• Title/Summary/Keyword: Intraarticular

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Clinical and Structural Outcomes of Arthroscopic Intraarticular Knotless Fixation for Upper Subscapularis Tendon Tears: A Preliminary Report

  • Cho, Nam Su;Shim, Hee Seok;Nam, Ju Hyun;Rhee, Yong Girl
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.130-136
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    • 2016
  • Background: A novel technique for the repair of tears of the upper subscapularis tendon-intraarticular knotless fixation-has been introduced recently. The purpose of this study was to evaluate the clinical and structural outcomes of arthroscopic intraarticular knotless fixation for the treatment of upper subscapularis tendon tears. Methods: We retrospectively analyzed the clinical and radiological outcomes of 27 patients who underwent arthroscopic intraarticular knotless fixation for upper subscapularis tendon tears. Finally, a total of 10 patients who could participate in at least a 6 month follow-up of magnetic resonance imaging evaluation and in a least 1-year follow-up on an outpatient basis were enrolled in our study. The mean age at the time of operation was 60.7 years, and the mean duration of follow-up was 14.7 months. Two patients had concomitant tears of the supraspinatus tendon and 8 patients had concomitant tears of the supraspinatus and the infraspinatus tendons. Results: The clinical and radiological outcomes improved after the patients had undertaken arthroscopic intraarticular knotless fixation. The mean visual analogue scale score for pain during motion improved from 6.7 preoperatively to 1.4 at the final follow-up (p<0.001). The mean Constant score improved from 59.3 preoperatively to 79.6 at the final follow-up, and the mean the University of California at Los Angeles score, from 21.7 to 30.2, respectively (p<0.001 and p<0.001). The upper subscapularis tendon tear was healed in every patient except one (90%), for the patient had suffered from a postoperative trauma that resulted in a retear. Conclusions: We found that arthroscopic intraarticular knotless fixation gives good clinical and structural outcomes for the repair of upper subscapularis tendon tears. Arthroscopic intraarticular knotless fixation provided such a reliable and efficient restoration of the subscapularis tendon footprint that we anticipate it will become a widely-used procedure for upper subscapularis tendon tears.

Analysis of the Calcaneocuboid Joint Involvement in Intraarticular Calcaneal Fractures (관절내 종골 골절에서 종입방 관절 침범 분석)

  • Shin, Won-Ju;Yang, Sang-Hoon;Park, Hong-Ki
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.42-47
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    • 2006
  • Purpose: This study was performed to analyze the characteristics of calcaneocuboid joint involvement in intraarticular calcaneal fractures. Materials and Methods: Total number of 92 patients (111 cases) who underwent operation for intraarticular calcaneal fractures between Jan. 2000 and Oct. 2005 were included in this study. The preoperative computed tomographs of the subjects were retrospectively reviewed to analyze calcaneocuboid joint involvement. Results: It was revealed that 63 cases (56.8%) involved calcaneocuboid joint; 29cases (46.0%) showed type 1 (undisplaced or minimally displaced type, articular gap ${\le}1\;mm$), 16 cases (25.4%) exhibited type 2 (moderately displaced type, articular gap ${\ge}2\;mm$), 7 cases (11.1%) were included in type 3 (comminuted type) and 11 cases (17.5%) belonged to type 4 (fracture and dislocation). 48 out of 63 cases belonged to Sanders classification II and III that involved calcaneocuboid joint and included 25 cases (52.1%) of type 1 and 14 cases (29.2%) of type 2. Among 15 out of 63 cases included in Sanders classification IV, 4 (26.7%) showed type 1 and 6 (40.0%) belonged to type 4. According to our results, Sanders classification allowed to predict pattern of the involvement of calcaneocuboid joint (P<0.05). However, there was no statistically significant relationship between degree of posterior facet joint injuries and calcaneocuboid joint involvement (P>0.05). Conclusion: Calcaneocuboid joint involvement in intraarticular calcaneal fractures was common and more than half showed severe injuries. We concluded that further studies on the involvement of calcaneocuboid joint should be performed prior to surgical treatment of intraarticular calcaneal fractures.

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CT Classification and Treatment of Intraarticular Calcaneal Fractures - Conservative vs. Surgical Treatment by Prospective Study - (관절내 종골 골절의 전산화 단층 촬영에 따른 분류 및 치료)

  • Kang, Jae-Do;Kim, Hyung-Chun;Kim, Jin-Hyung
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.1
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    • pp.35-42
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    • 2001
  • Purpose: To analyze the results of conservative or surgical treatment after computed tomograhy(CT) classification in intraarticular calcaneal fractures. Materials and methods: From January 1996 to May 1999, we prospectively analyze 23 cases of intraarticular calcaneal fractures who were treated conservatively or operated by open reduction and internal fixation by extensive L-shaped lateral approach after CT classification. Results: A functional scoring system of 0-100 points which was based upon the responses to AOFAS Ankle-Hindfoot Scale for the operative group was at 82.8, compared with 73.2 for the non-operative group, and these were meaningful statistically(P<0.05). Of type I fracture, in the operative group there were 2 excellent results and in the non-operative group there were 2 excellent results, 1 good result. or type II fractures, in the operative group there were 2 excellent results, 3 good results, 1 fair result and in the non-operative group there were 1 good result, 1 fair result, 2 poor results. Of type III fractures, in the operative group there were 2 fair results, 2 poor results and in the non-operative group there were 1 fair result, 3 poor results. Bohler angles of subtalar joint were changed from initial average $13.3^{\circ}$ to postoperative average $20.9^{\circ}$ for the operative group compared with from initial average $15.5^{\circ}$ to follow-up average $14.8^{\circ}$ of the non-operative group(P<0.01). Conclusions: Computed tomography in the evaluation of intraarticular calcaneal fractures is effective tool. We believed that open reduction and internal fixation in all Crosby & Fitzgibbons type II and according to degrees of comminution reducible type III for the intraarticular calcaneal fractures is more effective method than conservative treatment.

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Operative Treatment with the Plate Fixation in Intraarticular Calcaneal Fractures (관절 내 종골 골절에서 금속판 고정을 이용한 수술적 치료)

  • Hong, Ki-Do;Kim, Jae-Young;Ha, Sung-Sik;Sim, Jae-Chun;Kang, Jung-Ho;Park, Kwang-Hee
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.86-90
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    • 2007
  • Purpose: We evaluated the results of operative treatment with F or H plates and screws using extensile lateral approach in intraarticular calcaneal fractures. Materials and Methods: From August 2003 to July 2006, twenty intraarticular calcaneal fractures which were operated with open reduction and internal fixation with F or H plates and screws were evaluated retrospectively. According to the Essex-Lopresti classification, 3 cases were tongue type and 16 were joint depression type. With the Sanders classification, 2 cases were IIA type, 7 were IIB, 5 were IIIAB, 2 were IIIAC and 3 were IV. We have analysed the $B{\ddot{o}}hler$ angle, Gissane angle, and calcaneal width in radiologic evaluation, and evaluated clinical result according to the Creighton-Nebraska Health Foundation Score. Results: Radiologic changes showed as follows: $B{\ddot{o}}hler$ angle improved from $5.8^{\circ}$ to $25.9^{\circ}$, Gissane angle from $119.0^{\circ}$ to $113.3^{\circ}$, and calcaneal width from 50.4 mm to 37.8 mm. In the clinical results, excellent cases were noted in 8 cases, good in 8 cases, fair in 2 cases, poor in 1 case. Conclusion: Operative treatment with F or H plates and screws using extensile lateral approach in intraarticular calcaneal fractures was thought to be a useful operative method allowing anatomical reduction.

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Intraarticular Osteochondroma of the Phalanx of the Hand - A Case Report - (수지골에 발생한 관절내 골연골종 - 증례 보고 -)

  • Han, Chung-Soo;Pyo, Na-Sil;Lee, Jae-Hoon;Cho, Nam-Su;Park, Yong-Koo;Ryu, Kyung-Nam
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.88-91
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    • 2000
  • The osteochondroma is the most common benign bone tumor, which occupies 40% of the benign bone tumor. About 80% of lesions arise in the long bone of the extremities, particularly in the knee and the upper extremity. But the occurrence of an intraarticular osteochondroma is rare, especially in the interphalangeal joint. We report the case of a intraarticular osteochondroma which occurred at the interphalangeal joint of the hand in a 12-year-old male patient. The plain X-ray demonstrates an exostosis arising from intraarticular dorsal aspect of the proximal phalanx of the right middle finger. The excised mass was round, measuring $8{\times}3$mm in size and 1 mm in thickness with definite cartilage capsule.

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Effects of Intraarticular Prolotherapy on Sacroiliac Joint Pain (천장관절 증후군 환자에서 관절강 내 증식치료의 효과)

  • Lee, Jae Dam;Lee, Dae Wook;Jeong, Cheol Won;Lee, Hyung Gon;Yoon, Myung Ha;Kim, Woong Mo
    • The Korean Journal of Pain
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    • v.22 no.3
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    • pp.229-233
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    • 2009
  • Background: Sacroiliac (SI) joint pain is a challenging condition that causes lower back or buttock pain; however, there is no universally accepted long-term treatment. There have been several reports of ligament prolotherapy for SI joint pain, but these have had inconsistent results, probably due to the lack of a specific diagnosis for patient selection and variability in the volume, number and sites of injection. Therefore, this study was conducted to assess the efficacy of intraarticular prolotherapy for relieving SI joint pain diagnosed by local anesthetic intraarticular injection. Methods: Twenty-two patients with SI joint pain confirmed by 50% or more improvement in response to local anesthetic block underwent intraarticular prolotherapy with 25% dextrose water every other week three times. The numeric rating scale (NRS) for pain and Oswestry disability index (ODI) were assessed at the initial visit and after completion of a series of prolotherapy and the NRS was checked during monthly follow-up sessions to evaluate the long-term effectiveness of this technique. Results: Twenty patients completed prolotherapy and followed up as scheduled. The NRS and ODI were significantly improved from 6 (4-8) and $34.1{\pm}15.5$ to 1 (0-3) and $12.6{\pm}9.8$ (P < 0.01), respectively, at 1 month after prolotherapy. The mean duration of pain relief of 50% or more was 12.2 months (95% CI, 10.0-14.3) as determined by Kaplan-Meier survival analysis. Conclusions: Intraarticular prolotherapy provided long-term relief of sacroiliac joint pain and may have more benefits than ligament prolotherapy or neurolysis.

Minimally Invasive Reduction and Pin Fixation Treatment for Displaced Intraarticular Calcaneal Fracture (최소 침습적 정복술 및 금속강선 고정술을 이용한 전위된 관절내 종골 골절의 치료)

  • Lee, Jin-Young;Park, In-Heon;Kim, Gab-Lae;Kim, Tae-Hwa;Oh, Bum-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.66-72
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    • 2010
  • Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.

Effectiveness of arthroscopic procedure combined with Brostrom one (만성 족관절 외측 불안정성에서 변형 Brostrom 술식과 동시에 시행한 관절경적 치료의 유용성)

  • Yoo, Yon-Sik;Lee, Sang-Soo;Jeung, Eun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.201-207
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    • 2003
  • Purpose: We reviewed the value of treatment for chronic lateral instability of theankle with arthroscopic procedure combined with Brostrom one. Material and Method: From May 2000 to June 2002, 18 patient with chronic lateral instability of the ankle with Modified Brostrom procedure and arthroscopic one. Mean follow-up period was 18 months. Result: Chronic lateral instability of the ankle almost had intraarticular pathology, such as osteophye, osteochondral lesion, So we could resolve intraarticular pathology by arthroscopic procedure during Brostrom one for lateral collateral ligament reconstruction. Conclusion: Modified Brostrom procedure and arthroscopic one are an excellent treating method for chronic lateral instability of the ankle which has intraarticular pathology.

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5th MTP Joint Reconstruction with Autogenic Costal Osteochondral Graft (자가늑골연골이식을 이용한 제 5중족족지관절재건술)

  • Park, Jae-Yong;Kang, Hwa-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.154-160
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    • 2013
  • The treatment of open, traumatic intraarticular injuries to the metatarsophalangeal joint with severe articular comminution and cartilage defect of metatarsal head is a challenge to the foot surgeon. We report the joint reconstruction treating the injured joint by autogenic costal osteochondral graft with satisfactory outcome.

Recurred Intraneural Ganglion on Superficial Peroneal Nerve (A Case Report) (재발한 표재 비골신경내 결절종(1예보고))

  • Lee, Kyung-Chan;Kwak, Ji-Hoon;Park, Hong-Gi
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.161-164
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    • 2013
  • Intraneural ganglilon of superficial peroneal nerve was rare condition around foot and ankle. we experienced a case of recurred intraneural ganglion of superficial peroneal nerve on foot. We treated the case with idendify of intraarticular branch of ganglion. We report the case with a review of literature.