• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.173-176
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• 2018

Pigmented villonodular synovitis (PVNS) is a proliferative disease that affects the synovial joint, tendon and bursa. PVNS can form a nodular structure in any joint, but it most commonly affects the knee joint and is rare in the foot and ankle joint. PVNS is divided into two types. Localized-type PVNS exhibits focal involvement with a nodular mass, while diffuse-type PVNS involves the entire synovium. Synovitis of the affected joint can also destroy cartilage and bone. Diffuse type accounts for 75% of PVNS and has a reported recurrence rate of 12.2% to 46%; aggressive synovectomy is recommended as the most effective treatment. In localized-type PVNS, only arthroscopic partial synovectomy is effective with a lower recurrence rate. We report a patient with severe ankle joint arthritis induced by diffusetype PVNS. The patient was treated by lateral malleolar ostectomy and ankle arthrodesis with a plate and screws via a lateral approach.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.269-275
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• 2019

Purpose: This study analyzed the treatment effects of drain insertion in the posteromedial portal after an arthroscopic synovectomy and posterior septum resection for pyogenic arthritis. Materials and Methods: From June 2005 to December 2016, 56 cases (55 patients, 1 case of bilateral knee) were diagnosed with pyogenic arthritis and arthroscopic treatment was performed. Fourteen patients (25.0%) were identified with causative organisms. The average follow-up period was 12.3 months, and the mean age was 67.8 years old. Twenty-four cases were males and 31 cases were females. Kellgrene-Lawrence grade (K-L grade) I was 6 patients, II was 20 patients, III was 11 patients, and IV was 18 patients. Surgery was performed through six portal. The posterior septum was removed and a drainage tube was inserted from the posterior medial side to the posterior side of the joint. The Lysholm score was used after surgery for a functional evaluation. The K-L grade at the time of admission and at the last follow-up were compared for a radiological evaluation. Results: The mean normalization period of the C-reactive protein was 59.8 days (6-164 days). Intravenous antibiotics were used for an average of 37.1 days. The results of the functional evaluation revealed a mean Lysholm score of 64.5 (30-98) in a total of 56 cases. Two reoperations was performed, but the treatment was completed with same method in all patients. The K-L grade was similar at the time of surgery and at the last follow-up (p>0.05). Conclusion: The method of drain insertion in the posteromedial portal after arthroscopic synovectomy and posterior septum resection for pyogenic arthritis is an effective technique that can obtain satisfactory results by inducing proper exudate discharge.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.38-43
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• 2013

Purpose: To evaluate the efficiency of arthroscopic treatment for infected total knee arthroplasty (TKA), and to investigate the factors affecting the outcomes. Materials and Methods: We analyzed 17 cases which underwent arthroscopic treatment to treat infection after TKA. After confirming infection by hematologic examination and analysis of joint fluid, we performed arthroscopic debridement, synovectomy and irrigation with normal saline mixed with antibiotics. Through routine examination after operation, we checked failure of treatment or recurrence of infection. If there is no recurrence until 2 years after the operation, we considered it as a success of treatment. Results: Of the 17 cases taken arthroscopic treatment, 13 cases were treated successfully with primary arthroscopic treatment only, but 4 cases had to undergo re-operation because of persistence or recurrence of infection. Analyzing the factors affecting the results, we found that symptom duration of the re-operation group is longer than the treated group after arthroscopy (p<0.05). Conclusion: Arthroscopic treatment can be effective when we performed appropriate selection of patients, careful and extensive arthroscopic irrigation and debridement, and suitable use of antibiotics. However, we have to do early arthroscopic surgery as soon as possible when infection after TKA is suspected.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.140-145
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• 2007

Pigmented villonodular synovitis(PVNS) is a benign proliferative lesion, involving synovial tissue in joints, tendon sheaths, and bursae. Pigmented villonodular synovitis is a rare and usually monoarticular condition and primarily affects the knee joint and hand. Polyarticular PVNS appears in less than 1% of all case and its occurrence in the shoulder is rare(<2%). We present a 64-year-old male who had pigmented villonodular synovitis of both shoulder joints, which was treated by arthroscopic total synovectomy.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.167-172
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• 2003

Olecranon bursitis rarely Progresses to septic arthritis. In our case, the 24 year old woman was visited due to progressing right elbow pain, despite antibiotic treatment of chronic olecranon bursitis caused by elbow laceration 2 months ago. Pus draining sinus, localized heating and swelling could be seen on physical examination. Septic arthritis and pathologic fracture was diagnosed under arthroscopic examination. Arthroscopic irrigation and synovectomy for elbow joint, olecranon bursectomy and curettage of olecranon bone was done. In the operation field, the elbow and draining sinus over olecranon was communicated each other on saline irrigation test. The patient was treated for 3 weeks with intravenous antibiotics. At postoperative 4 weeks, bone graft was done. The possibility of chronic osteomyelitis and septic arthritis must be considered in a patient with chronic olecranon bursitis.

• 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.

• Clinics in Shoulder and Elbow
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• v.17 no.4
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• pp.197-200
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• 2014

Reports of osteomyelitis in the proximal humerus with pyogenic glenohumeral arthritis of adjacent joints mostly involve pediatric patients. Nowadays, osteomyelitis that is secondary to adjacent pyogenic glenohumeral arthritis is extremely rare, even more so in adults than in pediatrics. We report a rare case of the pyogenic glenohumeral arthritis followed by osteomyelitis of the proximal humerus in an elderly patient. Initially, we diagnosed a case of pyogenic glenohumeral arthritis only, which, despite arthroscopic synovectomy, did not resolve and severe pain continued. Subsequent radiological imaging, performed after our suspicion of a secondary involvement, allowed us to diagnose osteomyelitis combined with the pyogenic glenohumeral arthritis, which we had overlooked because of the extreme rarity of the condition in adults since the antibiotic era began.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.202-206
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• 2006

Synovial chondromatosis is an uncommon condition and involvement of the glenohumeral joint is rare comparing its involvement of knee and hip. We report a case of synovial chondromatosis with its radiography, MRI and microscopic findings and treatment by arthroscopic synovectomy & loose body removal which have been developed in right shoulder of a 46 year-old-female and presented as impingement syndrome.

• Clinics in Shoulder and Elbow
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• v.4 no.2
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• pp.196-198
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• 2001

Synovial chondromatosis is the chondroid metaplasia of the synovial membrane, Large joints such as the knee and hip are commonly involved. Synovial chondromatosis very rarely develops within the shoulder joints. We have experienced the synovial chondromatosis developed in the right subscapular recess communicating the shoulder joint of a 30 year-old-female who was diagnosed by plain radiograph, MRI and microscopic findings, and then treated by arthroscopic synovectomy and removal of loose bodies.

• The Korean journal of sports medicine
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• v.36 no.4
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• pp.221-226
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• 2018

Synovial chondromatosis is an uncommon disorder characterized by cartilaginous proliferation within the synovial membrane of the articular joint. Smaller joints are rarely affected and it may be progressed to osteochondromatosis after ossification or calcification of metaplastic cartilage. It is commonly presented in the third to fourth decade of life, but rarely presented in adolescence. We report a unique case of synovial osteochondromatosis of the subtalar joint in 14-year-old baseball player. Arthroscopic removal of loose body and complete excision of the osteochondral mass with concomitant synovectomy resulted in satisfactory outcome without recurrence at final follow-up.