• Title/Summary/Keyword: Arthroscopic classification

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Relationship between Radiographic Classification and Articular Cartilage Lesions in Medial Degenerative Arthritis of the Ankle (족관절 내측 퇴행성 관절염의 방사선적 분류와 관절 연골 손상의 관계)

  • Lee, Woo-Chun;Moon, Jeong-Suk;Lee, Kang;Choi, Hong-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.130-134
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    • 2007
  • Purpose: To investigate the relationship between classification based on simple radiographic findings and arthroscopic findings of the cartilage lesions in medial degenerative arthritis of the ankle joint. Materials and Methods: We studied 41 ankles of 36 patients with asymmetrical narrowing of the medial joint space. Degenerative arthritis following fracture and those with generalized arthritic disease were excluded, but those with a history of ankle sprain were included. Standing radiographs of all patients were graded according to the Takakura classification and the Kellgren-Lawrence (K/L) classification. Arthroscopic findings were classified according to the depth, width, and anteroposterior dimension of articular cartilage damage. Results: According to the Takakura classification, 29 ankles were classified as stage II, 7 cases as stage IIIA and 2 cases as stage IIIB. According to our classification of arthroscopic findings of 29 ankles in stage II, 1 ankle was graded as Grade I, 3 ankles as grade II, 10 ankles as grade III, and 15 ankles as grade IV. Spearman correlation coefficient between Takakura classification and arthroscopic classification was 0.342 (P=0.028), and coefficient between K/L classification and arthroscopic classification was 0.480 (P=0.001). Conclusion: Degenerative changes of the articular cartilage are more advanced than radiographic findings in many patients with ankle degenerative arthritis with asymmetrical narrowing of medial joint space. Therefore, we conclude that more aggressive effort should be made for correct diagnosis and treatment of degenerative arthritis.

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Arthroscopic Debridement of the Knee Joint (슬관절의 관절경적 변연절제술)

  • Suh, Jeung Tak;Park, Byung Guk;Song, Jin Heon
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.159-163
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    • 1998
  • We reviewed the cases of 35 knees of 34 patients who had arthroscopic debridement for degenerative osteoarthritis of the knee. The patients were followed up for an average of 29 months (range: 13 months to 45 months). The mean age of the patients at operation was 54 years (range: 44 years to 75 years). At the time of follow up, the patients were evaluated using the nine-point scale by Baumgaertner et al. We divided the knee into 4 stages according to the classification system by Jackson et al. Satisfactory results were achieved in 80%(stage I), 75%(stage II), 55.6%(stage III) and 25%(stage IV) of the patients. Arthroscopic debridement is of significant value in the earlier stages of degenerative osteoarthritis (stage I and II) for the symptom relief as a simple procedure with rare complication as well as in the later stages(stage III and IV) as a time buying procedure before the total knee arthroplasty.

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Arthroscopic Osteochondroplasty of the Osteochonral Lesion of the Talus (거골의 골연골 병변에 대한 관절경적 골연골 성형술)

  • Min, Sang-Hyuk;Jung, Hong-Geun;Kim, You-Jin;Kim, Young-Jae;Yoo, Moon-Jib
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.144-149
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    • 2006
  • Purpose: To evaluate the clinical characteristics and the functional results of the osteochondral lesions of the talus (OLT) treated with arthroscopic osteochondroplasty. Materials and Methods: The study was based on 25 cases (25 feet) of osteochondral lesion of talus that were treated with arthroscopic osteochondroplasty from May 1997 to June 2005 with at least 1 year follow-up. Follow-up period was average 21.8 months. The average age was 37.2 years old. Male patients were 22 while female were 3. Postoperative evaluation was performed with American Orthopedic Foot and Ankle Society (AOFAS) Functional score, patient satisfaction and complications. Results: Ninety-two percent of patients had trauma history. Seventy-two percent of the lesions were located at the medial dome. As for the cartilage classification, 56% were fibrillation/fissure lesions while 44% were flap tears. Visual analogue scale (VAS) pain score improved from 6.8 points to 2.2 points, and AOFAS score improved from 71.3 points to 87.3 points. Eighty-eight percent of the patients were satisfied with the surgery and average period of returning to previous job was 6.5 weeks. Conclusion: We concluded that the arthroscopic osteochondroplasty is a viable surgical option for the osteochondral lesion of the talus.

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Arthroscopic-assisted Reduction and Percutaneous Screw Fixation for Glenoid Fracture with Scapular Extension

  • Kim, Se Jin;Lee, Sung Hyun;Jung, Dae Woong;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • v.20 no.3
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    • pp.147-152
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    • 2017
  • Background: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results. Methods: We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up. Results: Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication. Conclusions: We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.

MRI Follow-up Study After Arthroscopic Repair of Multiple Rotator Cuff Tendons (다발성 회전근 개 파열에서 시행한 관절경적 회전근 개 복원술 후 MRI 추적 검사)

  • Tae, Suk-Kee;Kim, Jin-Young;Park, Jae-Sik
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.96-103
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    • 2008
  • Purpose: This study investigated the rate of retear and related factors after arthroscopic repair of rotator cuff tears involving more than one tendon. Materials & Methods: Arthroscopic repair of 22 rotator cuff tears (average size 3.2cm: average age 58 years old) involving the supraspinatus and part or all of the infraspinatus were investigated using MRI on average 10 months after repair. The status of the repaired cuff was investigated using Sugaya's classification, and the change in muscle was evaluated with Goutallier's classification. Results: Retear (Sugaya grade IV, V) was found in 7cases(32%). Tears larger than 3cm had a higher retear rate(67%) than smaller tears(8%). Retear cases had Goutallier grade II or higher muscle changes preoperatively and showed aggravation of muscle atrophy postoperatively. Even without retear, reversal of muscle change was not seen Conclusion: Rotator cuff tears not confined to the supraspinatus had a 32% retear rate after arthroscopic repair. The size of the tear was the most crucial factor influencing retear. Retear was frequent in tear over 3cm. Atrophy of the cuff muscle worsened when the repair failed but did not improve even without retear.

Operative Treatment of Osteochondral Lesion of the Talus: Arthroscopic Bone Marrow Stimulation (Multiple Drilling or Microfracture) (거골 골연골병변의 수술적 치료: 관절경적 골수 자극술(다발성 천공 또는 미세 골절술))

  • Gwak, Heui-Chul;Eun, Il-soo
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.48-54
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    • 2020
  • Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. Various terms are used to describe this clinical entity, including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Several treatment options are available; the choice of treatment is based on the type and size of the defect and the treating clinician's preference. Arthroscopic microfracture (a bone marrow stimulation technique) is a common and effective surgical strategy in patients with small lesions or in those in whom non-operative treatment has failed. This study had the following aims: 1) to review the historical background, etiology, and classification systems of OLT; 2) to describe a systematic approach to arthroscopic bone marrow stimulation for OLT; and 3) to determine the characteristics that are useful for assessing osteochondral lesions, including age, size, type (chondral, subchondral, cystic), stability, displacement, location, and containment of the lesion.

Arthroscopic Synovectomy of the Shoulder Joint for Rheumatoid Arthritis (류마티스 관절염환자에서 견관절의 관절경적 활액막절제술)

  • Kim, Kyung-Taek;Lee, Myung-Jin;Kim, Wook
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.76-80
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    • 2003
  • 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.

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Clinical Results of the Radial Tear of Posterior Root of Medial Meniscus (내측 반월상 연골 후각부 방사형 파열의 임상적 결과)

  • Nha, Kyung-Wook;Jo, Jin-Ho;Lee, Dong-Bong
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.128-133
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    • 2007
  • Purpose: To examine the clinical results after arthroscopic meniscectomy of radial tear of medial meniscus. Materials and Methods: We studied 45 cases with the radial tear of medial meniscus which follow up more than 2 years(range 2 to 7 years). Arthroscopic surgery was performed to the patients with grade 0-2 according to the Kellgren and Lawrence classification. Evaluation of cartilage damage was performed on surgical photos according to Outerbridge classification. Evaluation of clinical result was used the modified Lysholm score. Results: The mean pre-operation Lysholm score was 79.1, 71.2, 68.5, 67.9, 67.2, 61.5 and post-operation Lysholm score was 86.3, 75.1, 73.0, 73.1, 73.2, 66.2 and 61.5%, 62.5%, 60.0%, 50.0%, 50.0%, 25.0% improved knee pain and 69.2%, 75.5%, 70.0%, 66.6%, 75.0%, 75.0% were satisfied knee surgery and 30.7%, 20.5%, 20.0%, 50.0%, 25.0%, 50.0% required further surgery in patients respectively. According to Kellgren and Lawrence classification, 7 cases(15.5%) progress grade 3 osteoarthritis. Conclusions: The radial tear of medial meniscus showed the poor results with arthroscopic meniscectomy even if the grade 0-2 osteoarthritis. For the improvement of the clinical results, consider the technique to restore the hoop stresses or use the high tibia osteotomy for preventing the osteoarthritis.

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