• Title/Summary/Keyword: 관절경적 절제술

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Comparison of Arthroscopic Debridement and Multiple Drilling for Osteochondritis Dissecans of the Talus (거골 박리성 골연골염의 관절경적 변연 절제술과 다발성 천공술의 비교)

  • Kim, Kyung-Tae;Kim, Jin-Hak;Lee, Song;Choi, Dae-Jung;Cho, Kun-Ho;Jeon, Young-Won
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.206-213
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    • 2005
  • Purpose: To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling. Materials and Methods: Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5 years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups. Results: There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved $53.1{\pm}2.7$ points preoperatively to $85.1{\pm}8.5$ points postoperatively in group I and $54.6{\pm}6.8\;to\;80.7{\pm}8.5$ points group II. Subjective and functional scores was also improved $49.6{\pm}10.5$ points preoperatively to $84.6{\pm}7.7$ points postoperatively in group I and $50.7{\pm}9.2\;to\;83.0{\pm}9.6$ points in group II. But there were no statistical significance between them. Conclusion: Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.

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Arthroscopic Treatment of Synovial Chondromatosis (활액막 연골종증의 관절경적 치료)

  • Bae Dae Kyung;Kwon Oh Soo;Lee Jeong Heui;Lim Chan Teak
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.43-48
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    • 2002
  • Purpose : We evaluated the results of the arthroscopic treatment of nine cases of synovial chondromatosis in the knee joints. Materials and Methods : From June 1989 to September 1999, eight patients nine cases with synovial chondromatosis involving knee joints underwent arthroscopic total synovectomy and removal of loose bodies. There were 6 females and 2 males. The average age at surgery was 44.1 years(range, 20-57 years). The average follow-up period was 5.9 years (range, 2.5-7.3 years). All cases had pain and swelling and two cases had locking preoperatively. Flexion contracture was found in three cases. Results : Pathologic finding revealed Milgram I in one case, Milgram II in six cases and Milgram III in two cases. There were six cases of generalized synovial hypertrophy and one case of localized type. All patients had symptomatic relief by arthroscopic total synovectomy and loose body removal. Second arthoroscopic surgery was performed in one patient due to recurred lesions 11 months after the primary surgery. Conclusion : Clinical results of the synovial chondromatosis with arthroscopic total synovectomy and loose body removal were satisfactory. Arthroscopic total synovectomy was also effective for the recurred case.

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Arthroscopic Treatment of an Acute Septic Arthritis after Meniscal Allograft Transplantation - A Case Report - (반월상 연골 동종 이식술 후 발생한 화농성 관절염의 관절경적 치료 - 증례 보고 -)

  • Kim, Yeub;Yoon, Jung-Ro;Suh, Dong-Hoon;Jang, Hyoung-Won
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.63-67
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    • 2009
  • We report the case of a 21-year-old man with acute septic arthritis of the knee after meniscal allograft transplantation, which was successfully treated with repeated arthroscopic debridement and irrigations. Our procedures included arthroscopic debridement and irrigation with 10L normal saline, repeated arthroscopic irrigations (5 times), and intravenous antibiotics. Our decision to repeat the debridement was based on clinical and laboratory results. The significance of this case is that early aggressive arthroscopic debridement and repeated irrigations as part of a treatment protocol of acute septic arthritis after meniscal allograft transplantation can be an effective treatment option in selected cases.

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Arthroscopic Treatment of Meniscal Cyst (슬관절 반월상 연골 낭종의 관절경적 치료)

  • Bae, Dae-Kyung;Yoon, Kyung-Ho;Kwon, Oh-Soo;Shin, Dong-Jun;Im, Yang-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.14-20
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    • 2002
  • Purpose : To analyze the clinical result of the arthroscopic decompression of meniscal cyst and meniscus resection or repair of meniscus tear. Materials and Methods : From April 1994 and October 2001, 19 patients with diagnosis of meniscal cyst associated with tears of the meniscus were treated by arthroscopic meniscal resection or repair with decompression of the cyst. The mean age was 39.8 years(range, 22-58years). The follow-up period ranged from 3 months to 36 months with an average of 18 months. Seven of 19 patients had tenderness over the joint line with palpable mass. Treatment consists of arthroscopic resection or repair of meniscal tear with decompression of the cyst through transmeniscal approach. Open excision of cyst was performed in one case. Clinical evaluation was performed using Lysholm knee score and Tegner activity. All cases were executed proper treatment using arthroscopy. Results : Twelve cysts involved the lateral meniscus$(64\%)$ and seven cysts were on medial cyst$(36\%)$. Most of lateral meniscal cysts were located in anterior one-third and medial meniscal cyst were on posterior one-third. Meniscal tear were observed in seventeen cases$(89.5\%)$ and most tears were horizontal$(79\%)$. Preoperative symptom disappeared and no cyst recurrences were observed at last follow-up(mean follow-up: 18 months). Conclusion : Meniscal cysts involved lateral side in $64\%$ and most of them were associated with meniscus tear$(89.5\%)$ which consists of mainly horizontal component$(79\%)$.

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Knee Arthroscopy in the Obese: A Case Report (비만환자에서 시행한 슬관절 관절경술 - 증례 보고 -)

  • Baek, Seung-Hoon;Kim, Shin-Keun
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.29-32
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    • 2010
  • Several reports have described the increased perioperative risks as well as surgical techniques for performing various procedures in obese patients. However, few reports have addressed the effects of obesity on routine arthroscopic procedures known to be common and safe. Describing the case of a partial meniscectomy performed in a 17-year-old male with a body weight of 120 kg, we review literatures published to the present and provide technical problems and possible complications that can occur when performing routine knee arthroscopy in bariatric patients.

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Arthroscopic Shaving Cystectomy of Popliteal Cyst by using Posteromedial Portal (관절경적 후내측 도달법을 이용한 슬와 낭종의 절삭 절제술)

  • Kwak, Kyoung-Duck;Ahn, Sang-Min;Baek, Seung-Il;Jung, Chan-Jong;Roh, Jae-Su
    • 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.

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Arthroscopic treatment of septic arthritis of the knee in adults (성인의 화농성 슬관절염의 관절경적 치료)

  • Kyung Hee-Soo;Ihn Joo-Chul;Oh Chang-Wug;Kim Sung-Jung;Kim Joon-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.21-24
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    • 2002
  • Purpose : The purpose was to assess the result of arthroscopic management of the septic arthritis on the knee in compromised patients. Materials and Methods : Fourteen patients with septic knee were analyzed. The mean age was 55 years and the mean follow-up period was 14.6 months. Underlying diseases included 4 cases of diabetes, and history of direct acupuncture in 4 cases. Clinical stage of septic arthritis was judged by $G\ddot{a}chter's$ classification, which was determined by arthroscopic findings. After arthroscopic irrigation and debridement, we observed the results of laboratory data and improvement of clinical findings. Results : Causative organism was identified in 7 cases and no organism was detected in the remaining 7 cases. Stage I was 1, stage II 8, stage III 4, and stage IV 1, respectively. Eleven of 14 cases were improved by one stage operation. Two cases of stage III were recurred and additional arthroscopic management was done. In 1 case of stage IV, symptom was not improved and needed arthrotomy. The result was unsatisfactory in patients with stage III and IV. Serum erythrocyte sedimentation rate and C-reactive protein were normalized after 29.3 and 20.8 days following the operation, respectively. Clinical symptoms disappeared average 2 days following the operation. Conclusion : Arthroscopic management of acute septic arthritis of the knee would be an effective and satisfactory treatment modality in that its postoperative pain and complications are minimal, and it can be done with ease repeatedly.

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Arthroscopic Treatment of Fungous Arthritis of Knee Joint by Candida pelliculosa - A Case Report - (Candida pelliculosa에 의한 진균성 슬관절염의 관절경적 치료 - 증례 보고 -)

  • Kim, Hyung-Chun;Ahn, Su-Han;Kim, Kwang-Yeol;Hwang, Youn-Soo;Lee, Ji-Hoon;Lee, Dong-Eun
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.79-83
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    • 2013
  • Candida infection of knee joint is very rare. Diagnosis of Candida infection is difficult due to lack of obvious clinical symptoms. Candida albicans is the most common strain in Candida infection of knee joint, but Candida pelliculosa has been rarely reported. We report a case of Candida pelliculosa infection of knee after intra-articular steroid injection, which was treated successfully by repeated arthroscopic debridement and irrigations and arthroscopic implantation with antifungal agent-impregnated cement bead spacer.

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Long-Term Outcome Of Arthroscopic Meniscectomy In Traumatic Patients (외상성 반월상 연골 파열의 관절경적 절제술 후 장기 추시 결과)

  • Seo, Jae-Seong;Min, Hak-Jin;Yoon, Ui-Seong;Kim, Hee-Seon;Kim, Yoon-Jong;Kim, Yoo-Mih
    • 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.

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Fenestrated Medial Plica Syndrome - A Case Report - (공혈형 내측 활막추벽 증후군 - 1례 보고 -)

  • Bae, Dae Kyung;Jun, Myung Ho;Pyo, Na Sil;Lee, Jeong Heui
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.150-154
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    • 1999
  • Fenestrated medial patellar plicae are unusual. These fenestrated medial plica may vary in size and shape from being small circular and 5mm in diameter to being large opening 3-4cm long. Arthroscopic resection of the painful medial plica can provide lasting and satisfactory relief of symptoms. There is high percentage of associated medial knee symptoms that are relieved by complete resection. We had performed arthroscopic excision of the symptomatic fenestrated medial plicae present in both knees. The symptoms were dramatically relieved after arthroscopic surgery.

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