• Clinics in Shoulder and Elbow
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• v.6 no.1
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• pp.72-79
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• 2003

Purpose: To compare the results of arthroscopic rotator cuff repair and subacromial decompression in partial thickness rotator cuff tear (PTRCT) with those in full thickness rotator cuff tear (FTRCT). Subjects and method: Of the 46 patients who were rested of the rotator cuff tear based on the operational findings, 42 patients who were able to receive a serial follow-up for 2 years were selected as the study subjects. The average age of the patients at the time of the operation was 55 years, and the mean duration of the follow-up was 34 months. The subjects included 22 cases of PTRCT and 20 cases of FTRCT. In terms of rotator cuff repair, the average number of tendon to tendon repair (TTR) was 1 in both PTRCT and FTRCT, and that of tendon to bone repair (TBR) was 1 and 3 in PTRCT and FTRCT, respectively. The average number of use of suture anchor was 1 and 2 in PTRCT and FTRCT, respectively. The level of shoulder pain and function of the subjects were measured using shoulder functional evaluation score of American shoulder and elbow society (ASES score) at before and 2 years following the operation. Results: At the final follow-up following the operation, PTRCT group showed changes in scores from 7.2 to 0.9 on average pain score and 34 to 91 on ASES score, whereas FTRCT group showed changes in scores from 7.6 to 1.2 on pain score and 29 to 88 on ASES score. There were no significant differences between the two groups (P > 0.05). The average range of motion of shoulder significantly increased in both groups at the final follow-up in comparison with the pre-operative time point. The evaluation at the final follow-up showed that 93% of the total subjects showed good or excellent results, and 95％ showed satisfactory results from the procedure with regard to pain reduction and functional outcomes. Two cases of the 3 fair results were caused by acromioclavicular arthritis. Conclusion: It may be anticipated that arthroscopic rotator cuff repair and subacromial decompression may bring satisfactory post-operative outcomes in both PTRCT and FTRCT on pain relief and functional recovery. However, careful preoperative examination of the acromioclavicular joint is critical to avoid failures of these procedures.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.147-152
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• 2003

Purpose : The purpose of this study was to evaluate the arthroscopic findings of the transplanted human allogenic meniscus including MRI changes at follow up. Materials and Methods : From Oct. 1999 to Jun. 2002, nine patients underwent arthroscopic evaluation at follow-up. We used nonirradiated cryopreserved meniscus allograft for 6 cases and fresh-frozen for 3 cases. We used bone-plug method for medial meniscus and bone-bridge method for lateral meniscus to fix the transplanted meniscus. The average follow-up time was 13 months. We evaluated the result by lysholm score, MRI and second-look arthroscopic finding. Results : The second-look arthroscopy after allogenic meniscal transplantation revealed that grafts were well incorporated with surrounding capsular tissue. But one case showed wear on the post horn and the other case which was operated at other local clinic showed tear of the anterior hem due to non-anatomic placement of bone bridge. There was improvement of average Lysholm score form 64 to 87. Conclusion : Second-look arthroscopy revealed excellent incorporation of the allograft with firm attachment and early clinical results are satisfactory. But further studies are necessary to assess whether meniscal transplantation can prevent progressive degenerative changes.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.138-143
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• 2000

Purpose : We analyzed clinical and radiological results of the treatment of osteochondritis dissecans in the femoral condyle under arthroscopic guidance. Materials and Methods : The study group consists 19 cases in 17 patients. Average follow up period was 34 months and average age was 16 years. The cases were classified by 4 different groups, using the fellowing system: Group 1-stable lesion and no specific treatment after arthroscopic examination; Group 2-early separation and multiple drilling; Croup 3-unstable lesion and Herbert screw fixation; Croup 4-loose body removal and/or crater curettage. The results were analyzed by the criteria of Hughston which including clinical and radiologic outcomes. Results : There were 14 cases$(74\%)$ of good and excellent results in 19 knees in which, $75\%$(3/4) in Group 1, $75\%$(3/4) in Group 2, $86\%$(7/8) in Group 3 and $33\%$(1/3) in Group 4. The result of Herbert screw fixation group was better than that of other groups with statistically significant differences. Conclusion : In the treatment of osteochondritis dissecans of skekletally immature patients, arthroscopic finding was reliable guidance in decision of treatment method and active fixation was recommended in patients with large, unstable lesion.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.22-26
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• 2001

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.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.92-98
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• 2011

Purpose: We describe a all-arthroscopic technique for decompression of spinoglenoid ganglion cyst and present our clinical results for this procedure. Materials and Methods: From March 2006 to June 2009, eight patients (7 males, 1 female; mean age 40.6 years; range: 21~61) were included who underwent arthroscopic decompression of spinoglenoid ganglion cyst. The most common symptoms were vague shoulder pain and external rotation weakness, which lasted 6.4 months (range: 3~8) on average. Five of eight patients were noted abnormalities on electromyographic (EMG) examination to have suprascapular nerve neuropathy and magnetic resonance imaging (MRI) showed spinoglenoid ganglion cysts in all eight patients and the cyst size was 2.6 cm (range: 1.8~3.6). Labral pathology was identified intraoperatively in all patients and the cysts were decompressed by the posterosuperior capsulotomy under arthroscopic control and labral repair with suture anchors was performed in six patients. Results: The average clinical outcome scores including Constant and Murley, Simple shoulder test (SST) all improved significantly at the time of the final follow-up and there were no complications resulting from the procedures. All patients including the patients with abnormal EMG study recovered strength on isokinetic strength testing. Follow-up MRI scans were performed on all patients at a mean of 5.2 months postoperatively (range: 3~12) revealed complete resolution of the cysts and no evidence of recurrences were seen at an average of 18 months (range: 12~26) of follow-up. Conclusion: Arthroscopic decompression of spinoglenoid ganglion cyst effectively restores patient function and all patients in this study showed improvement in their postoperative MRI findings. Arthroscopic decompression is also useful in the appropriate treatment for labral pathology and may contribute to decreased risk of cyst recurrence.

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.7-12
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• 2011

Purpose: We purposed to evaluate clinical results after undergoing arthrocopic surgery of lateral discoid meniscus in children. Materials and Methods: Retrospective evaluation was executed for the 21 cases which showed abnormal findings of knee joint due to lateral discoid meniscus, from Janunary 1 1999 to December 30 2007. Average observation period was 38.4 months (14months~60 months), and average age was 9.5 years old (7~12 years old). The major clinical findings for knee joint extension limitations were the most common with 11 cases, and there were 8 cases of knee joint pain, 6 cases of snapping, and 10 cases of gait abnormality. The forms of lateral discoid meniscus were 14 cases of complete type, 5 cases of incomplete type, and 2 cases of Wrisberg type. All patient had arthroscopic partial menisectomy and some patient who had meniscus tear had arthroscopic meniscus repair. The clinical results were evaluated using Ikeuchi grading system, and the change of knee joint was observed through routine radiography. Results: The peripheral hypermobility of lateral disciform meniscus was observed in 7 cases. The peripheral tear was observed in 4 cases, where partial menisectomy was along with suture at the same time. The final clinical results were 5 cases of Excellent, 12 cases of Good, 4 cases of Fair. Radiologically, there were 5 cases of subchondral sclerosis and narrowness of hardness at the lateral knee joint, and osteochondritis occurred at the joint facet of external femur in 1 case. In clinical result, meanwhile, there were 20 cases of normal or almost normal and only 1 case of abnormal in IKDC score. Conclusion: Knee joint arthroscopic partial menisectomy for treatment of lateral discoid meniscus is useful, and when accompanied by peripheral disruption, suture is thought to be necessary.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.78-85
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• 2008

Purpose: The findings of preoperative magnetic resonance imaging (MRI) and ultrasonography (US) examination in the diagnosis of rotator cuff tear were then compared with the findings of arthroscopic examination, and to evaluate the postoperative integrity of rotator cuff using serial US examination. Methods: Between February and May 2008, 29 patients with rotator cuff tear had undergone preoperative US and MRI examination and subsequent arthroscopic examination. And the results of MRI and US were compared with intra-operative results of the arthroscopic examination. We observed the postoperative integrity of rotator cuff using serial (postoperative 2 weeks, 6 weeks, 3 months) US examination. Results: The sensitivity of US and MRI for identifying rotator cuff tear were 100% and 100%. The sensitivity of US and MRI were 95% and 82% in full thickness tear, and 50%, 33% in partial thickness tear, respectively. Overall accuracy of US and MRI were 86%, 69%. Among 22 patients were operated for full thickness tear, intra-operative gap formation was identified in 11 patients (50%, small to medium 2 cases, large to massive 9 cases) which were identified at 2 weeks postoperative US. We could find 5 re-tears (23%, small to medium 1 case, large to massive 4 cases) on 6 weeks postoperative US after passive range of motion (ROM) exercise, and could also find 7 re-tears (32%, small to medium 2 cases, large to massive 5 cases)on 3 months postoperative US after active ROM exercise. Conclusion: Serial US after arthroscopic rotator cuff repair was useful to differentiate intra-operative gap formation from postoperative re-tear. We found 5 retears (23%) at 6 weeks and 7 retears (32%) at 3 months postoperative US, it was useful to make treatment plan during postoperative rehabilitation.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.33-38
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• 2009

Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.45-48
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• 2010

We report a case of an 85-year-old woman with tuberculous subdeltoid bursitis. Tubeculous bursitis without adjacent joint tuberculosis may occur any site but it is rare. It is common in bursae subjected to trauma like trochanteric, prepatellar, olecranon and so on. Because the clinical findings or physical examination of tuberculous subdeltoid bursitis are similar to rotator cuff disorder and the MRI or arthroscopic findings are similar to synovial diseases, careful differential diagnosis is necessary.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.63-65
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• 2008

We treated a 37-year-old male with traumatic hematoma in the suprapatellar bursa that had developed in the form of persistent swelling on suprapatellar area of left knee after blunt trauma. Though there were no obvious abnormal findings on plain roentgenographs, an isolated suprapatellar cystic lesion with fluid-fluid level on T2-weighted sagittal image of MRI was noted. We found the suprapatellar plica with complete septum and no synovitis in the knee joint proper by arthroscopy. We incised the plica and found leakage of blood-stained fluid from the suprapatellar bursa. There were no findings of pigmented villonodular synovitis or other tumorous lesions. At 6 months after surgery, the patient felt symptom-free and there was no recurrence.