• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.76-82
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• 2004

Purpose: In the traumatic anterior shoulder instability, the laxity of joint capsule and ligament is frequently demonstrated. Although a arthroscopic procedure to address anterior instability with joint capsular redundancy have generally provided good results, its recurrence rate is higher than open procedure. By reducing the capsular redundancy, thermal shrinkage is likely to improve the outcome of arthroscopic anterior stabilization. The objective of this study was to evaluate additional thermal capsular shrinkage as a treatment of joint capsular redundancy in anterior shoulder instability. Materials and Methods: From March 1999 to June 2000, 25 shoulders of 23 patients of recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with shrinkage procedure. The mean follow up was 29 months and average age at the time of operation was 26 years. Of these patients, 20 were male and 3 were female who had been experienced the average 8 times of dislocation before operation. Thermal shrinkage alone without Bankart repair was performed in two cases who did not have Bankart lesion. The clinical result was evaluated in according to Modified Rowe Score. Results: The Modified Rowe Score was improved from preoperative 35 points to postoperative 88 points. None of cases showed recurrence of dislocation. But, in two cases, temporary sensory hypesthesia of the axillary nerve was developed and in two cases of postoperative stiffness, arthroscopic capsular release and brisement were performed. Conclusion: Additional capsular shrinkage in arthroscopic technique to address recurrent anterior shoulder instability could treat effectively the capsular redundancy.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.14-18
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• 2005

Purpose: Limitation of motion of the elbow joint due to stiffness affect on life quality of the patients. So contracture of the elbow should be treated as soon as possible. Among the many treatment modalities, we described the result of arthroscopic treatment. Materials and Methods: From Mar. 2000 to Mar. 2003, 40 patients, who received the arthroscopic treatment by author for contracted elbow, were the subjects. We estimated the range of motion (ROM) of elbow joint before and after surgery by goniometer. The clinical result was evaluated by Severance elbow scoring system. The final ROM was evaluated at the point of no further increasement of joint motion. Male ware 30 cases, female ware 7 cases, average 42.6 years old and mean follow up period were 31 months. During arthroscopic treatment we had done release of the joint capsule or resection, synovectomy, removal of loose bodies. We used traditional portals. Results: The avarage preoperative ROM of elbow joint was 72.5 degree(range, 5 - 132 degree) and the increasement of ROM was totally 49.3 degree in flexion 26.5 degree and extension 22.8 degree. There was no other complication. Conclusion: Arthroscopic treatment for contracted elbow permit early joint ROM and it decrease the secondary injury to the elbow joint. Also there are few complications. It is thought to be a good treatment modality in contracted elbow joint.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.109-114
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• 2004

Purpose: To evaluate the clinical results and prove the effectiveness of arthroscopic capsular release in refractory adhesive capsulitis of shoulder. Materials and Methods: We preformed arthroscopic capsular refractory adhesive capsulitis that not responded by stretching execies for above 1 year. 21 cases were followed above 1 year and average follow up 3 years 1 months (1${\sim}$5 years). We checked VAS of pain, ADL of function. UCLA score which were evaluated at preoperation, postoperation 6 months, 1 years and last follow up period, and compared with each other at last follow up. Results: The VAS score improved average preoperative score 8 to average postoperative score1, the ADL score improved average preoperative score 7 to average postoperative score 26, the UCLA score improved average preoperative score 8 to average postoperative score 34. Forward elevation improved average preoperative 75 degrees to average postoperative 175 degrees, external rotatiion at side improved average preoperative 4 degrees to average postoperative 52 degrees, abduction improved average Preoperative 60 degrees to average postoperative 170 degrees, internal rotation at posterior improved preoperative thigh-lumbar 3 spinous process to postoperative 7th thoracic spinous process~9th thoracic spinous process. Conclusion: Arthroscopic capsular release in refractory adhesive capsulitis that non responsive to stretching exercise for above 1 year were effective treatment method.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.41-45
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• 2004

In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.97-101
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• 2002

Purpose : To describe clinical results and improvement of range of motion and pain after arthroscopic treatment for the athletic elbow lesion. Materials and Methods : We reviewed 13 cases of functional restriction of the elbow motion, who all patients were treated by conservative treatment during than 6 months but failed. We performed arthroscopic osteophytectomy, capsular release, spur excision. The interval from injury to operation was average of 13 months (range, eight to sixteen months). We used the Broberg and Morrey functional rating score system in evaluating result. The follow-up period averaged 6 months. Results : Arthroscopic finding that moderative to severe synovitis in all cases, intraarticular loose body in 9 cases, olecranon bony spur in 2 cases, was observed. All cases were successfully improved in range of motion and pain without in any further operation. Preoperative average score was 65 and postoperative average score was 89.4 in Broberg and Morrey functional rating score. Conclusions : Arthroscopic treatment appear to be satisfactory management modality due to diagnose the casative factor and reduce the injury around the elbow joint in painful elbow lesion. Elbow arthroscopy appears to be a safe and effective treatment for athletes, allowing easy return to participation in sports.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.104-110
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• 2001

Purpose : To analyze the patterns of osteochondral fracture associated with patellar dislocation and to assess the results of arthroscopic treatment. Materials and Methods : Fourteen patients were treated from March, 1989 to April, 1998 for patellar dislocations with osteochondral fracture. The average follow-up was 32 months. All were treated by arthroscopic procedures. The location and size of the fracture fragments were recorded. To assess the functional results, we used Larsen & Lauridson's score system. Results : Osteochondral fractures were found 8 cases in medial side of patella, 1 case in lateral side of patella, 5 cases in lateral margin of lateral femoral condyle. The range of maximal diameter of osteochondral fragment was from 1cm to 4.2cm. Treatments include fragment excision only in 6 cases, excision and medial retinacular repair in 2 cases, excision and medial retinacular repair and lateral retinacular release in 3 cases, and internal fixation only in 3 cases. The functional results were excellent in 5 cases$(36\%)$. good in 6 cases$(43\%)$, fair in 1 case$(7\%)$ and poor in 2 cases$(14\%)$. Conclusion : In osteochondral fractures associated with patellar dislocation, arthroscopic treatment is useful to diagnose precisely, to determine proper treatment modality, and to minimize the complications.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.214-218
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• 2006

Purpose: We describe a new technique of arthroscopic medial plication using pull-out suture with consideration of anatomical location of medial patellofemoral ligament for the treatment of acute or recurrent patellar dislocation. Operative technique: Under arthroscopic examination, sutures are passed through the medial capsule, at which medial patellofemoral ligament is located, from outside to inside of knee joint. Three guide wires are inserted from anterior surface of the patella to upper half of its medial border. Intraarticular portions of sutures are pulled out toward anterior surface of the patella through bony tunnels. Under appropriate tension, the sutures are tied after performing lateral retinacular release. Conclusion: As suturing medial patellofemoral ligament, this technique can maximize the effect of medial plication and can correct subluxation and tilt of the patella. It seems to be a minimally invasive, easy and effective method for the treatment of acute or recurrent patellar dislocation.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.2
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• pp.69-74
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• 2012

Purpose: By confirm the change of popliteal arterial position when extension or flexion of the knee and estimate the change of popliteal arterial position after posterior capsular release, we tried to know the position can minimize injury of popliteal artery during arthroscopic surgery and usefulness of posterior capsular release. Materials and Methods: Total of two middle-aged man and woman, fresh frozen cadavers as systemic, all four cases of the knee were included in this study. After the knee was flexed to 0 degrees, 30 degrees, 60 degrees, 90 degrees angle, we estimated distance from posterior tibial cortex to popliteal artery at articular surface, the distal 1 cm and 2 cm from articular surface. We performed posterior capsular release by arthroscopy, and estimated distance between posterior tibial cortex and popliteal artery in the same way. Results: Mean distance between popliteal artery and posterior tibial cortex was 6.3 mm (4.5~7), 4.6 mm (3.6~6), 4.9 mm (3.9~5.8) when knee flexion to 0 degrees at articular surface, distal 1 cm and 2 cm from articular surface each. When knee flexion to 30 degrees, it was 7.4 mm (5.2~9), 4.9 mm (3.6~7.2), 5.3 mm (3.8~6.6). When knee flexion to 60 degrees, it was 8.7 mm (5.4~11), 5.2 mm (4.9~7.3), 6.2 mm (5.4~9.6). When knee flexion to 90 degrees, it was 9.8 mm (5.8~12.1), 5.5 mm (5.1~7.4), 6.5 mm (5.4~10.7). After posterior capsule release, the distance was 6.5 mm (5.5~7.5), 5.8 mm (3.9~7.2), 5.2 mm (3.8~7.0) when knee flexion to 0 degrees, 7.7 mm (5.5~9,1), 7.1 mm (4.6~7.6), 5.5 mm (4.1~6.9) when knee flexion to 30 degrees, 8.9 mm (5.7~11.2), 8.5 mm (5.5~9.2), 6.4 mm (5.3~10.1) when knee flexion to 60 degrees and 10.2 mm (6.3~13.6), 9.5 mm (6.5~11), 6.6 mm (5.9~9.8) when knee flexion to 90 degrees. Conclusion: As knee joint is flexed, the distance from posterial tibial cortex to popliteal artery are increased beween knee joint articular surface and distal 2 cm from knee joint. So popliteal artery injury will be reduced at knee joint surgery. Posterior capsular release could also reduce popliteal artery injury by increasing distance between posterior tibial cortex and popliteal artery.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.14-19
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• 2006

The patient with a posttraumatic stiffness frequently has a history of prolonged immobilization after a traumatic event. Adhesions in the extraarticular humeroscapular motion interface may be present independently or in combination with intraarticular capsular contractures. A through history and physical examination usually reveal the cause and anatomic location of stiffness. Passive stretching exercise program is effective as a first line treatment, but manipulation under anesthesia is usually not effective because of potential complication such as fracture, tendon rupture and neurologic injury. The humeroscapular motion interface adhesion can be released either open or arthroscopically. The combined technique coupled with an aggressive rehabilitation program can provide more effective motion restoration and pain relief.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.19-23
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• 2008

Purpose: To evaluate the bursoscopic findings of refractory primary adhesive capsulitis of the shoulder and to determine the clinical correlation. Materials and Methods: Arthroscopic capsular release was performed in 21 refractory adhesive capsulitis patients who had not responded to conservative treatment. The VAS for pain, range of motion, UCLA score was checked before and after surgery, and at the last follow up. Results: Bursitis, mild friction and impingement on coracoacromial ligament, as well as adhesion were observed. The function and pain improved earlier than after simple acromiohumeral joint capsular release. Conclusion: Subacromial bursoscopy helps rule out a hidden secondary frozen shoulder or secondary changes with primary adhesion. In addition, it has the advantage of being both a treatment and procedure for making a prognosis.