• Title/Summary/Keyword: Arthroscope

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Arthroscopic Treatment of Elbow Osteoarthritis and Arthroscopic Ulnar Nerve Decompression

  • Chung, Seok Won
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.256-263
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    • 2016
  • Although arthroscopic surgery has been used conventionally, it has not been widely adopted yet due to the risks of complications, including nerve damage, technical difficulties, and limited indications. As shown in other joints, however, the use of an arthroscope will gradually increased in the elbow joint ('Arthroscopy always wins'). Herein, arthroscopic treatments and arthroscopic ulnar nerve decompression will be discussed in cases of elbow osteoarthritis.

Rotating Arm Internally Can Change the Arthroscopic Diagnosis of a Partial-thickness Tear of the Subscapularis

  • Kim, Hyungsuk;Song, Hyun Seok;Kang, Seung Gu;Han, Sung Bin
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.135-138
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    • 2019
  • Background: The aims of this study were (1) to examine the footprint of the subscapularis tendon using the traditional posterior portal and $30^{\circ}$ arthroscope by simple internal rotation of the arm during surgery, and (2) to classify the pattern of a subscapularis partial-thickness tear. Methods: This study analyzed a total of 231 patients with a partial-thickness subscapularis tear from 550 consecutive patients undergoing an arthroscopic operation who had a visualization of the subscapularis tendon footprint by internal rotation of the arm. First, the patients were classified into four categories according to the tear pattern: (1) stable lamination, (2) unstable lamination, (3) avulsion, and (4) laminated avulsion. Randomized arthroscopic videos were reviewed blindly by two independent orthopedic surgeons. The pattern of the tear of the subscapularis at the neutral position and after internal rotating the arm were assessed and compared with the treatment decision (level IV case series). Results: Stable lamination, unstable lamination, avulsion, and laminated avulsion were observed in 9.1% (n=21), 20.8% (n=48), 41.1% (n=95), and 29.0% (n=67) of cases, respectively. In 145 out of 231 cases (62.8%), the decision was changed after inspecting the footprint after internal rotation of the arm, and the treatment method was changed in 116 (50.2%) cases. Conclusions: In a subscapularis tendon partial-thickness tear, inspecting the footprint of the subscapularis tendon is essential to diagnosing and deciding on the appropriate treatment. In addition, simply internal rotating the arm during surgery when using the traditional posterior portal and $30^{\circ}$ arthroscope can be a valuable method.

Current Concepts in Arthroscopic Treatment of Anterior Shoulder Instability (견관절 전방 불안정에 대한 관절경적 최신 치료 경향)

  • Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.13-27
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    • 2003
  • In the past, the report of shoulder instability undergoing open shoulder stabilization had satisfactory outcomes of greater than 90%. However, the functional loss of open procedure is severe in abduction and external rotation especially. Current arthroscopic techniques for shoulder instability result in success rate equal to open surgical procedure when the labrum is properly fixed to the glenoid rim using suture anchors, the capsule is tightened, and associated bony and soft tissue pathology is addressed. The arthroscopic surgery facilitates the view within shoulder joint for more accurate diagnosis, reduces operating time, minimises postoperative pain, reduces operative morbidity, improves shoulder function, and provides the possibility to perform other procedure simultaneously. However, to accomplish a successful arthroscopic stabilization procedure and to prevent complications, numerous advanced arthroscopic skill must be mastered. Although the arthroscope provides means to visualize new lesions, the pathomechanism and biomechanical explanation is not clear yet. Further studies are necessary to develop for shoulder reconstruction.

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New Retear Pattern after Rotator Cuff Repair at Previous Intact Portion of Rotator Cuff

  • Choi, Chang-Hyuck;Kim, Sung-Guk;Nam, Jun-Ho
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.237-240
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    • 2016
  • Retear patterns after arthroscopic rotator cuff repair are classified into two patterns according to retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method. Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope.

Is an Arthroscopically Assisted Reduction and Fixation Necessary in the Medial Malleolar Fracture of the Ankle? (족관절 내과 골절시 보조적 관절경적 정복 및 내고정술이 필요한가?)

  • Shin, Dong Min;Ju, Pyong
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.93-96
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    • 1998
  • We treated 10 cases of the medial malleolar fracture of the ankle by open reduction and internal fixation from June 1997 to December 1997. After the rigid internal fixation, we measured the gap of the fracture site and the step off of the articular surface by special instrument under the ankle arthroscopy whether it was reduced anatomically or not. And we tried to know the necessity of the arthroscopically assisted reduction and fixation in the medial malleolar fracture of the ankle. Under the arthroscopic view, all 10 cases were anatomically reduced as less than 1 mm of gap of the fracture site and less than 1mm of step off of the articular surface after open reduction and internal fixation in the medial malleolar fractures. In conclusion, through the arthroscopic management, it has advantage in finding and treating the accompanying intraarticular lesion, but also has disadvantage in setting the arthroscope and prolonging the operation time.

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Foreign Body Synovitis of a Child's Knee - A Case Report - (소아에서의 이물질에 의한 슬관절 활액막염 - 증례보고 -)

  • Kim, Sung-Jae;Lee, Su-Chan;Lee, Young-Soo;Lee, Yun-Tae
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.51-53
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    • 1999
  • A four-year-old boy with knee pain who had an obscure history showed radiopaque material in the radiograph of the medial side of the knee joint. We successfully treated removal of a piece of glass by arthroscope followed by debridement of erosive cartilage and torn meniscus.

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Review of Shoulder Joint Impingement Syndrome (견관절 충돌증후군의 고찰)

  • Kim, In-Sup
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.2 no.1
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    • pp.93-100
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    • 2004
  • Shoulder impingement syndrome is cause by the collision of acromion, acrominoclaviclar joint, coracoacromino ligament, coracoid process and synovial sac, biceps brachiialis tendon, rotator cuff muscle. Treatment for Shoulder impingement syndrome is genetally classified into two different methods; preservative method and operational method. Operational method includes rotator cuff sutura, anterior acromioplasty, arthroscope decompression. Preservative method includes rest, medicinal therapy, physical therapy. Physical therapy concentrates on pain control, functional recovery and prevention of disease progress. It is also important for physical therapy to maintain the strength of rotator cuff. Strengthening rotator cuff decreases the collision and helps the stability of shoulder joint. In conclusion, it must be aware that shoulder impingement syndrome and some other shoulder problem demand different treatment, which results in a better outcome.

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Ankle Arthroscopy: Anatomy, Portals and Instrument (발목 관절경: 해부학, 삽입구 및 기구)

  • Sung, Ki-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.1-8
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    • 2012
  • Major technologic advances in fiberoptic light transmission, video cameras, and instrumentation have allowed great advances in small-joint arthroscopy. Arthroscopy in particular is now well established procedure for accurate diagnosis and operative management of certain ankle disorders. The small size of the ankle and significant periarticular soft tissue structures make placement and advancement of the arthroscope and instrumentation more difficult than in larger joints. Successful arthroscopy of the ankle requires knowledge of the regional anatomy and a familiarity with the available arthroscopic portals. This review article is going to describe the gross and arthroscopic anatomy of the ankle as it relates to current arthroscopic techniques. Particular emphasis is placed on the anatomic relations of the important osseous and soft tissue structures for a safe, reproducible approach to arthroscopic treatment of ankle pathology. Also, current arthroscopic equipment and instruments are included.

All-inside Arthroscopic Capsular Imbrication and Lateral Release in Patellofemoral Instability (Operative technique) (슬개대퇴관절 불안정성에서의 관절경적 All-inside 관절막 중첩술 및 외측 지대 유리술 (수술 술기))

  • Kim, Jae-Hwa;Cho, Duck-Yun;Yoon, Hyung-Ku;Kim, Jung-Ryul
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.118-122
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    • 2006
  • Purpose: We introduce a technique of all inside arthroscopic capsular imbrication and lateral release used to treat patellofemoral instability. Methods: With the arthroscope in the anteromedial portal for best viewing, the arthroscopic scissor is placed through superolateral portal for proximal to distal release. The release performed 5mm to 1cm from the edge of the patella. After completion of the procedure, with the arthroscope in anterolateral portal, we inserted 5mm cannula in superolateral portal and made working portal from superomedial portal. Medial reefing was performed with all inside technique by using curved needle of the spectrum suturing system and No. 1 monofilament PDS suture is passed through the superomedial portal percutaneously and retrieved through a superolateral portal. Conclusion: Several methods for arthroscopic patella realignment have been proposed, but they have consisted primarily of arthroscopically assisted techniques using a medial incision. We believe that our procedure is preferable to arthroscopically assisted methods commonly used, in that an incision is avoided and the vastus medialis obliqqus is not violated. Our technique is minimally invasive and is easy to control the tightness of the medial patellofemoral ligament (MPFL) under direct vision.

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Arthroscopic Treatment of Recurrent Prepatellar Bursitis (관절경을 이용한 재발성 슬개골전 점액낭염의 치료)

  • Kyung Hee-Soo;Kim Hee-Soo;Hwang Jun-Kyung;Ihn Joo-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.183-187
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    • 2002
  • Purpose : We report a result of arthroscopic treatment of the recurrent prepatellar bursitis. Materials and Methods : Between March 2001 and May 2002, we treated 4 patients with prepatellar bursitis, the average follow-up period was 14.5 months. The causes were acute trauma 3 cases and repeated minor trauma 1 case. All cases were recurred after previous history of the conservative therapy at other hospital but one was a recurred case after operative excision. Operative technique was as follows. Before inserting the arthroscope, the bursa was inflated with saline. The portals fur 4 mm diameter arthroscope were placed 1cm away from the bursal sac through small skin incision. Superficial layer of the bursa was resected first and then deep portion was the next. Several percutaneous mattress sutures were applied to the overlying skin with deep tissue, and compressive dressing was applied and maintained for 2 weeks. Results : All 4 cases were no recurrence, no pain, no tenderness. The results were considered satisfactory, Two cases of mild skin dimpling at suture site were observed. Conclusion : Arthroscopic treatment of the prepatellar bursitis is an another method of operation technique fur recurrent prepatellar bursitis, however long term follow-up will be needed about recurrence.

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