• Title/Summary/Keyword: High anteromedial

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Analysis of Clinical Outcomes in Ankle Arthroscopy Focusing on Prognostic Factors and Usefulness of High Portals (Outcomes in 169 Consecutive patients) (족근관절 관절경의 예후 인자와 상방 입구의 유용성에 대한 임상적 분석 (169례 보고))

  • Kim, Sung-Jae;Kim, Sung-Hun;Kang, Eung-Shick;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.103-111
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    • 2001
  • Purpose: The purpose of this study was to evaluate prognostic factors of ankle arthroscopy and the effectiveness of high anteromedial and anterolateral portals in diagnosis and treatment for various disease entities. Materials and Methods: The results of ankle arthroscopy were evaluated between March 1992 and January 2000 by one surgeon. Total 169 patients who were followed for a minimum of 12 months, were included in this study. Using high anteromedial and high anterolateral portals, all procedures were done with accessory portals if necessary. A functional evaluation was performed using the Karlsson score and questionnaire subjectively. Results: Fifty-six synovial impingement, 48 osteochondral lesion on talus, 10 impingement exostosis, 8 loose body, 27 osteoarthritis and chondromalacia, 10 postfracture fibrosis, 3 lateral plica, and 1 pigmented villonodular synivitis(PVNS) among 169 patients were diagnosed. Patients with the former four groups had satisfactory results and the latter four groups had not. Remaining 6 patients underwent arthroscopic arthrodesis, and 5 had satisfactory results. Conclusion: Using high anteromedial and anterolateral portals, we could get better visualization of talar dome and posterior chamber of ankle. For better clinical results, in ankle arthroscopy, not only operative skill but also proper indications are important. In case of synovial impingement after trauma, arthroscopy should be considered within one year after initial trauma. There were little correlation between the radiographic findings and arthroscopic findings of articular cartilage in osteochondral lesion of talus, and it is better to determine treatment modality based on the arthroscopic or MRI findings. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

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Medial impingement syndrome of the ankle associated with large anteromedial osteophyte of talus - A case report - (거골의 전내측에 큰 골극이 동반된 족관절의 내측 충돌증후군)

  • Yu, Sun-O;Kim, Jong-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.124-128
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    • 2002
  • After a severe ankle sprain, the incidence of residual complaints, particularly on the medial side of the joint, is high. We experienced a case of medial impingement between medial malleolus and anteromedial osteophyte of talus, specially in the dorsiflexion of the right ankle. Twenty five-year-old male was complained tenderness and chronic pain over the medial side of the right anklel for 3 years after an inversion sprain of the ankle. The plain radiography revealed a bony osteophyte on the anteromedial side of talus. The patient was treated by the open arthrotomy of the ankle. At surgery, impingement between articular surface of medial malleolus and osteophyte of the talus was observed when ankle dorsiflexion was done. Chondral lesion of medial malleolus and chondromalacic degeneration on anteromedial talus was viewed. Surgical removal of osteophyte on talus and debridement and multiple drilling of chondral lesion on medial malleolus was done. The symptom was improved. After postoperative 1 year, recurrence was not.

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Arthroscopic Treatment of the Osteochondral Talar Lesion (거골의 골연골 병변의 관절경적 치료)

  • Kim, Sung-Jae;Kwon, Sae-Kwang;Kang, Eung-Shick;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.28-34
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    • 2002
  • Purpose: The purpose of this study was to evaluate outcome of ankle arthroscopy with high anteromedial and anterolateral portals for osteochondral talar lesion. Materials and Methods: A prospective study was conducted between March 1992 and January 2000 by one surgeon. Total 48 patients who had osteochondral talar lesion were included. Using high anteromedial and anterolateral portals, arthroscopic treatment was performed. A functional evaluation was performed with the Karlsson scoring scale. Results: Of the 48 patients, 28 cases had anterolateral talar lesion and 18 cases had medial talar lesion and 2 cases had central lesion. The 42 cases(87.5 %) had trauma history. On Karlsson scoring scale, anterolateral talar lesion was better than medial talar lesion(p=0.035). Conclusion: Using high portals, we could get better visualization of talar dome and posterior chamber of ankle, and do some limited procedures without additional portals. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

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Effect of Anteromedial Cortex Oblique Angle on Change of Tibial Posterior Slope Angle in High Tibial Osteotomy Using Computer Assisted Surgery (CAS) (Computer Assisted Surgery(CAS)를 이용한 개방형 근위경골절골술 시 전내측피질골경사각이 경골후방경사각에 미치는 영향)

  • Lee, Ho-Sang;Kim, Jay-Jung;Wang, Joon-Ho;Kim, Cheol-Woong
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.36 no.3
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    • pp.351-361
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    • 2012
  • The leading surgical method for correcting the misalignment of the varus and valgus in the knee joint is the high tibial osteotomy (HTO). In the opening wedge HTO (OWHTO), there is no concern about damaging the peroneal nerve on the lateral tibia of the proximal fibula. OWHTO has been the preferred choice, as the opening of the correction angle can be modulated during the operation. The correction of the varus and valgus on the coronal plane are performed adroitly. Nevertheless, there have been numerous reports of unintended changes in the medial tibial plateau and posterior slope angle (PSA). The authors have developed an HTO method using computer-assisted surgery with the aim of addressing the abovementioned problems from an engineer's perspective. CT images of the high tibia were reconstructed three-dimensionally, and a virtual osteotomy was performed on a computer. In addition, this study recommends a surgical method that does not cause changes in the PSA after OWHTO. The results of the study are expected to suggest a clear relationship between the anteromedial cortex oblique angle of each patient and the PSA, and an optimal PSA selection method for individuals.

High Lumbar Disc Herniation Treated with A Modified Posterolateral Approach - Case Report - (상위 요추간판 탈출증에 대한 후측방 접근술 - 증 례 보 고 -)

  • Hwang, Hyung Sik
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.114-117
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    • 2001
  • Generally, the posterolateral approach had been recommended in case of extraforaminal disc herniation or lateral stenosis but it has been speculated that this procedure may be feasible to posterolateral disc herniation at the high lumbar levels of the L1-L2 interspace. Topographically, a posterolateral approach should be able to access anteromedial side of the spinal canal without the risk of the bony instability and damage to the neural structures. During the past one year period, three patients with high lumbar discs at the L1-L2 level were treated by the modified posterolateral approach. This article describeds the details of this approach with pertinent literature review.

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The Effect of Anteromedial Tibial Cortex Angle on Change of Posterior Tibial Slope Angle in PTO(Proximal Tibial Osteotomy) using Computer Assisted Surgery(CAS) (Computer Assisted Surgery(CAS)를 이용한 개방형 쐐기 근위경골 절골술에서 전내측 경골피질경사각이 후방경골경사각의 변화에 미치는 영향)

  • Lee, Ho-Sang;Kim, Cheol-Woong;Bae, Ji-Hoon;Wang, Joon-Ho;Park, Jong-Woong;Oh, Dong-Joon
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1467-1470
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    • 2008
  • An upper tibial opening wedge osteotomy is an operation to cure a malalignment and a degenerate arthritis. To prevent the postoperative malalignment caused by the upper tibial opening wedge osteotomy, the research to define the relationship between a Hinge Axis Angle and a Posterior Slope Angle is needed. The effect of the relationship between the hinge axis angle and the gap angle on the posterior slope angle is studied. After 3-D Compute Tomography (CT) scanning image is reconstructed, the virtual surgery is performed by the reconstructed 3-D tibia model. It was proved that the relationship between the hinge axis angle and the gap angle were constant and the simple mathematical model could be derived. To verify the suggested mathematical model, it compared with the measured data from the virtual surgery. In conclusion, while the deviation between the data from the virtual surgery and ones of the mathematical model under the gap angle<$10^{\circ}$ was less than 1%.

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Ankle Impingement Syndrome (족관절 충돌 증후군)

  • Choi, Gi-Won;Choi, Woo-Jin;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.19-25
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    • 2012
  • The ankle impingement syndrome is an established cause of ankle dysfunction. In most cases with suspected ankle impingement, the diagnosis can be possible on the basis of mechanism of injury involved and the clinical examination. An appropriate imaging study should be selected where clinical doubt about the exact diagnosis exists. Radiography plays an important role in the initial assessment of these conditions, especially in anterior and posterior impingement. Magnetic resonance arthrography seems to be the most accurate means of assessing the capsular abnormalities present in anterolateral and anteromedial impingement and for confirmation of possible concomitant injury. Surgical treatment can be considered for the patients who did not respond to conservative treatment for more than 6 months, and has a low complication rate and a high level of success.

The Effect of Anatomical Axis and Mechanical Axis on Change of Posterior Tibial Slope Angle in PTO(Proximal Tibial Osteotomy) (근위경골절골술에서 해부학적 축과 역학적 축의 변화가 경골후방경사각에 미치는 영향)

  • Shin, Eun-Ji;Kim, Cheol-Woong;Lee, Ho-Sang;Bae, Ji-Hoon;Wang, Joon-Ho;Park, Jong-Woong;Oh, Dong-Joon
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1543-1546
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    • 2008
  • The purpose of this study was to investigate factors affecting the change of tibial posterior slope and introduce a mathematical model which calculate, through 3-dimensional analysis of the proximal tibia, how the angle of the opening wedge along the anteromedial tibial cortex influences the tibial posterior slope and valgus correction when performing a medial open wedge osteotomy. This mathematical model with navigation system can be guidelines which provide surgeons on preoperative and intraoperative measurements to maintain or correct the tibial slope and to obtain the desired valgus correction of the lower limb during an opening wedge osteotomy.

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Cross-Pin and Interference Screw Femoral Fixation in Anterior Cruciate Ligament Reconstruction using Hamstring Tendon -Technical Note- (슬괵건을 이용한 전방십자인대 재건술시 횡고정 핀과 간섭나사를 이용한 대퇴터널 고정술 -수술 수기-)

  • In Yong;Bahk Won-Jong;Park Jong-Beom;Hong Seung-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.60-63
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    • 2002
  • Purpose : The purpose of this study was to introduce new femoral fixation technique using a cross-pin and a bioabsorbable interference screw in hamstring ACL reconstruction. Method : Semitendinosus and gracilis were harvested for quadrapled graft. After tibial tunnel had been made, femoral tunnel was made 35 mm in depth. Then the graft passed through the tunnels. Cross-pin was fixed through the drill hole which had been made through upper sleeve of the Rigidfix system. While pulling the graft, bioabsorbable interference screw was fixed through the anteromedial portal. Conclusion : We introduced the new femoral fixation technique using a cross-pin and a bioabsorbable interference screw as a good method with high fixation strength and tight graft-bone contact.

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