• 대한관절경학회지
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• 제3권2호
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• pp.138-141
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• 1999

목 적 : 화농성 주관절염의 치료 방식 중의 하나인 관절경적 처치를 제시하고, 경과를 평가하고자 하였다. 대상 및 방법 : 급성 화농성 주관절염 환자 7례를 대상으로 하였으며, 연령 분포는 6세에서 32세로 다양한 양상을 보였다. 관절 천자와 임상 검사에 의해 확진되면 즉시 응급으로 관절경적 변연 절제술 및 세척술을 시행하였고, 환자의 경과 관찰을 시행하였다. 결 과 : 혈액 검사상 백혈구 수치 및 적혈구 침강 속도와 c-반응성 단백의 정상화는 소아에서 8.4일, 성인에서 12.3일 소요되었다. 1년 추시 결과 전례에서 주관절 운동 제한은 없었고, 혈액 검사상 정상 소견을 보였으며, 그 외 후유증이나 합병증은 관찰되지 않았다. 결 론 : 화농성 관절염의 치료는 적절한 배농과 항생제 처치가 원칙이며, 이러한 관점에서 본다면 관절경적 변연 절제술 및 세척술은 다른 방식에 비해 관절 연골을 보호하고 전체적인 병리 상태를 관찰하면서 시행할 수 있는 유용한 방식 중의 하나로 사료된다.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.6-11
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• 1998

Shoulder is a common site for calcific deposit and is frequently asymptomatic. There is a general agreement that calcific tendinitis should be initially treated nonoperatively and excision reserved for cases unresponsive to the conservative measures. There are several reports that arthroscopic excision of symptomatic calcific deposit is proved to be efficient in the calcific tendinitis refractory to nonoperative management. The results of arthroscopic treatment of chronic resistant calcific tendinitis of the shoulder in eleven patients were evaluated. Each patient had shoulder pain for more than one year prior to the arthroscopic surgery. The average age of the patients was 48 years(range 35-70). Arthroscopic calcium removal and subacromial bursectomy was performed in all patients. Arthroscopic acromioplasty was additionally done in four patients. The results turned out to be good in nine patients with full range of motion and complete pain relief. One patient with full motion and occcasional episodes of pain was satisfactory. One patient with persistent pain was unsatisfactory which converted to satisfactory six months later after subacromial injection. So we conclude that the arthroscopic treatment is a reasonable alternative in treatment of the chronic calcific tendinitis resistant to conservative treatment.

• 대한족부족관절학회지
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• 제16권1호
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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.

• Clinics in Shoulder and Elbow
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• 제19권2호
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• pp.60-66
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• 2016

Background: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. Methods: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. Results: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). Conclusions: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.

• Clinics in Shoulder and Elbow
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• 제22권1호
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• pp.9-15
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• 2019

Background: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients. Methods: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon's (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one. Results: Mean patient age was 55 years (range, 48-61 years), and mean follow-up period was 20 months (range, 12.0-27.2 months). Mean VAS score significantly improved from $6.6{\pm}2.6$ preoperatively to $1.8{\pm}2.5$ postoperatively (p=0.009), mean ASES score increased from $67.6{\pm}9.2$ to $84.6{\pm}15.1$, and mean UCLA score from $18.0{\pm}1.4$ to $28.8{\pm}8.5$ (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome. Conclusions: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.299-303
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• 2010

목적: 주관절 강직의 관절경적 처치는 효과적이지만 술자의 능력이 요구되는 것이 사실이다. 이 종설의 목적은 주관절 강직에 대한 관절경적 처치 방식을 기술하고자 한다. 대상 및 방법: 비수술적 치료에 반응하지 않는 주관절 강직의 경우 운동 제한을 유발하는 연부 조직 및 골성 물질을 제거하게 된다. 이때 주두, 구상 돌기의 골극과 유리체의 제거는 합병증의 빈도는 낮고 좋은 결과를 보장한다. 결과 및 결론: 관절경을 이용한 주관절 강직의 치료에서는 구축된 조직을 절제하고 중요한 해부학적 구조물들을 보호하기 위한 지식과 숙련된 기술이 필수적이다.

• The Korean Journal of Pain
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• 제22권3호
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• pp.224-228
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• 2009

Background: Shoulder arthroscopic surgery is frequently associated with severe postoperative pain, which can be difficult to manage without the use of high-dose opioids. Although an interscalene brachial plexus block (ISBPB) can be used to provide anesthesia for shoulder arthroscopic surgery, its effect using low-dose mepivacaine on postoperative pain management has not been reported. We hypothesized that ISBPB using a low-dose mepivacaine can provide effective postoperative analgesia for shoulder arthroscopic surgery without the need for high-dose opioids and act as a significant motor or sensory block. Methods: This study examined a total of 40 patients, who underwent shoulder arthroscopic surgery, and received ISBPB with 10 ml of normal saline (group NS; n = 20) or 10 ml of 1% mepivacaine with epinephrine 1:200,000 (group MC; n = 20). The block was performed preoperatively. The postoperative pain score, opioid consumption, and side effect were recorded. Results: The visual analog scale scores were significantly lower in group MC than in group NS at 120 minutes after shoulder arthroscopic surgery ($1.9{\pm}1.0$ versus $4.0{\pm}1.4$). Group MC showed significantly lower fentanyl consumption after shoulder arthroscoic surgery than group NS ($27{\pm}32.6$ versus $79{\pm}18.9{\mu}g$). The degree of motor and sensory block after surgery was minimal. Conclusions: ISBPB using low-dose mepivacaine reduced the level of postoperative pain and fentanyl consumption without significant side effects. ISBPB using low-dose mepivacaine is a useful analgesic technique for shoulder arthroscopic surgery.

• 대한관절경학회지
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• 제2권2호
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• pp.141-146
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• 1998

Recent studies suggest that most meniscal cysts can be treated surgically by arthroscopic management of the meniscal tear and arthroscopic cyst evacuation. But arthroscopic cyst decompression may sacrifice a substantial amount of meniscal tissue that is not torn in order to expose the "stalk" of the cyst. Nowadays, the trend is changing as preserving the involved meniscus to prevent from inevitable degenerative changes after meniscectomy. The purpose of this report is to describe a new surgical technique that minimizes loss of meniscal tissue in hopes of maximizing residual meniscal function. We experienced 10 patients with meniscal cysts that were consisted of four lateral cysts and six medial cysts. Menisci were torn in all cases. Arthroscopic partial meniscectomy and decompression of cysts were performed in 9 cases, and arthroscopic partial meniscectomy and open cystectomy in 1 case. The procedures were consisted of injection of the methylene blue into the cyst, partial meniscectomy of the meniscal tear until the dye was seen in orifice of the cyst, and decompression of cyst through cystic opening. This article serves to confirm the relationship between torn menisci and cysts, to re-evaluate the occurrence ratio of the meniscal cyst on the medial to lateral meniscus, and to assess the efficacy of arthroscopic partial meniscectomy and decompression of cyst as a potentially meniscal sparing procedure.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.334-338
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• 2022

Currently, the literature contains few studies that describe any potential complications following arthroscopic acromioplasty. Because part of the anterior deltoid originates from the anterior acromion, there is a risk for violation and subsequent iatrogenic rupture or avulsion during this procedure. This type of injury can be a devastating problem for patients that may lead to poor function and debilitating pain. We present a patient with deltoid insufficiency following arthroscopic acromioplasty who elected to proceed with operative management with a planned arthroscopic evaluation of the shoulder followed by an open deltoid repair. At the final follow-up visit 2.5 years postoperatively, the patient reported improved pain from baseline and no residual disability and was able to perform most activities of daily living without difficulty. This case serves as an example of a surgical repair for a deltoid avulsion following arthroscopic acromioplasty. As there is still a lack of standard guidelines, our suture repair technique can be considered one method of treatment for this type of injury.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1999년도 학술대회
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• pp.38-40
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• 1999

$\cdot$ Arthroscopic management is the effective method with acceptable results for coronoid impingement of stiff elbow contributing to the functional improvement and pain relief. $\cdot$ The functional improvement and pain relief seem to be affected by the severity of a degenerative change of the elbow joint. $\cdot$ Excision of coronoid process is required in a marked limitation of further flexion in addition to deeping of the coronoid fossa and anterior capsular release. $\cdot$ Excision of olecranon tip or posterior capsular release are effective method in severe flexion contracture.