• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.38-43
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• 2013

Purpose: To evaluate the efficiency of arthroscopic treatment for infected total knee arthroplasty (TKA), and to investigate the factors affecting the outcomes. Materials and Methods: We analyzed 17 cases which underwent arthroscopic treatment to treat infection after TKA. After confirming infection by hematologic examination and analysis of joint fluid, we performed arthroscopic debridement, synovectomy and irrigation with normal saline mixed with antibiotics. Through routine examination after operation, we checked failure of treatment or recurrence of infection. If there is no recurrence until 2 years after the operation, we considered it as a success of treatment. Results: Of the 17 cases taken arthroscopic treatment, 13 cases were treated successfully with primary arthroscopic treatment only, but 4 cases had to undergo re-operation because of persistence or recurrence of infection. Analyzing the factors affecting the results, we found that symptom duration of the re-operation group is longer than the treated group after arthroscopy (p<0.05). Conclusion: Arthroscopic treatment can be effective when we performed appropriate selection of patients, careful and extensive arthroscopic irrigation and debridement, and suitable use of antibiotics. However, we have to do early arthroscopic surgery as soon as possible when infection after TKA is suspected.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.288-293
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• 2013

Purpose: Number of arthroscopic surgery is gradually increasing with development of its equipment and technique. Arthroscopic ankle surgery performed with the traction device has various complications and need more time for preparation. We investigated whether the complication rate increased when surgery was performed without the traction device, and compared the complication rate of arthroscopic surgery with the traction device. Materials and Methods: From January 2009 to June 2012, arthroscopic ankle surgery was performed without the traction device in four hundred eleven cases. There were two hundred sixty-one males and one hundred fifty females. The average age at operation was 35 years (range, 17-56), and the average follow up period was 28 months (range, 12-41). Postoperative symptoms and complications were checked. Results: There were difficulties performing arthroscopic surgery without the traction device in five cases with severe traumatic osteoarthritis. However, after burring and shaving, we had enough space to work on. Superficial peroneal nerve symptom was found in two cases, grooving of talus was found in 11, and saphenous vein injury was found in five. Since preparing for the traction device was unnecessary, we were able to save time with the mean duration of surgery of 50 minutes (range, 30-120). Conclusion: With only manual traction, we could explore the entire ankle joint without damage on cartilage. Yet, skilled arthroscopic technique will be necessary for arthroscopic surgery without the traction device.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.115-118
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• 2004

Purpose: The purpose of this study is to measure the internal and external rotation of shoulder and compare with normal volunteer and patients diagnosed as SLAP lesion. Materials and Methods: Thirty-eight cases (group 1) who had SLAP lesions at shoulder arthroscopy and fourty young volunteers(group 2) were analyzed retrogradely with medical record, intra-operative arthroscopic photo & video for SLAP lesions and the ROM of shoulder Under the interscalene anesthesia, the range of motion of internal rotation and external rotation were measured on flxed scapula and 90 degree abduction of shoulder, and the same method for group 2. We analyzed the results with two sample T-test and Wisconsin signed ranks test. Results: There was a significant difference between group 1 and group 2 for the ROM of shoulder. (IR; p<0.001,ER; p<0.001).For the group 1, internal and external rotation with the arm abducted 90 averaged 50 and 64 degrees and for the group 2, internal and external rotation averaged 77 and 90 degrees with significant difference(IR; p<0.001,ER; p<0.001).Conclusion: The range of motion of shoulder, especially internal and external rotation significantly decreased in SLAP lesions. Our results suggest that a limited rotational motion of shoulder closely related with SLAP lesion.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.27-31
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• 2001

Purpose : The purpose of this study was to evaluate results of the arthroscopic treatment of calcific tendinitis of the shoulder resistant to conservative treatment. Materials and Methods : From March, 1996 to June, 1998, fourteen patients underwent shoulder arthroscopy to treat resistant calcific tendinitis of the rotator cuff despite conservative treatment for more than 6 months. Calcium deposits were localized to the supraspinatus tendon only in eleven patients, the supraspinatus and infraspinatus tendon in two patients, and to the supraspinatus and subscapularis tendon in one patient. Each shoulder was evaluated with UCLA shoulder rating scale and Constant-Murley score Results : The Constant-Murley pain score improved from average score 3.2 before surgery to average score 8.3 after surgery, and the UCLA functional average score improved from 4.5 preoperatively to 8.3 postoperatively. Preoperative ROM averaged $110^{\circ}$ of flexion, $45^{\circ}$ of external rotation, $90^{\circ}$ of abduction, and internal rotation with the thumb reaching to the spinous process of the third lumbar vertebra, but postoperative range of motion averages improved as follows: $170^{\circ}$ or flexion, $50^{\circ}$ of external rotation, $140^{\circ}$ abduction, and internal rotation with the spinous process of the twelveth thoracic vertebra. Overall 3 patients were rated excellentm 9 were good, 2 were fair. Conclusion : Shoulder arthroscopy is an effective treatment in patients with refractory calcific tendinitis.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.255-263
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• 2009

Purpose: An osseous defect in the glenoid and humeral head is closely associated with recurrence of anterior shoulder instability. The purpose of this article is to describe the open surgical techniques and introduce our experiences with anterior instability with a significant osseous defect. Materials and Methods: We reviewed the articles that have focused on and/or mentioned the affect of osseous defects on anterior shoulder instability. The open surgical techniques and its related pearls are summarized in this review. Results: Accurate evaluation for the size and location of the osseous defect is critical for preventing recurrence after restoration of the anterior capsulolabral structure. The glenoid bone restoration techniques include the coracoids transfer (the Bristow procedure and the Latarjet procedure) and a structural iliac bone graft. Rotational humeral osteotomy and an osteoarticular allograft could be used for repairing a significant posterosuperior humeral defect (Hill-Sachs lesion). Shoulder arthroplasty may be tried for treating a humeral bone defect, but more study on this is needed. Conclusion: Open surgical restoration decreases the risk of recurrence anterior shoulder instability that is combined with a significant osseous defect. Arthroscopic surgery currently has limitations for treating an osseous defect, but it will become useful in proportion to the development of arthroscopic instruments and techniques in the future.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.133-139
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• 2006

Purpose: To evaluate the results of mosaicplasty and microfracture after surgical treatments for symptomatic osteochondral lesion of talus (OLT) by second-look arthroscopy. Materials and Methods: 7 cases of mosaicplasty and 7 cases of microfracture were reviewed who undertook second-look arthroscopy at 6 months or one year after undertaking mosaicplasty or microfracture for OLT between December 2004 and October 2005. The mean age at first operation was 43.6 years (Range, 20-59) (Mosaicplasty; 43.9 years, Microfracture; 43.4 years). The mean size of cartilage defect was $15.0{\times}7.7\;mm$ in mosaicplasty and $7.1{\times}6.6\;mm$ in microfracture. Clinical outcomes were evaluated by Freiburg ankle score. Cartilage healing state was evaluated by Insall's classification for chondromalasia during second-look arthroscopy. Results: By the Freiburg ankle score, 9 ankles (6 in mosaicplasty, 3 in microfracture) had excellent and 5 (1 in mosaicplasty, 4 in microfracture) had good results at the times of second-look arthroscopy. By Insall's classification, consistency of the osteochondral grafts and congruity between grafts and native cartilage (Grade I) were shown in 9 (6 ankles in mosaicplasty, 3 ankles in microfracture), a fissuring (Grade II) in one ankle of mosaicplasty, a fasciculation (Grade III) in one ankle of microfracture, and partial exposure of subchondral bone (Grade IV) in 3 ankles of microfractures. Conclusion: Mosaicplasty was more excellent in consistency and hardness of cartilage than microfracture. In some cases of microfracture, cartilage healing was incomplete at 6 months postoperatively, so second-look arthroscopy is necessary to identify. If incomplete cartilage healing was shown, additional procedure such as microfracture or mosaicplasty was needed.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.155-159
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• 2007

Arthroscopic single-row rotator cuff repair is a well established surgical technique for the treatment of rotator cuff tears. However, the problem of postoperative retear remains a concern. Various avenues are being explored to address this problem. Some studies have suggested that restoring the anatomical footprint may improve the healing and initial strength of the repaired rotator cuff tendon. The double-row technique was introduced as a method of reconstructing the anatomical footprint. According to biomechanical studies on cadavers, this technique improved mechanical strength and reduced gap formation. However, the biological properties of reattached tendon such as tension, and vascularity have not been proved yet. Furthermore, the apparent mechanical superiority of the double-row over the single-row construction has not resulted in better functional outcomes. Therefore, the less complicated and less costly single-row technique is still the recommended treatment for rotator cuff repairs.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.153-158
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• 2006

Purpose: We evaluated the effectiveness of arthroscopic shaving cystectomy by using posteromedial portal for popliteal cyst with the correction of valvular mechanism. Materials and Methods: We had treated 15 cases of popliteal cyst with arthroscopic shaving cystectomy by using posteromedial portal from April 2004 to June 2005. The mean duration of follow up was 15 months (range: $12{\sim}28$). Functional results were based on the Rauschning and Lindgren criteria. We estimated operative time, time for regaining pain-free full range of motion and checked sonography for recurrence of the cyst at 12 months after the surgery. Results: The functional results by Rauschning and Lindgren criteria were rated Grade 0 or Grade 1 in all cases at last follow up. The average operation time was 45 minutes (range: $35{\sim}70$). All cases regained pain-free full range of motion within five days after surgery and range of motion was also normal at last follow up. There were no recurrence and no walking disturbance in all cases. Conclusion: Arthroscopic shaving cystectomy by using posteromedial portal is one of the effective alternative method of the treatment for popliteal cyst and it is also useful to correct the valvular mechanism.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.119-123
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• 2004

Purpose: The purpose of this study is to check the range of motion of shoulder and inverstigate the frequencies and patterns of partial thickness rotator cuff tear in SLAP lesions. Materials and Methods: Forty-six patients, forty-seven cases who had SLAP lesions at shoulder arthroscopy were analyzed spectively using the medical records, intra-operative arthroscopic photo & video for SLAP lesions and rotator cuff articular side partial tear. Under the interscalene anesthesia, the range of notion of foreward elevation, internal rotation and external rotation was measured on fixed scapula and 90 degree abduction of the shoulder. Results: The rang of Motion are 150 degree on foreward elevation, 65.5 degree on external rotation, 61.7 degree on internal rotation. By Snyder's classification, type ll SLAP lesion is noted in 24 cases (five cases in type 1, one case in type IV). Rotator cuff articular side partial tear is noted in 24 cases ( one case in type I, 22 cases in type II, one case in type IV SLAP). All the rotator cuff articular side partial thickness tear were located in the anterior part of the supraspinatus. Conclusion: The rotator cuff partial thickness tear is mostly noted on the articular side and frequently found in the relatively more unstable type of SLAP lesions. So we consider that SLAP lesion may be a one of the causes for partial tear of the rotator cuff articular side.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.174-179
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• 2005

Purpose: To study the long-term outcome of arthroscopic meniscectomy with regard to clinical symptoms and radiographic signs of osteoarthritic change. Materials and Methods: The materials for the investigation consisted of 79 individuals among 144 patients who underwent knee arthroscopy due to an isolated meniscal tear from October 1990 to September 1992 in our hospital. Those 79 individuals were followed up for $10{\sim}15$ years after the knee arthroscopy and were took clinical examination through the review of knee radiographies obtained with weight bearing. 52 of the 79 patients were men, and the mean age of the total materials was 34.6 years old (in the range $17{\sim}48$). Results: At follow-up, radiographic changes including Fairbank changes and joint space narrowing were seen from 45 of the 79 patients (56.2%). In other calculation, radiographic changes were seen in 23 out of 54 patients (42.6%) who had a partial meniscectomy, but were presented in 22 out of 25 patients (88.0%) who had a total meniscectomy. As a result, more radiographic changes were seen after total meniscectomy (p=0.03). In clinical results, 39 out of 54 patients (72.2%) after partial meniscectomy were satisfactory, and 14 out of 25 patients (56.0%) after total meniscectomy were satisfactory, therefore, more percentage of patients were satisfactory in partial meniscectomy group than in total meniscectomy group, but the statistical differences were absent (p=0.24). Conclusion: The frequency of radiographic changes in $10{\sim}15$ years after meniscectomy was related to the quantity of the meniscus removed, but the differences of these changes were low and had little influence on activity and knee function.