• Title/Summary/Keyword: Suture Materials

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Arthroscopic Retrieval Analysis for Intra-articular Foreign Body of the Knee Joint (슬관절내 이물질에 대한 관절경적 제거술식의 분석)

  • Lee, Byung-Ill;Choi, Hyung-Suk;Jo, Joo-Hyoung;Kwon, Sai-Won
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.211-216
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    • 2008
  • Purpose: The frequency of foreign body in the knee joint is not as high, but it sometimes required wide or multiple arthrotomy in order to remove, which can baffle the surgeon in some ways. Our study is to evaluate for effectiveness of arthroscopic retrieval for intra-articular foreign body in the knee joint. Materials and Methods: The 22 patients(16 males, 6 females) had received arthroscopic foreign body retrieval in the knee joint from March 1983 to September 2006. The causes of foreign bodies of the knee joint were 7 of trauma (31.9%) related cases, 13 of surgery related cases (59.0%), 2 found during follow up after operation (8.1%) in pathologies of foreign body. Results: There were 15 of metal showed the most percentage (68.1%), 7 of non-metal (31.9%) in types of foreign bodies, and others included bullet, suture material, pencil lead, broken wire etc. All cases were used by arthroscopic techniques. All foreign bodies were removed easily and were showed no complication such as postoperative joint stiffness. Conclusion: Arthroscopic foreign body retrieval in the knee joint is effective surgery in terms of easy access to foreign body and less postoperative complication.

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Arthroscopic Decompression of Spinoglenoid Ganglion Cyst (견갑골 극관절와 결절종의 관절경하 감압술)

  • Hwang, Tae Hyok;Wang, Tae Hyun;Cho, Hyung Lae;Kim, Keun Young
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.92-98
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    • 2011
  • Purpose: We describe a all-arthroscopic technique for decompression of spinoglenoid ganglion cyst and present our clinical results for this procedure. Materials and Methods: From March 2006 to June 2009, eight patients (7 males, 1 female; mean age 40.6 years; range: 21~61) were included who underwent arthroscopic decompression of spinoglenoid ganglion cyst. The most common symptoms were vague shoulder pain and external rotation weakness, which lasted 6.4 months (range: 3~8) on average. Five of eight patients were noted abnormalities on electromyographic (EMG) examination to have suprascapular nerve neuropathy and magnetic resonance imaging (MRI) showed spinoglenoid ganglion cysts in all eight patients and the cyst size was 2.6 cm (range: 1.8~3.6). Labral pathology was identified intraoperatively in all patients and the cysts were decompressed by the posterosuperior capsulotomy under arthroscopic control and labral repair with suture anchors was performed in six patients. Results: The average clinical outcome scores including Constant and Murley, Simple shoulder test (SST) all improved significantly at the time of the final follow-up and there were no complications resulting from the procedures. All patients including the patients with abnormal EMG study recovered strength on isokinetic strength testing. Follow-up MRI scans were performed on all patients at a mean of 5.2 months postoperatively (range: 3~12) revealed complete resolution of the cysts and no evidence of recurrences were seen at an average of 18 months (range: 12~26) of follow-up. Conclusion: Arthroscopic decompression of spinoglenoid ganglion cyst effectively restores patient function and all patients in this study showed improvement in their postoperative MRI findings. Arthroscopic decompression is also useful in the appropriate treatment for labral pathology and may contribute to decreased risk of cyst recurrence.

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Results of Arthroscopic-assisted Minimally Invasive Removal of a Lateral Periarticular Plate used for the Treatment of AO Type-C Distal Femoral Fractures (AO C-형 원위 대퇴골 골절의 치료로 삽입된 관외측 금속판의 절경 보조하 최소 침습적 제거의 결과)

  • Kim, Young-Mo;Lee, June-Kyu;Yang, Jae-Hoon;Kim, Bo-Kun;Lee, Won-Gu
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.46-52
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    • 2009
  • Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

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Accompanying Lesions and Clinical Results in the Greater Tuberosity Fracture of the Humerus with Anterior Shoulder Dislocation Under the Age of Forty (40세 이하에서 견관절 전방 탈구가 동반된 상완골 대결절 골절에서 관절내 병변 및 임상 결과)

  • Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Kyu;Park, Hyeun-Kook;Park, Jang-Hee;Shin, John
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.20-26
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    • 2011
  • Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.

Anchor Hole Augmentation with Bone Cement in Arthroscopic Rotator Cuff Repair (관절경적 회전근 개 봉합술에서 골 시멘트를 이용한 봉합 나사 구멍 보강술)

  • Lee, Ho-Min;Tae, Suk-Kee;Park, Jeong-Min
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.237-243
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    • 2010
  • Purpose: In arthroscopic rotator cuff repair, the crucial step is secure fixation of Anchor to bone. However, osteoporosis of the tuberosity is frequently encountered in old patients, and can cause insecure fixation of anchors. The Aim of our study was to introduce a technique for anchor hole augmentation with bone cement when fixation failure of an anchor occurs, and to investigate the outcome. Materials and methods: Among 223 rotator cuff repairs performed between 2005 and 2009, anchor hole augmentation with polymethylmethacrylate was performed in 15 cases (all females; mean age of 65 years: range 49~77). Bone cement was injected into the anchor hole in a thick fluid state and the procedure was repeated to make a pot-like cement mantle. The anchor was inserted into the cement mantle while the cement hardened. The outcome was investigated, on average, at 16 months (6~32). Results: Radiographs showed cystic changes of the tuberosity. On follow-up radiographs and MRI, a change in the cement mantle was not noted. The final average UCLA score was 31 (28~35); 6 had excellent, 8 good and 1 fair results (p=0.008). Age-sex matched Constants score was 90 (74~98) (p=0.008). Conclusion: Anchor hole augmentation with bone cement is useful when fixation failure of an anchor is encountered due to bone atrophy. Anchor hole augmentation with bone cement does not negatively influence the outcome.

Geochemical Characteristics of Granodiorite and Arenaceous Sedimentary Rocks in Chon-Ashuu Area, Kyrgyzstan (키르키스스탄 촌아슈 지역 화강섬록암질암 및 사질원 퇴적암의 지화학적 특징)

  • Kim, Soo-Young;Chi, Sei-Jung;Park, Sung-Won
    • Economic and Environmental Geology
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    • v.44 no.4
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    • pp.273-288
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    • 2011
  • Chon-Ashuu copper mining claim area is located, in terms of the geotectonic setting, in the northern part of the suture line which is bounded with the marginal part of Issik-kul micro-continent on the southern part of North Tien-Shan terrane. The geological blocks of Chon-Ashuu districts belong to the southern tip of Kazakhstan orocline. The rock formation of this area are composed of the continental crust or/and arc collage and the paleo-continental fragments-accretionary wedge complex of pre-Altaid orogenic materials. ASI(Alumina Saturation Index) of Paleozoic plutonic rocks in Chon-Ashuu area belong to the peraluminous and metaluminous rocks which were generated from fractional crystallization of Island and volcanic arc crusts in syn-post collisional plate. The geology of the ChonAshuu area consists of upper Proterozoic and Paleozoic rock formations. According to Harker variation diagrams for Chon-Ashuu arenaceous sedimentary rocks, the silty sandstone of Chon-Ashuu area showing the mineralogical immaturity were derived from Island arc or the marginal environments of active continent in Cambro-Carboniferous period. Numerous intrusive rocks of Chon-Ashuu area are distributed along north east trending tectonic structures and are bounded on four sides by the conjugate pattern. The most common type of the plutonic rocks are granodiorite and monzodiorite. According to the molecular normative An-Ab-Or composition (Barker, 1979), the plutonic rocks in Chon-Ashuu area are classified into tonalite - trondhjemite - granodiorite (TTG) series which are an aggregation of rocks which is the country rock of copper mineralization, that are formed by melting of hydrous mafic crust at high pressure.

The Bone Regenerative Effects of Chitosan on the Calvarial Critical Size Defectin Sprague Dawley Rats (백서 두개골 결손부에서 키토산의 골조직 재생 유도 효과)

  • Jung, Ui-Won;Suh, Jong-Jin;Choi, Seong-Ho;Choi, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.30 no.4
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    • pp.851-870
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    • 2000
  • The major goals of periodontal therapy is the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. There have been increasing interest on the chitosan made by chitin. Chitin is second only to cellulose as the most abundant natural biopolymer. It is a structural component of the exoskeleton of invertebrates(e.g., shrimp, crabs, lobsters), of the cell wall of fungi, and of the cuticle of insects. Chitosan is a derivative of chitin made by deacetylation of side chains. Many experiments using chitosan in various animal models have proven its beneficial effects. The aim of this study is to evaluate the osteogenesis of chitosan on the calvarial critical size defect in Sprague Dawley rats. An 8 mm surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into two groups: Untreated control group versus experimental group with 50mg of soluble chitosan gel. The animals were sacrificed at 2, 4 and 8 weeks after surgical procedure. The specimens were examined by histologic, histomorphometric and radiodensitometric analyses. The results are as follows: 1. The length of newly formed bone in the defects was $102.91{\pm}25.46{\mu}m$, $219.46{\pm}97.81{\mu}m$ at the 2 weeks, $130.95{\pm}39.24{\mu}m$, $212.39{\pm}89.22{\mu}m$ at the 4 weeks, $181.53{\pm}76.35{\mu}m$ and $257.12{\pm}51.22{\mu}m$ at the 8 weeks in the control group and experimental group respectively. At all periods, the means of experimental group was greater than those of control group. But, there was no statistically significant difference between the two groups. 2. The area of newly formed bone in the defects was $2962.06{\pm}1284.48{\mu}m^2$, $5194.88{\pm}1247.88{\mu}m^2$ at the 2 weeks, $5103.25{\pm}1375.88{\mu}m^2$, $7751.43{\pm}2228.20{\mu}m^2$ at the 4 weeks and $8046.20{\pm}818.99{\mu}m^2$, $15578.57{\pm}5606.55{\mu}m^2$ at the 8 weeks in the control group and experimental group respectively. At all periods, the means of experimental group was greater than those of control group. The experimental group showed statistically significant difference to the control group at the 2 and 8 weeks. 3. The density of newly formed bone in the defects was $14.26{\pm}6.33%$, $27.91{\pm}6.65%$ at the 2 weeks, $20.06{\pm}9.07%$, $27.86{\pm}8.20%$ at the 4 weeks and $22.99{\pm}3.76%$, $32.17{\pm}6.38%$ at the 8 weeks in the control group and experimental group respectively. At all periods, the means of experimental group was greater than those of control group. The experimental group showed statistically significant difference to the control group at the 2 and 8 weeks. These results suggest that the use of chitosan on the calvarial defects in rats has significant effect on the regeneration of bone tissue in itself

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The Bone regenerative effects of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague dawley rats (백서 두개골 결손부에서 항생제를 함유한 키토산 차단막의 골재생 유도 효과)

  • Chae, Gyung-Joon;Kim, Tae-Gyun;Jung, Ui-Won;Lee, Soo-Bok;Jung, Yong-Sik;Lee, Yong-Keun;Kim, Chang-Sung;Chae, Jung-Kiu;Cho, Kyoo-Sung;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.35 no.4
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    • pp.1019-1037
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    • 2005
  • The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. There have been increasing interest on the chitosan made by chtin. Chitosan is a derivative of chitin made by deacetylation of side chains. Chitosan has been widely studied as bone substitution and membrane material in periodontology. Many experiments using chitosan in various animal models have proven its beneficial effects. Tetracycline has been considered for use in the treatment of chronic periodontal disease and gingivitis. The aim of this study is to evlauate the osteogenesis of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague Dawley rats. An 8mm surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into five groups: Untreated control group versus four experimental group. Four types of membranes were made and comparative study was been done. Two types of non-woven membranes were made by immersing non-woven chitosan into either the tetracycline solution or chitosan-tetracycline solution. Other two types of sponge membranes were fabricated by immersing chitosan sponge into the tetracycline solution, and subsequent freeze-drying. The animals were sacrificed at 2 and 8 weeks after surgical procedure. The specimens were examined by histologic analyses. The results are as follows: 1. Clinically the use of tetracycline blended chitosan membrane showed great healing capacity. 2. The new bone formations of all the experimental group, non-woven and sponge type membranes were greater than those of control group. But, there was no significant difference between the experimental groups. 3. Resorption of chitosan membranes were not shown in any groups at 2 weeks and 8 weeks. These results suggest that the use of tetracycline blended chitosan membrane on the calvarial defects in rats has significant effect on the regeneration of bone tissue in itself. And it implicate that tetracycline blended chitosan membrane might be useful for guided tissue regeneration.

Intraoperative Ultrasound-Guided Percutaneous Repair of a Ruptured Achilles Tendon: A Comparative Study with Open Repair (초음파 유도하 경피적 아킬레스건 봉합술: 개방적 봉합술과의 비교 연구)

  • Kang, Dong Hun;Kang, Chan;Hwang, Deuk Soo;Song, Jae Hwang;Choi, Bo Sung
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.522-529
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    • 2018
  • Purpose: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. Results: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p<0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. Conclusion: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.