• Title/Summary/Keyword: Knee surgery

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Arthroscopic Treatment of Septic Knee Arthritis in Old Aged Group: Prognostic Factor (50세 이상에서 발생된 화농성 슬관절염의 관절경적 치료: 예후 인자)

  • Lee, Dong-Chul;Shon, Oog-Jin;Kong, Byung-Sic
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.114-119
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    • 2010
  • Purpose: The purpose of this study was to assess the result of arthroscopic treatment in septic knee arthritis and evaluate the prognostic factor over 50 years old. Materials and Methods: Fifty-two patients were treated by arthroscope for septic knee arthritis from January, 2002 to August, 2005. The mean follow-up period was 27.5months. We assessed Lysholm score as functional result, CRP normalized period as laboratory result, and knee range of motion as clinical result. We evaluated patient's age, underlying disease, causative organism, previous knee status (Kellgren stage), clinical status of septic arthritis (G$\ddot{a}$chter stage) and history of intra-articular injection as prognostic factor. Results: Mean Lysholm score was improved from 40.7 to 67.1. And the mean CRP normalized period was 38.7days. At last follow-up, almost patient (92%) were recovered to prior knee full range of motion and 45 patient (74%) were completely cured by one stage operation. The microorganism isolated were MSSA (n=13), MSSE (n=3), MRSA/MRSE (n=4),no microorganism (n=27) and others (n=5). In Lysholm score, young age (42.8(preop.)$\rightarrow$83.5(postop.)), Kellgren stage 0 ($45.5{\rightarrow}84.2$), G$\ddot{a}$chter stage I ($39.3{\rightarrow}73.1$) and no microorganism (442.1{\rightarrow}72.6$) were more increased than old age (439.3{\rightarrow}61.7$), Kellgren IV ($28.3{\rightarrow}43.7$), G$\ddot{a}$chter stage IV ($40.2{\rightarrow}67.1$) and MRSA/MRSE ($40{\rightarrow}58.75$). In case of old age (42.3days), G$\ddot{a}$chter stage IV (55.5), Kellgren stage IV(43.7), DM patient (42.1) and intra-articular injection history (52.1), the CRP titer normalized period was longer than mean period. MRSA/MRSE(n=3,75%) were not normalized in CRP titer at last follow-up. Conclusion: Arthroscopic treatment of septic knee would be an effective and satisfactory procedure. Age, previous knee status (Kellgren stage), underlying disease (DM), intra-articular injection history, microorganism and Ga¨chter stage effect end result outcome.

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Pull-out repair for root tear of medial meniscus (내측 반월상 연골 후방 골 기시부 파열의 수술적 봉합술)

  • Kim, Deok-Weon;Moon, Jeong-Seok;Kim, Min-Gun;Kim, Jin-Goo
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.40-45
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    • 2005
  • Purpose: This study is to evaluate the clinical findings of media] meniscus root tear, pull-out repair technique and it's short term results. Materials and Methods: From September 2003 to August 2004, 23 cases of total 27 medial meniscus root tears were treated by pull-out repair technique. Mean age was 60.2 years old. The pull-out technique was divided into 2 groups In group 1(14/23 cases), anterolateral portal was used and in group 2(9/23 cases), anterolateral and posteromedial portals were used for bed preparation. Concomitant cartilage lesions were documented as ICRS mapping system. The clinical outcomes were evaluated according to Lysholm Knee Score. Results: The postoperative Lysholm Knee Score was 77.1(range; $58{\sim}97$) in group 1 and 81.4(range; $72{\sim}94$) (p>0.05). The failure rate was 3 of 14 cases(21.4%) in group 1 and 1 of 9 cases(11.1%) in group 2. Twenty of 22 cases(90.9%) showed cartilage lesions in weight bearing portion of medial femoral condyle which were 8 grade III and 5 grade IV according to the Outerbridge classification. Conclusion: Pull-out repair seems to be a useful treatment of the medial meniscus root tear for preservation of circumferential hoop tension of meniscus.

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The Clinical Results of Autologous Osteochondral Grafts in Osteochondral Lesion of the Talus (거골 골연골 병변의 자가 골연골 이식술의 임상 결과)

  • Choi, Hong-Joon;Moon, Jeong-Seok;Lee, Woo-Chun;Ko, Han-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.209-215
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    • 2007
  • Purpose: To evaluate clinical results of autologous osteochondral graft in osteochondral lesions of the talus. Materials and Methods: Twenty feet in twenty patients underwent osteochondral autologous transfer in the osteochondral lesions of the talus. Sixteen were men and four were women. The mean age was 40.8 years old. The mean follow up was 2 years 9 months. Eighteen cases were medial, one case was lateral and one case was both, respectively. The average duration of symptom was 4 years 3 months. AOFAS ankle/hindfoot score (AOFAS score), visual analogue scale (VAS), Lysholm knee score were evaluated preoperatively and at the final follow up. Results: Postoperative AOFAS score was 87.3 (range, 69-100), which was significantly improved from preoperative AOFAS score of 62.0 (p=0.000). Postoperative VAS was 2.9 (range, 0-7), which was significantly improved from preoperative VAS of 7.5 (p=0.000). Postoperative Lysholm knee score was 92.4 (range, 80-100). All osteotomy of medial malleolus was united by the 4th month after surgery. Postoperative VAS was conversely correlated with the follow up period (p=0.024). There was no complications associated with surgery. Conclusion: Autologous osteochondral grafts in osteochondral lesion of the talus demonstrated excellent results with a short-term follow up.

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Arthroscopic Evaluation of Graft Extrusion after Lateral Meniscal Allograft Transplantation - A Case Report - (외측 반월상 연골 이식술 후 이식물 탈출의 관절경적 평가 -증례 보고-)

  • Kim, Hee-Chun;Kim, Taik-Sun;Kim, Young-Bae;Yang, Jai-Hyuk;Kim, Jin-Kak;Yoon, Jung-Ro
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.76-78
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    • 2013
  • The meniscus is considered "extruded" when it extends beyond the tibial margins more than 3 mm in a coronal view of magnetic resonance imaging (MRI). However, identifying the meniscal extrusion intraoperatively may be difficult because of the simple fact that most of the arthroscopic procedures are done in knee flexion position while follow up MRI studies area taken at knee extension position. Here, we demonstrate the arthroscopic technique for evaluating the meniscal extrusion.

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THE EFFECT OF HYPERBARIC OXYGEN THERAPY IN TREATMENT OF DIABETIC FOOT ULCER (당뇨병성 족부 병변에 있어 고압 산소 치료의 효과)

  • Park, Tae-Woo;Cho, Sung-Do;Cho, Young-Sun;Kim, Bum-Soo;Lew, Sog-U;Kim, Moon-Chan
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.35-39
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    • 2002
  • Purpose: The purpose of this study was to evaluate the effect of hyperbaric oxygen therapy(HBOT) and the resultant amputation rate in the treatment of diabetic foot ulcer. Material and methods: From 2000 Jan. to 2002 April, thirty two diabetic foot patients were admitted for treatment of foot ulcers and infection. Of the thirty two cases, thirteen patients received HBOT and nineteen did not. The results were analyzed by amputation rate and healing time. All were classified according to the Wagner classification. Results: Of the HBOT treated group, three(23%) patients underwent amputation: two below knee and one metatarsophalangeal disarticulations. Of the non-treated group, eleven(58%) patients underwent amputation, : four below knee and seven metatarsophalangeal disarticulations. The healing times, based on hospital days were average 16, 38, 43 days in the HBOT treated group and average 20, 50, 35 days in the non treated group respectively in Wagner grade II, III, IV. Conclusions: HBOT might be effective in decreasing amputation rate and hospital stay in diabetic patients with severe foot ulcers.

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Intra-articular Benign Fibrous Histiocytoma of the Knee: A Case Report (슬관절 관절내 발생한 양성 섬유성 조직구종: 증례 보고)

  • Hong, Ki-Do;Ha, Sung-Sik;Sim, Jae-Cheon;Kim, Tae-Ho;Lee, Jong-Seong;Sung, Min-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.94-98
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    • 2012
  • Benign fibrous hitiocytoma of the infrapatella fat pad is very rare. It has usually do not induced a pain or a symptom because it was located deep tissue. So it was very difficult to be diagnosed. We experienced a case of deep benign fibrous histiocytoma in a 53-year-old woman. It was diagnosed by MRI. Diagnostic arthroscopic procedure was performed and the lesion was completely resected by open excision. We report a rare case of benign fibrous hitiocytoma presenting as an intra-articular tumor in the joint causing pain and limitation of movement.

Femoral Nerve Injury after Rectus Abdominis Muscle Slap Harvesting: A Case Report (복직근 유리피판 거상 후 합병된 대퇴 신경손상 1례)

  • Kim, Jino;Lew, Dae Hyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.510-513
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    • 2006
  • Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.

The Efficacy and Safety of Beef Tallow Extract Including Cis-9-cetylmyristoleate in Patients with Osteoarthritis - As an Adjuvant Pharmacological Treatment -

  • Lee, Sang-Hoon;Kim, June-Hyuk;Cho, Whan-Seong;Seo, Sung-Wook;Kim, Sung-Kyu;Oh, Joo-Han
    • Preventive Nutrition and Food Science
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    • v.10 no.3
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    • pp.285-289
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    • 2005
  • In this double-blind, placebo-controlled trial, we assessed the efficacy and safety of beef tallow extract (BTE) including Cis-9-cetylmyristoleate in patients with arthritis. Between May and December 2003, we selected 80 patients (n=80) who showed/manifested arthritic symptoms and whose radiological findings were suggestive of arthritis, and randomly assigned them to placebo-controlled (n=40) and treatment group (n=40). The placebo (corn starch 350 mg) and BTE (208 mg) were orally administered to placebo-controlled and treatment group three times a day, respectively. We assessed the efficacy and safety based on the visual analogue scale (V AS) and modified knee society knee scores (MKSKS) at baseline and endpoint, respectively. To assess the safety, we monitored the adverse effects noted in liver, kidney, cardiovascular and gastrointestinal system for 3 weeks. Then, we performed not only a questionnaire study but also laboratory tests (e.g., liver function test, kidney function test, urinalysis, electrocardiography [EKG], complete blood cell counts [CBC] and chest X-ray). For statistical analysis, Student (-test and paired (-test were done using SPSS■ Version 11.0. Statistical significance was set at p < 0.05. The scores between V AS and MKSKS showed statistical significance (p < 0.05) with an improvement of $69.2\%$ (27/39) and $3.8\%$ (21/39) of treatment-group patients, respectively. Abnormal laboratory findings were noted in neither placebo-controlled nor treatment group. In conclusion, our results indicate that the administration of BTE was a safe and effective treatment regimen for patients with arthritis. In addition, the efficacy of BTE was more remarkable in alleviating the symptoms rather than improving the function.

Treatment of Transverse Patella Fracture with Minimally Invasive Load-Sharing Patellar Tendon Suture and Cannulated Screws (최소 침습 기법 슬개건 부하 분산 봉합술과 유관 나사못을 이용한 슬개골 횡골절의 치료)

  • Lee, Beom-Seok;Park, Byeong-Mun;Yang, Bong-Seok;Kim, Kyu-Wan
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.540-545
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    • 2021
  • A transverse fracture is the most common type of displaced patella fracture requiring surgery. These fractures are commonly fixed with parallel Kirschner wires or screws that cross the fracture line, often with an additional tension band. Nevertheless, conventional fixation methods of patella fractures have prevalent complications caused by the protrusion of wires or pins. These complications necessitate additional surgery for hardware removal, increase medical cost, and can limit the function of the knee joint. This paper reports cases treated with a minimally invasive load-sharing percutaneous suture of the patella tendon. The procedure provides reliable fixation for transverse patella fractures, minimizes soft tissue injuries, preserves blood flow, and reduces postoperative pain. In addition, the procedure also reduces the irritation and pain caused by the internal fixture, thereby reducing the risk of restricted knee joint movement.

Symptomatic Mid-Substance Posterior Cruciate Ligament Calcification of the Knee Joint (증상을 동반한 슬관절의 후방십자인대 실질부에 발생한 석회화)

  • Ahn, Gil Yeong;Lee, Tae Hun;Hwang, Sung Hyun;Lee, Kyung Jin
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.93-97
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    • 2021
  • Calcification in the tendon is a common disease especially in the rotator cuff. The condition can be treated conservatively in the chronic stage, but surgically in the acute stage. On the other hand there are few reports of calcification in the cruciate ligament of the knee joint, especially calcification of the posterior cruciate ligament. A 51-year-old patient with symptomatic calcification in the mid-substance of the posterior cruciate ligament was treated conservatively. The symptoms did not improve after eight months of conservative treatment, so arthroscopic surgery was performed. During arthroscopic removal of the calcification, the ligament was damaged beyond preservation. Eventually a posterior cruciate ligament reconstruction was performed. At two years after surgery, radiography confirmed no recurrence of the calcification, and the patient was free. We report this case study with a review of the relevant literature.