Purpose : To analyze the result of arthroscopic synovectomy of the shoulder for rheumatoid arthritis. Material and Method : Sixteen patients were treated from May, 1998 to December, 2002 who undergone arthroscopic synocvectomy of the shoulder for rheumatoid arthritis. The study group constisted 2 men and 14 women. the age at surgery ranged from 32 to 66 years, with average of 50 years. The result were analyzed using the clinical assessment of shoulder surgery classification system issued by the Japanese Orthopaedic Association and subjective satisfactation of the patients cartegorized excellent, good, poor. Results : The mean score of ROM was increased from 13.9 preoperative to 23.8 postoperative and the mean score of pain was inclosed from 22.0 preoperative to 26.5 postoperative. The result of subjective satisfaction were 7 excellent, 7 good,2 unsatisfied, so forteen cases $(88\%)$ above the good. Conclusions : The shorter morbidity date, and the letter damage of articular cartillage, the better results of the arthroscopic synocvectomy of the shoulder for rheumatoid arthritis.
Purpose: To evaluate the results of surgical treatment and relationship between the recurrence and characteristics of ganglions in foot and ankle. Materials and Methods: Seventeen cases of ganglions located in foot and ankle, excised at St. Benedict Hospital from Mar. 1993 to Apr. 2003, were included in the study. All of cases were analyzed retrospectively in terms of age, sex of the patients, location and size of the ganglion, symptom, operative method as well as recurrence rate were evaluated. The mean follow up was 1.8 years (11 months${\sim}$6.5 years). Results: The size of ganglion ranged from 0.5 cm to 5.0 cm with mean size of 2.5 cm. The most common area of ganglion was the dorsum of foot and pain was the primary chief complain. The recurrence was found in 4 cases (23.5%): 1 of them occurred among 8 cases the diameter of which was less than 2.5 cm and other 3 occurred among 9 cases larger than 2.5 cm. 12 cases were completely excised mass with no recurrence. But 5 cases were incompletely excised & ligated stalk of mass and 4 cases of them were recurred. A correlation was only observed between complete excision and low recurrence rate. Conclusion: Recurrence rate of ganglions in foot and ankle was high and the correlation was obtained between complete excision and low recurrence rate.
Purpose: The purpose of this study is to investigate the relationship between rotator cuff tear and nerve injury, and prevalence of nerve injury using electromyographic study. Materials and Methods: From May 2004 to Feb. 2005, 19 cases, who underwent surgery for full-thickness rotator cuff tear, were evaluated for nerve injury using electomyogram instruments preoperatively. Rotator cuff tears caused by acute high energy trauma were excluded in this study. Mean age was 59 (range, 45-87) years and mean duration of symptoms was 45 (range, 1-360) month. Results: There were six nerve injuries (31.6%). All of them were incomplete brachial plexus injuries, and mainly postganglionic lesions. Four cases among them had minor trauma history. There were no significant differences in terms of cuff tear size, range of motion, pain score and functional score between groups with and without nerve injury. Conclusion: This study showed high prevalence (31.6%) of nerve injury in full-thickness rotator cuff tear. So careful physical examination and evaluation for nerve injury are needed in rotator cuff tear.
Purpose : To confirm the efficacy of arthroscopic synovectomy fur the pigmented villonodular synovitis in the knee. Materials and Methods : Between October 1996 and February 2000, the arthroscopic synovectomy had been performed in six patients(six knee joints), whose diagnoses were confirmed by pathologist. All patients complained of painful swelling in involved knee and four of the six patients had trauma history. There were three male and three female patients. Average age was 35.8 years ranging from 16 to 67 years. Follow up period was average 22.7 months(range, $13\~53$ months). Results : According to arthroscopic findings, there were three localized forms and three diffuse forms. At their last follow-up examinations, all patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : Complete arthroscopic excision is the definitive treatment for localized pigmented villonodular synovitis and meticulous arthroscopic excision through all portals including posterior portal can be considered as a valid alternative to traditional open synovectomy for the patients with diffuse pigmented villonodular synovitis.
We evaluated the results of the surgery for impingement syndromes and partial thickness tears of the rotator cuff with an average follow-up period of 15 months. One group(group I) of 43 patients, 46 cases underwent arthroscopic subacromial decompression. The other comparable group(group Ⅱ) of 10 patients, II cases underwent open acromioplasty. The average age at operation was 48 years, old. Arthroscopic subacromial decompression achieved slightly better pain relief, the range of the acti ve forward flexion, function, strength and the overall score with improvement from the preoperative condition than open acromioplasty. The patient's satisfaction was better in group I as well. Using the UCLA Shoulder Rating Scale, 89% of group I and 82% of group n had good or excellent results. Preservation of the origin of the deltoid during an arthroscopic acromioplasty reduced the postoperative morbidity and made it possible to start rehabilitation sooner and to achieve the better and more predictable results.
Purpose : The purpose of this study was to evaluate clinical efficacy of the arthroscopic anterior acromioplasty for the treatment of chronic impingement syndrome of the shoulder. Materials and Methods : Between July 1995 and December 1997, twenty seven consecutive shoulders of 26 patients with chronic impingement syndrome of the shoulder were treated by arthroscopic anterior acromioplasty. The patients who had severe osteoarthritis of the shoulder full thickness tear of the rotator cuff, and nonoutlet impingement were excluded. The clinical results were evaluated by using UCLA shoulder rating scale. The average follow-up was 2years 3months(range, 1year 7months to 3years 1 11months). Results : Twenty three patients$(85.2\%)$ were rated as excellent or good results, while four patients$(14.8\%)$ were fair. Twenty six cases$(96.3\%)$ were satisfied with the results of the operations, while one case$(3.7\%)$, who had Parkinsonian syndrome, ossification of posterior longitudinal ligament(OPLL) of the cervical spine, and spinal stenosis of the 5th and 6th cervical spine was not satisfied. Conclusion : Arthroscopic anterior acromioplasty was an effective treatment method, especially for relief of pain, for the treatment of chronic impingement syndrome of the shoulder. If the patient has the combined lesions in the cervical spine and the shoulder, and systemic lesions, these lesions may influence the results of treatment after operation, and cause the unpredictable results.
Song Eun Kyoo;Yoon Taek Rim;Lee Young Keun;Kim Jong Seok
Journal of the Korean Arthroscopy Society
/
v.4
no.2
/
pp.117-122
/
2000
Purpose : To compare the mid term with long term follow up results of the anterior cruciate ligament(ACL)> reconstruction using patellar tendon. Materials and Methods : Seventy-six cases, which could be followed up more than 2 years were included in this study. They were classified into two groups, mid-term group(41 cases) with mean follow-up periods of 2 years and 10 months and long-term group(35 cases) off years and 6 months. Clinical and radiological results and peripatellar complications were evaluated & compared. Results . There was no statistically significant difference in radiological finding and anterior instability between two groups. However, the incidence of anterior knee pain, paresthesia at incision site, kneeling pain, crepitus and quadriceps weakness was lower in long-term group than in mid-term group. Conclusion : ACL reconstruction using patellar tendon graft could successfully restone the stability of knee joint, but there are some complications in donor site and patellofemoral joint. However this complications were gradually decreased with long term follow-up.
We present a etrospective analysis of arterial embolectomies performed at the Inje University Seoul Paik Hospital. During the period of March 1987 Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had sensBrylmotor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities artery in 6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 1 1 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 1) patients while in the other patient p eoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patients, the Fogarty embolectomy catheter was used without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were re-operated via transpopliteal approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of anticogulation was patients of valvular heat disease andfor atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom improvement after re-operation, B. K. amputation in 1 case who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing number of old aged patient who had suffered from ischemic heart diease. Preoperative angiography was not always needed for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, embolectomy of tibial artery was difficult.
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
/
pp.199-206
/
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.
Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
The Journal of the Korean bone and joint tumor society
/
v.9
no.1
/
pp.115-123
/
2003
Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.
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