• Title/Summary/Keyword: Knee surgery

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Meniscus Repair using Meniscus Arrow with Anterior Cruciate Ligament Reconstruction (전방 십자 인대 재건술시 동반된 반월상 연골 파열에 대한 meniscus arrow를 이용한 봉합)

  • Cho Sung-Do;Park Tae-Woo;Hwang Su-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.156-160
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    • 2002
  • Purpose : To evaluate the results and usefulness of meniscal repair using meniscal arrows with ACL reconstruction. Material and Methods : Among cases of the simultaneous meniscal arrow fixation and ACL recontruction performed between May, 1997 and September, 2000, 17 cases could be evaluated. The average follow-up were 18.5 months. Twelve cases were medial meniscus, 5 cases, lateral meniscus. All cases were longitudinal tear. Meniscal tear were seen at red-red zone in 13 cases, red-white zone in 5 cases. The results were analyzed by pain, joint line tenderness, locking, McMurray test, the Marshall knee scoring scale and complications. Results : Postoperatively two patients had mild joint line tenderness without pain on joint motion or weight bearing. No patient had locking or positive McMurray test. At last follow-up, 15 cases $(88\%)$ were 'excellent' or 'good' according to the Marshall knee score scale. There were two complications which are soft tissue irritation sign on active knee motion and a femoral chondral injury due to protruded T-shaped head of meniscus arrow. Conclusion : Meniscus arrow can be one of the options in repairing the associated meniscus tear, especially the posterior horn of medial meniscus, during ACL reconstruction. However, surgeons using meniscus arrow should be aware of its potential complications such as pain due to soft tissue irritation and chondral damage of the femoral condyle.

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Treatment of Ruptured Posterior Cruciate Ligament using Augmentation of the Synthetic Polyester Prosthetic Ligament (Synthetic Polyester Prosthetic Ligament 보강술을 이용한 후방 십자 인대 손상의 치료)

  • Sohn, Sung-Won;Jeon, Si-Hyun;Park, Jin-Uck
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.121-125
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    • 2002
  • Purpose : The purpose of this study was to assess the clinical outcomes and radiological changes of arthroscopic augmentation with synthetic polyester ligament for posterior cruciate ligament injury Materials and Methods : The assessment was made among 60 patients who underwent arthroscopic augmentation with synthetic polyester ligament (ABC ligament, Surgicraft, U.K.) into the substance of ruptured PCL proper under the arthroscopic control from January, 1990 to January, 1996 and whose follow-up period was more than 5 years (average 7.8 years). The results were analyzed by using the posterior stress radiographs by Telos stress device, KT-2000 arthrometer and the clinical assessment by using Lysholm knee score. Results : The average difference of posterior displacement on stress radiographs were 13.2 mm preperatively and 3.6 mm at last follow up. Both knee showed minimal difference on KT-2000 arthrometer (0.7 mm on 20 lb) at the last follow-up. The mean Lysholm knee score was 49.2 preoperatively and improved to 84.3 post-operatively. Conclusion : Authors observed that long-term results of arthroscopic augmentation with synthetic polyester ligament for PCL injury were similar with those using human allograft. Taking these results into consideration, the synthetic polyester ligament is assumed to be a method of treatment of the PCL injury.

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Clinical Results after Arthroscopic Treatment in Acute Pyogenic Arthritis of the Knee (급성 화농성 슬관절염에서 관절경적 치료 후 결과)

  • Lee, Jung-Hwan;Yoon, Kyoung-Ho;Bae, Dae-Kyung;Kim, Jeong-Weon;Park, Soo-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.53-57
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    • 2008
  • Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

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Musculocutaneus Island Flap Based on the Distal Vascular Pedicle of Gracilis Muscle (박근의 원위혈관경을 이용한 도서형 근피판술)

  • Chung, Duke-Whan;Lee, Yong-Wook;Cho, Chang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.96-102
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    • 1997
  • The gracilis that is frequently used as a donor of free muscle trasfer is appropriate in the muscular shape and vascular position. This muscle is belonged to the second type of muscle group by the classification of the pattern of muscular nutrient vessel. The adductor branch or first perforating branch of deep femoral artery which supplies the proximal 1/3 of this muscle is a dominant one and this is used for the microscopic anastomosis of muscle or musculocutaneous flap. The minor vascular pedicles which enter the distal 1/3 of this of this muscle are branches of the superficial femoral artery and it is 0.5mm in diameter, 2cm in length with two venae comitantes. These minor pedicles supplies distal half of the gracilis muscle. This island musculocutaneous flap using distal vascular pedicle can be used to cover the defect of soft tissue around the distal femoral supra-condylar area, knee joint and proximal tibial condyle area which cause limitation of motion of knee joint, or in the cases that usual skin graft is impossible. The important operative procedure is as follows; The dissection is carried proximally and distally and the entire gracilis muscle including proximal and distal pedicle is completely dissected. After temporary blocking of the proximal vascular pedicle, the adequate muscle perfusion by the distal pedicle is identified and it is rotated to the recipient site around knee joint. The advantages of this procedure are simple, no need of microscopic vascular anastomoses and no significant functional loss of donor site. Especially in the cases of poor condition of the recipient vessel, this procedure can be used effectively. From 1991 to 1996, we performed 4 cases; complete survival of flap in 3 cases and partial survival of flap with partial necrosis in 1 case. This procedure is though to be useful in the small sized soft tissue defect of distal femoral supra-condylar area, knee joint and proximal tibial condylar area, especially in the defect of anterior aspect which expected to cause limitation of motion of knee joint due to scar contracture. But the problems of this procedure are the diameter of distal vascular pedicle is small and the location of distal vascular pedicle is not constant. To reduce the failure rate, identify the muscular perfusion of distal vascular pedicle after blocking the proximal pedicle, or strategic delay will be helpful.

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The Effects of Auricular Electroacustimulation and Transcutaneous Electrical Nerve Stimulation on Postoperative Pain Control in Total Knee Replacement Patients (외이전기경혈자극과 경피전기신경자극이 슬관절 전 치환슬 환자의 수술 후 통증조절에 미치는 효과)

  • Kim, Tae-Youl;Hwang, Tae-Yeun;Huh, Choon-Bok
    • Journal of Korean Physical Therapy Science
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    • v.1 no.1
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    • pp.145-163
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    • 1994
  • This study was done to determine differences in effect of postoperative pain control in patients receiving auricular electroacustimulation vs transcutaneous electrical nerve stimualtion following total knee replacement surgery. Thirty-one cases referred to physical therapy department after treated by total knee replacement surgery by orthopedic surgery department at the Pohang St. Mary's Hospital from January 1993 through June 1994. Of 31 total knee replacement cases, 13 cases were auricular electroacustimulation group, 11 cases were transcutaneous electrical nerve stimulation group, and 7 cases were control group. The results of the study summerized are as follows: Thirty-one total knee replacement cases(male in 12 cases, female in 19 cases), ranging in age from 34 to 61 years(mean${\pm}$SD=49.90 7.56) with diagnoses of degenerative arthritis(20 cases), rheumatoid arthritis(9 cases), and other(2 cases). In auricular electroacustimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In transcutaneous electrical nerve stimulation group, there was a significant change of pain intensity, unpleasantness, and active range of motion after treatment(p<0.01). In control group, did not show significant pre-posttreatment differences in pain intensity, unpleasantness, active range of motion(p>0.05). The mean change in pain intensity and unpleasantness, active range of motion from pretreatment baseline for the 3 groups. Auricular electroacustimulation group showed the large magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. Transcutaneous electrical nerve stimulation group showed small magnitude of increase in pain intensity and unpleasantness, active range of motion when compared to its own pretreatment cycle. No significant changes were observed in control group. Highly significant differences in pain intensity, unpleasantness, and active rage of motion were found using an ANOVA measures between treatment groups and control group(p<0.01). The squares correlation coefficients of pain and function measures pretreatment-posttreatment differences for each group. In treatment group, there was significant correlation between pain scale and function(p<0.001). In control group, there was no correlation between the pain scale and function (p>0.05). The continuous study is needd for many interesting issues of auricular electroacustimulation in new future.

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2 Separate Meniscal Cysts Arising from Tears of the Medial Meniscus - A case report - (내측 반월상 연골 파열에서 발생한 독립된 2개의 반월상 연골 낭종 - 1예 보고 -)

  • Suh, Mn-Sam;Park, Hyung-Taek;Kim, Sang-Hyo
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.214-217
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    • 2005
  • Meniscal cyst is an uncommon disease of knee joints, arising less frequently from medial meniscus than lateral. Most of they are accompanied with horizontal tear of meniscus. This is the case of 24 year old man who had 2 separate medial meniscal cysts with longitudinal tear on posterolateral side of medial meniscus without trauma. Treatment consisted of arthroscopic decompression of cysts and meniscal repair.

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Discoid Medial Meniscus Rupture - Case report - (원판형 내측 연골판 파열 - 1 예 보고 -)

  • Kim, Dong-Hui;Kim, Bae-Gyun;Kim, Jung-Man
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.51-53
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    • 2004
  • Although the lateral discoid meniscus of the knee has been observed frequently, the discoid medial meniscus has rarely been reported in the literature. A discoid medial meniscus with the horizontal tear and the peripheral tear of upper lip were observed. This tear pattern is not usual in the lateral discoid meniscus as well as in the normal meniscus. A plausible mechanism of the tear pattern compared with the normal shape and the discoid lateral meniscus was discussed in the following.

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Pre and Post Surgery Management and Practicality of Prosthesis for Patients with Lower Limb Amputation (하지 절단환자의 수술 전후 관리와 의지의 실용성에 대한 연구)

  • Ahn, Wang-Hun;Lee, Kang-Noh;Choi, Yoo-Jung
    • Journal of Korean Physical Therapy Science
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    • v.12 no.4
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    • pp.89-97
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    • 2005
  • Objective: The purpose of this study was to access quality of life and evaluate pre and post surgery management for persons with lower limb amputations. Method: This study was designed as a telephone survey. The subjects were patients who underwent their lower limb amputation between January 1994, and February 2005 at Asan Medical Center in seoul. sixty one of 203 subjects had granted consent and were studied. Results: The major cause of below knee amputations was vascular disease. Traumatic injuries were more common among subjects with above knee amputations. 93.4% of subjects were in use of prosthesis and 70.1 days were required to fit the prosthesis. 68.4% of subjects were able to ambulate with single point cane or without assistive devices. 80.3% of subjects complained phantom pain. Most subjects expressed the unsatisfactory result regarding the functional usage of prosthesis and education from hospital. Conclusion: Pre and post surgery rehabilitation program will benefit to promote better functional status and quality of life for persons with lower limb amputations.

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Traumatic Hemorrhage in Suprapatellar Bursa Complicated by Suprapatellar Plica with Complete Septum -A Case Report- (완전 격막형 슬개상 추벽에 의해 합병된 슬개상 점액낭 내 외상성 출혈 -1예 보고-)

  • Koh, Hae-Seok;In, Yong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.63-65
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    • 2008
  • We treated a 37-year-old male with traumatic hematoma in the suprapatellar bursa that had developed in the form of persistent swelling on suprapatellar area of left knee after blunt trauma. Though there were no obvious abnormal findings on plain roentgenographs, an isolated suprapatellar cystic lesion with fluid-fluid level on T2-weighted sagittal image of MRI was noted. We found the suprapatellar plica with complete septum and no synovitis in the knee joint proper by arthroscopy. We incised the plica and found leakage of blood-stained fluid from the suprapatellar bursa. There were no findings of pigmented villonodular synovitis or other tumorous lesions. At 6 months after surgery, the patient felt symptom-free and there was no recurrence.

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Intraarticular Migration of the Staple Used for Extraarticular Lateral Collateral Ligament Repair - A Case Report - (슬관절 외측 측부인대 복원술시 사용된 staple의 관절내 이동 - 증례 보고 -)

  • Yoo, Jae-Chul;Bae, Sang-Wook;Kim, Byung-Kwan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.184-186
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    • 2006
  • Isolated lateral collateral ligament injury has been reported as avulsion fracture of attachment site or intrasubstance tear. The treatment of avulsion fracture of lateral collateral ligament was primary repair with anchor or staple. There are some reports about loosening or migration of staple which used in repairing meniscus of knee. There is, however, no report about loosening or migration of staple which was used for lateral collateral ligament repair. We report a case of migrated staple that was used for lateral collateral ligament repair, which was migrated to intraarticular posterolateral corner of the knee.

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