• Title/Summary/Keyword: 복원술

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Hill-Sachs 병변을 동반한 재발된 외상성 견관절 불안정성에서 'Remplissage' 술기를 이용한 관절경적 술식 - 증례 보고 -

  • Go, Sang-Hun
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.185-185
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    • 2009
  • 관절와 및 상완골의 의미 있는 골결손을 동반한 불안정한 견관절에 대해 어떻게 최선의 치료를 할 것인가에 대한 의문은 남아있다. 어떤 저자들은 외회전과 외전을 제한하는 것으로 Hill-Sachs 병변의 진입을 예방하는 일종의 관혈적 관절낭 변위를 통한 제한된 상완와관절 운동을 주장해왔으며, 다른 관혈적 시술들은 극하근건과 관절낭을 Hill-Sachs 병변 내로 관혈적 전이시키는 것으로 기술되어왔다. 최근에는 여러 저자들에 의해 Hill-Sachs 병변의 진입을 치료하는 더 새로운 접근법들이 기술되었으며, Bankart 병변 복원술에 더하여 Hill-Sachs 병변을 채우기 위해 관절경 하 후방 관절낭 고정술과 극하근건 고정술로 이루어진 이른바 'Remplissage'술기가 소개된 바 있어, 이에 저자는 외상성 견관절 불안정성으로 관절경 하 Bankart 병변 복원술 및 관절낭 축화술 시행 후 외상으로 재발된 견관절 불안정성이 발생하여 관절경 하 Bankart 병변 복원술과 함께'Remplissage'술기를 이용한 Hill-Sachs 병변 복원술을 시행한 예를 보고하는 바이다.

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Arthroscopic Bony Procedure During of Rotator Cuff Repair - Acromioplasty, Distal Clavicle Resection, Footprint Preparation and Coracoplasty - (관절경적 회전근 개 봉합술 시 시행하는 골 처치 - 견봉 성형술·원위 쇄골 절제술·건 부착부 처치·오구 성형술 -)

  • Oh, Joo Han;Park, Hae Bong;Lee, Ye Hyun
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.153-162
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    • 2013
  • The arthroscopic bony procedures during rotator cuff repair include acromioplasty, distal clavicle resection, footprint preparation and coracoplasty. The indication of each bony procedure is based on the theoretical reasons, and various types of surgical techniques are available. The purpose of this review article is to review the backgrounds of the indication and surgical techniques in the arthroscopic bony procedures during rotator cuff repair.

Current Concept of Anterior Shoulder Instability Repair (견관절 전방 불안정성의 봉합술에 대한 최신 지견)

  • Kim, Young-Kyu
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.1-7
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    • 2006
  • 견관절 전방 불안정성의 관절경적 치료는 환자 개개인의 병리 상태를 잘 파악하여 적절한 복원술을 시행함으로써 보다 좋은 결과를 기대할 수 있다. 현재 관절경적 Bankart 복원술시 봉합 나사못이 가장 이상적인 봉합기구로 알려져 있으며 여러 병리 상태를 고려하여 관절경적 복원술을 시행한 결과 여러 학자들이 과거에 비해 좋은 결과를 보고하고 있다(Table 2). 따라서 술기상으로 보다 숙련된 술식을 통해 재발율을 낮출 수 있으며 보다 좋은 결과를 얻기 위하여 수술 후 적극적인 재활 프로그램이 요할 것으로 생각된다.

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Clinical Outcomes After Arthroscopic Double-Row Rotator Cuff Repair and Evaluation of Cuff Integrity by CT Arthrography (관절경적 2열 고정 회전근개 복원술 후의 임상 결과 및 CT 관절조영술을 이용한 건의 치유 평가)

  • Jo, Chris H.;Kim, Je-Kyoon;Yoon, Kang-Sup;Lee, Ji-Ho;Kang, Seung-Baek;Lee, Jae-Hyup;Han, Hyuk-Soo;Rhee, Seung-Whan
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: Our goal for this study was to prospectively evaluate the functional & structural outcomes, by means of CT arthroscopy, of arthroscopic double-row fixation for treating rotator cuff tear. We also attempted to determine the variants that affect the functional & structural outcomes. Materials and Methods: Twenty seven consecutive patients underwent arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty six years. The preoperative and postoperative examinations consisted of determining the Constant score, the score for the visual analogue scale for pain, the UCLA score, the American Shoulder and Elbow Surgeons (ASES) score, as well as a full physical examination of the shoulder. Preoperative MR arthrography was used to evaluate the integrity and atrophy of the rotator cuff. We measured the intraoperative tear size in the sagittal and coronal planes. Postoperative CT arthrography was used at one year postoperatively to evaluate the integrity and atrophy of the repaired tendons and muscles. Results: Preoperative MR arthrography revealed an average 29.22 mm tear size in the sagittal plane and an average 22.72 mm tear size in the coronal plane. Twelve cases of supraspinatus muscle atrophy and two cases of infraspinatus atrophy were observed on the preoperative MR arthrography. The average clinical outcome scores all significantly improved at the time of follow-up. At a mean of one year postoperatively, CT arthrography revealed 48.1% of the shoulders had healed, 11.1% showed incomplete healing and 40.7% showed retear of the repaired tendon. Conclusion: Arthroscopic double-row repair can result in improved clinical outcomes and good patient satisfaction. However, the problems about how to enhance healing of the repaired tendon still remain.

Clinical & Radiologic Result of Arthroscopic Bankart Repair Using Knotless Suture Anchor (비매듭 금속 봉합 나사못을 이용한 관절경적 방카트 복원술: 임상적 및 방사선학적 결과의 비교)

  • Oh, Jung-Hwan;Lee, Sang-Hoon;Park, Hong-Keun;Jeon, Suk-Ha;Park, Joon-Suk;Kim, Cheol-Ki;Park, Jin-Young
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.135-141
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    • 2008
  • Purpose: To study the clinical and radiologic results with arthroscopic Bankart repair using knotless metal suture anchor. Materials and Methods: From February 2001 to January 2005, 68 patients, who underwent arthroscopic Bankart repair using knotless suture anchor and were followed up more than 12 months, were evaluated. A mean follow-up period was 34 months. All shoulders were evaluated by Rowe scoring system, range of motion of the shoulder, pain degree of VAS, and This was compared by radiologic findings after surgery. Results: The Rowe scoring system was 43.30 preoperatively, which improved to 95.55 postoperatively. At last follow-up, there was no significance difference between operated shoulder and non-operated shoulder in range of motion. The degree of VAS was measured from 3.3 preoperatively to 0.5 postoperatively. The radiolucent line was shown around suture anchor in 15 shoulders. 2 shoulders of 15 shoulders were reoperated due to redislocation and anchor arthropathy. In Odds ratio, this group (15 patients) had more 2.6 times the subjective instability than other group (53 patients). Conclusion: Arthroscopic Bankart repair using knotless anchor suture is very effective operative technique. But we have to be careful because the radiolucent line around anchor showed up during a follow -up period may indicate poor prognosis.

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