic acid. Furthermore, patient positioning can have a dramatic effect on visualization with both the beach chair position and lateral decubitus positioning having various strengths and weaknesses depending on the intended procedure being performed. The purpose of this review is to examine the benefits and complications reported in the literature for improving visualization in shoulder arthroscopy.

Arthroscopic Latarjet procedure: current concepts and surgical techniques

  • Sang-Jin Shin;Jae Hyung Kim;Jonghyun Ahn
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.445-454
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    • 2023
  • The Latarjet procedure is a surgical procedure that can effectively restore glenohumeral stability, especially in patients with anterior shoulder instability and glenoid bone loss. Many studies have shown comparable clinical outcomes between patients undergoing the arthroscopic Latarjet procedure and those undergoing traditional open methods or other glenohumeral joint stabilization procedures. However, the arthroscopic Latarjet procedure is a challenging technique due to the unfamiliar portal placements, proximity of neurovascular structures, and serious postoperative complications. The arthroscopic Latarjet procedure has not yet been widely applied, and a clear understanding of the anatomical structure and the precise methods is required prior to operation performance. Satisfactory clinical outcomes can be achieved by thorough preoperative planning and proper implant fixation methods.

Needling Procedures for Calcific Tendinitis Performed by Orthopedic Surgeons

  • Pang, Chae Hyun;Kum, Dong Ho;Jeong, Jeung Yeol;Park, Seung Min;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.20 no.2
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    • pp.84-89
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    • 2017
  • Background: Common and effective treatments for calcific tendinitis involve needling procedures. However, it has been widespread practice to refer patients with calcific tendinitis, which is a predominantly orthopedic condition, to radiology department. The purpose of this study was to compare clinical and radiological outcomes after ultrasound-guided needling for calcific tendinitis between the orthopedics and radiology department. Methods: Seventy-seven shoulders (Group 1) and 38 shoulders (Group 2) treated in the radiology and orthopedic department, respectively. A fellowship-trained orthopedic surgeon and a musculoskeletal radiologist each performed the procedure of ultrasound-guided needle decompression with subacromial steroid injection. Clinical outcomes was evaluated using the visual analogue scale for pain (pVAS) and the American Shoulder and Elbow Surgeons (ASES) shoulder score before treatment and at each follow-up. The pre- and postneedling size and shape of the calcific deposits were compared between the two groups. Results: We analyzed a total of 56 shoulders for Group 1 and 32 shoulders for Group 2. The mean age and sex ratio of the patients no significantly different. We found that the mean decrease in the diameter of calcification between pre- and post-needling was 9.0 mm for Group 1 and 13.1 mm for Group 2; the difference was significantly larger in Group 2 than in Group 1. Both groups showed improved pVAS and ASES scores after needling but the extent of these improvements did not differ with the type of operator. Conclusions: Needling decompression performed by orthopedic surgeons could a viable option for the treatment of calcific tendinitis.

Chronic subtalar joint instability - One case report - (거골하 관절의 만성 불안정성 - 1예 보고 -)

  • Lee, Jin-Woo;Kwon, Oh-Ryong;Park, Kwan-Kyu;Kang, Eung-Shick;Hahn, Soo-Bong
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.251-255
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    • 2002
  • Purpose: Chronic subtalar instability is not common and similar to chronic ankle instability and the incidence and cause chronic subtalar instability are not well known. Recently we have experienced chronic subtalar instability without chronic ankle instability which was treated with modified Brostrom procedures. Materials and Methods: The patient is 46 year old man who has suffered from left ankle sprain for 30 years and recently aggravated more than twice a day. On subtalar stress view, 14 degree angulation of subtalar joint was noted and on anterior drawer view, 8 mm anterior displacement of left ankle was seen. Results: In operation, there was no anterior talofibular ligament abnormility but calcaneofibular ligament loosening was found. Ligament reconstruction was performed using modified Brostrom procedure. At 12 months after operation, the patient complains no pain and no limit of motion and no instability. Conclusion: We experienced chronic subtalar instability without ankle instability treated with modified Brostrom procedures. No instability was found after treatment without complication.

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Distal Fibular Rotational Plasty for Chronic Peroneal Tendon Recurrent Dislocation: A Technical Report (만성 비골건 재발성 탈구에서 원위 비골 회전 성형술: 술기 보고)

  • Suh, Jae Wan;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.168-172
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    • 2020
  • Chronic recurrent peroneal dislocation often responds poorly to conservative treatment. Surgical treatment has been reported to be more effective than conservative treatment, and various surgical treatment methods are available: superior peroneal retinaculum repair or reattachment, peroneal groove deepening procedures, rerouting procedures, or bone block procedures. Although various treatment options have been reported, there is no consensus regarding which treatment is better. This paper proposes a distal fibular rotational plasty that can prevent recurrent peroneal dislocations and recover its function well by securing a stable peroneal tendon excursion space.

Robotic Surgery in the Orthopedic Field (정형외과 영역에서 로봇수술)

  • Lee, Woo-Suk;Jung, Woo-Suk
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.459-465
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    • 2018
  • Of the many factors that affect the clinical outcomes of orthopedic surgery, the surgical procedure is the most important. Robotics have been developed to perform the surgical procedures more accurately and consistently. Robotic surgical procedures in the orthopedic field were developed 20 years ago. Some designs of surgical robots have disappeared due to practical problems and complications, and an another design of surgical robots is emerging. To date, the use of robot surgery in arthroplasty is still controversial in terms of the clinical outcomes, practicality, and cost-effectiveness, even though it has been reported to be effective in the alignment and positioning of components in the field of artificial joints. Early robotic surgery was based mainly on active robot surgery according to the scheduled operation without the intervention of the operator. Recently the semi-active system of robotic surgery has been introduced. In a semi-active system, the robot constrains the surgeon to a haptic boundary defined by the computer based on the 3-dimensional imaging preoperative plan, and the operator can change the preoperative plan through real-time feedback during operation.

Arthroscopic Decompression of an Inferior Paralabral Cyst of the Shoulder in an Elderly Patient: A Case Report

  • Kim, Ju-Oh;An, Ki-Yong;Bong, Hwang-Se;Lee, Kyu-Jung;Min, Woong-Bae
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.266-268
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    • 2015
  • The widespread use of diagnostic radiography, especially using magnetic resonance imaging, has helped to increase the diagnosis of paralabral cysts in patients with chronic shoulder pain. These paralabral cysts are frequent in the anterior, the superior, and the posterior compartment of the shoulder joint but are rare in the inferior compartment. Paralabral cysts in the shoulder appear particularly in men in their third and fourth decades but rarely in elderly patients. We report a case of an inferior paralabral cyst in an elderly patient whom we treated through arthroscopic decompression.

Considerations for Fluoroscopic Guided Intervention in Lumbar Spine (방사선 투시장치를 이용한 요추 중재술 시 고려점)

  • Kim, Dong-Hyun;Song, Kwang-Sup
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.210-221
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    • 2020
  • Spinal block procedures are useful methods that reduce the need for surgical treatment. In addition to their therapeutic aspects of pain relief, in many patients, they are also used for diagnostic purposes to distinguish from symptoms originating from extra-spinal areas. Therefore, these procedures are the most basic technique for orthopedic surgeons dealing with diseases from limbs and spine. On the other hand, despite the simplicity of the instruments and drugs used, the overall understanding of them and the lack of knowledge of the possible side effects and complications can cause serious harm to the patient at the beginning of the trial. Therefore, it is necessary to understand the types of drugs used in the spinal block procedures, pharmacokinetic properties, and the side effects of each drug. In addition, efforts should be made to identify their indications, as well as advantages and disadvantages of each procedure to avoid possible complications. The purpose of this review was to provide basic knowledge and skills necessary for lumbar spinal block procedures as well as provide the reader with the ability to perform themselves.

Total Ankle Replacement Arthroplasty (족관절의 인공관절 치환술)

  • Sung, Il Hoon;Kim, Hyun Uk
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.1
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    • pp.1-6
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    • 2015
  • Total ankle replacement has been performed for treatment of end stage arthritis of the ankle, hopefully being an alternative to ankle arthrodesis. However, due to its high failure rates, earlier versions of ankle replacements were not regarded as successful procedures. The latest design has shown increasingly positive results. Total joint replacement of the ankle itself is still regarded as a demanding procedure and much more challenging than that of the hip and knee in many aspects. Several studies, however, have pointed out that it is becoming the viable, accepted alternative for arthrodesis with advanced implants, appropriate patient selection, and proper training experience of procedures. Compared with arthrodesis, it shows equal or better outcomes in pain relief, range of motion, and patient's satisfaction. We are attempting to review its biomechanical characteristics, implant design, indications, complications, clinical outcomes, and survival rate.