• 제목/요약/키워드: 이차적 관절경

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Partial thickness tear: Debris vs. Repair (회전근 개 부전층 파열: 변연절제술가 봉합술)

  • Oh, Jeong-Hwan;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.34-39
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    • 2005
  • Partial thickness rotator cuff tears (PTRCTs) are now a well-established clinical entity, yrt there is no consensus in regards to surgical management. Recommended treatment varies widely from simple debridement of the torn tendon to subacromial decompression to excision of the degenerative tendon and repair. Surgery may be performed using an open, arthroscopically assisted (miniopen), or entirely arthroscopic procedure. The advantages and disadvantages of open and arthroscopic procedures may lie in the balance between precision and morbidity. Visualization of both the articular and bursal surfaces is mandatory to determine the level of rotator cuff disease and formulate a treatment strategy. Because these tear often are secondary finding, recognition of the primary pathology is critical. Treatment of the primary problem usually remedies the partial tear. However, when there is significant PTRCT, an arthroscopic or open repair of the diseased tendon will give the most consistent results.

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Arthroscopic Treatment of Acute Acromioclavicular Dislocation using $TightRope^{(R)}$ ($TightRope^{(R)}$를 이용한 관절경적 급성 견봉쇄골 관절 탈구의 치료)

  • Kim, In-Bo;Shon, Myung-Hwan;Kim, Moon-Chan;Kim, Dong-Jun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.13-18
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    • 2011
  • Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

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Failure of Cross-Pin Femoral Fixation after Anterior Cruciate Ligament Reconstruction - A Case Report - (전방십자인대 재건술후 대퇴골 경골핀 고정의 실패 - 증례보고 -)

  • Lee Kee-Byoung;Kwon Duck-Joo;Ji Yong-Nam
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.92-95
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    • 2003
  • A 34-year-old man with ACL total rupture due to slip down injury, had received ACL reconstruction using autogenous hamstrings tendon with cross-pin femoral fixation. Postoperative course was as usual. But postoperative 3 months later, he complained posterolateral knee pain, recurrent effusion and mild instability. He was managed repeatitive aspiration and nonsteroid antiinflammatory drugs but was failed to relieve symptoms & signs. In CT scans, perforation of posteromedial femoral cortex of lateral femoral condyle was found. In second look arthroscopy, two pieces of broken femoral cross pin were found in between tibiofemoral Joint which was badly injured cartilage. We considered malposition of pins was the main cause of failure. We propose that femoral tunnel must be made more acute angle and femoral cross-pin guide must be positioned more external rotation 10-20 degree than transepicondylar axis made confirm the cross-pin tunnel position in order to avoid posterior cortex perforation and early failure.

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Accompanying Lesions and Clinical Results in the Greater Tuberosity Fracture of the Humerus with Anterior Shoulder Dislocation Under the Age of Forty (40세 이하에서 견관절 전방 탈구가 동반된 상완골 대결절 골절에서 관절내 병변 및 임상 결과)

  • Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Kyu;Park, Hyeun-Kook;Park, Jang-Hee;Shin, John
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.20-26
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    • 2011
  • Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.

The Clinical Results of Meniscus Allograft Transplantation - Comparison between medial, Lateral, Isolated and Combined Procedure Groups - (동종 반월상 연골 이식술의 임상적 결과 - 내측과 외측 및 동반 손상의 유무에 따른 비교 -)

  • Cho, Seung-Mok;Yoon, Kyoung-Ho;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Kang, Chang-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.28-33
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    • 2009
  • Purpose: To compare the clinical outcomes after meniscus allograft transplantation between lateral and medial or isolated and combined procedure groups. Materials and Methods: Of the patients who had undergone arthroscopic meniscal allograft transplantation between Dec. 1997 and Jun. 2007, 52 patients were available for retrospective evaluation. Patients were grouped into lateral(33 cases) and medial(19 cases) transplant groups as well as those with isolated(18 cases) and combined(34 cases) procedure. The average age was 34.2 years and the mean follow-up period was 42.2 months. Postoperative range of motion (ROM), visual analog scale (VAS), International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score, patient's subjective satisfaction, $2^{nd}$ look arthroscopy and MRI were evaluated retrospectively. Results: Mean postoperative ROM was $130.3^{\circ}$. The VAS showed an improvement from 5.96 to 3.05 at the last follow up. IKDC subjective score and Lysholm score also showed an improvement from 46.5 to 64.5 and from 61.9s to 79.58 respectively. Tegner score was improved from 2.9 to 3.6. Overall, 61.5% of patients reported they were completely or mostly satisfied with procedure. There were no significant differences noted between lateral and medial groups as well as isolated and combined groups. In 2nd look arthroscopy, 10 of 18 cases showed good pheripheal healing and there were 6 cases of partial and 2 of complex tear. We observed graft subluxation or extrusion in 12 of 16 cases who were evaluated with follow-up MRI. Conclusion: Meniscus allograft transplantation alone or in combination with other procedure showed an improvement in knee pain and clinical score. But there were no significant difference between lateral and medial groups or isolated and combined procedure groups.

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A Case of Lemierre Syndrome Associated with Septic Pulmonary Emboli (패혈성 폐색전증을 동반한 Lemierre 증후군 1예)

  • Kim, Eun-Jin;Park, Jae-Hyoung;Kim, Chang Ho;Park, Jae Yong;Jung, Tae Hoon;Cha, Seung Ick
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.73-77
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    • 2005
  • Lemierre syndrome is characterized by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections such as septic pulmonary emboli and suppurative arthritis. In the preantibiotic era, this condition generally had a fatal outcome. The presentation is so distinctive that a clinical diagnosis is possible in most cases, and a cure is expected with the appropriate therapy in the majority of patients. We present a case report of Lemierre syndrome with a review of the relevant literature.

The Role of Meniscal Arrow in the Treatment of the Meniscal Tear (반월상 연골 파열의 치료에서 meniscal arrow의 역할)

  • Bae, Dae Kyung;Yim, Chang Moo;Jeong, Ki Woong
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.24-29
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    • 1999
  • Purpose : The purpose of this paper is to analyze the clinical results after meniscal repair using meniscal arrow. Materials and Methods : Between May 1997 and Aug 1998, we repaired 22 tom menisci in 22 patients using meniscal arrows. There were nineteen males and three females with an average age of 27 years. There were longitudinal tear in 14 cases, Bucket-handle tear were 7 cases and horizontal tear was in 1 case. In 22 meniscus tears, 16 cases were associated with anterior cruciate ligament tear. Average number of meniscal arrow that was used were 2.5(ranged 1 to 4). Average follow-up period was 14.7 months(ranged 6 to 22 months). We evaluated the clinical results by the Tapper and Hoover's grading system. Results : There were excellent in 16 cases, good in 4 cases and fair in 2 cases on the clinical results. At the last follow up, the range of the motion of the knee joint were average 135 degrees(ranged 125 to 140 degrees). Mean time elapsed for meniscal repair were 25 minutes(ranged 15 to 40 minutes). Conclusion : Meniscal arrow has many advantages such as short operative time, easy fixation technique, and less neurovascular injury. We think that arthroscopic meniscal repair using meniscal arrow is effective treatment method in selected patient who have longitudinal, bucket-handle tear at the posterior hom associated with anterior cruciate ligament tear.

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A CLINICAL EVALUATION OF 61 CASES VOCAL CORD PARALYSIS (성대마비 61례에 대한 임상적 분석)

  • 김상현;이원상;김동환;정덕희;김춘길
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.30-30
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    • 1991
  • 성대마비 이비인후과 영역에서는 비교적 빈번하게 관찰되는 질환으로 대부분은 미주신경과 그 분지인 반회신경이 경정맥공에서 후두까지의 주행중에 생긴 질환에 의하여 이차적으로 발생하거나, 드물게는 윤상갑상연골 관절의 고정에 의사여 발생하게 된다. 임상적인 진단은 간접후두경이나 화이버옵틱후두경 검사법에 의하여 간단하게 내려질 수 있으나, 그 발생원인은 다양하며, 임상적인 양상 및 그에 따른 치료 원칙도 다르게 나타난다. 이에 연자들은 1986년 1월 1일부터 1990년 12월 31일까지 5년간 국립의료원 이비인후과에 내원한 환자중 성대마비로 진단된 환자 61례에 대한 후향적 기록 분석에 의해 성별, 원인별, 측별, 성대의 위치, 및 그에 따른 치료방향에 대하여 비교 검토하여 다음과 같은 결과를 보였다. 1)성별은 남녀비가 3:2로 남자가 많았으며, 연령별 분포는 20대에서 70대까지 비교적 균등하였으나 50대(23.0%)에서 가장 많은 분포를 보였다. 2)원인으로는 원인불명이 16례(26.2%), 갑상선수술 8례(13.1%), 폐결핵과 기관내삽관후 각각 6례(9.8%), 폐암 5례(8.2%) 순이었다. 3)마비된 성대의 측별 분포는 편측성이 51례(83.6%), 양측성이 10례(16.4%)이며, 편측성중 좌측이 37례(60.6%)로 가장 많았다. 마비된 성대의 위치는 부정주위가 33례(54%)로 가장 많았다. 4)즉 증상은 단지 애성만 있었던 례가 31례(50.8%), 호흡곤란 혹은 기도흡인등을 동반한 애성이나, 애성을 동반하지 않은 례도 있었다(3례). 증상 발현후 병원 내원까지 기간은 2개월이내가 가장 많았다. 5)16례에서 수술적 처치가 시행되었거나(9례), 혹은 자연치유가 관찰되었는데(7례) 편측성마비때 갑상연골성형술 2례, 양측 마비때 후두외접근법에 의한 피열연골절제술 4례, 레이저를 이용한 피열연골절제술 2례, 승모판 협착증에 의한 편측성 성대마비에서 개심술후 성대마비 회복 1례, 자연 치유는 7례에서 관찰되었으며 6례에서는 증상발현후 6개월이내에 회복되었다.

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Complete mouth rehabilitation, using jaw motion tracking and double scan technique in a patient with osteoarthrosis: a case report (골관절증 환자에서 하악 운동 추적 장치와 이중 스캔 기법을 활용한 완전 구강 회복 증례)

  • Seo-Kyung Jeong;Jai-Young Koak;Seong-Joo Heo;Seong-Kyun Kim;Ji-Man Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.82-94
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    • 2024
  • This is a case report of complete mouth rehabilitation in a patient with generalized attrition and loss of posterior support. After analyzing the condition of the temporomandibular joint, multiple implants were placed to restore collapsed occlusion. Fixture/abutment level intraoral scanning was done instead of using conventional impression materials which entail multiple bite registration for cross-mounting. A 'jaw motion tracking'device, 'digital face-bow transfer', and 'double scan technique' which enables duplicating temporary restoration to definitive restoration were used to fabricate definitive prostheses. By using various digital techniques, complete mouth rehabilitation was done with minimal chair time in a patient with unstable occlusion.

Comparison of Results of ACL Reconstruction According to the Fixation Materials (Metal & Bioabsorbable Interference Screw and RIGIDfix) (금속, 흡수성 간섭 나사못 및 RIGIDfix를 이용한 전방 십자 인대 재건술의 결과 비교)

  • Lim Hong Chul;Wang Joon Ho;Rho Young Jin;Hwang Jin Ho
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.206-214
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    • 2003
  • Purpose : To analysis each clinical results after arthroscopic ACL reconstruction with using variable fixatives which are metallic and bioabsorbable interference screw, and RIGIDfix. Therefore, We reported the clinical reliability and safty of ACL reconstruction using RIGIDfix. Materials and Methods : We evaluated the results of arthroscopic ACL resconstruction with patellar tendon autograft among three groups, of which group 1 is used metal interference screw for 44 patients, group 2 used bioabsorbable interference screw for 47 patients, group 3 used RIGIDfix for 42 patients. We compared the clinical results by physical examination (anterior drawer test, Lachman test and pivot shift test), Lysholm score and KT-2000 arthrometer and compared the radiological results by measurement of tunnel and fixatives position and widening and by MRI findings. We analyzed the results by SAS 8.2 Ducan. Tukey and paired t-test Results : Physical instability was in 5 cases, which group 2 had 4 cases and group 3 had 1 case. Lysholm score improved from 59.8. 64.4, 61 to 90.1, 92.3. 92. KT-2000 arthrometer instability improved from 9.20, 10.2, 9.5 to 1.43. 1.62. 2.00 (p=0.478). Radiologically, all cases had excellent tunnel position and cyst change was observed the 8 cases in the group 2, but, all 20 cases 2nd MRI had signal change of peri-fixatives. But, no correlation of clinical results. Conclusion : No statistical difference of clinical instability was found among three groups. And femoral tunnel changes were much observed in group I, II than III. We considered the RIGIDfix has much advantages because the short operation time, better fixation position and much bone contact surface. But, further long term follow up study was needed.

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