• Clinics in Shoulder and Elbow
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• 제19권4호
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• pp.256-263
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• 2016

Although arthroscopic surgery has been used conventionally, it has not been widely adopted yet due to the risks of complications, including nerve damage, technical difficulties, and limited indications. As shown in other joints, however, the use of an arthroscope will gradually increased in the elbow joint ('Arthroscopy always wins'). Herein, arthroscopic treatments and arthroscopic ulnar nerve decompression will be discussed in cases of elbow osteoarthritis.

• Clinics in Shoulder and Elbow
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• 제22권3호
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• pp.135-138
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• 2019

Background: The aims of this study were (1) to examine the footprint of the subscapularis tendon using the traditional posterior portal and $30^{\circ}$ arthroscope by simple internal rotation of the arm during surgery, and (2) to classify the pattern of a subscapularis partial-thickness tear. Methods: This study analyzed a total of 231 patients with a partial-thickness subscapularis tear from 550 consecutive patients undergoing an arthroscopic operation who had a visualization of the subscapularis tendon footprint by internal rotation of the arm. First, the patients were classified into four categories according to the tear pattern: (1) stable lamination, (2) unstable lamination, (3) avulsion, and (4) laminated avulsion. Randomized arthroscopic videos were reviewed blindly by two independent orthopedic surgeons. The pattern of the tear of the subscapularis at the neutral position and after internal rotating the arm were assessed and compared with the treatment decision (level IV case series). Results: Stable lamination, unstable lamination, avulsion, and laminated avulsion were observed in 9.1% (n=21), 20.8% (n=48), 41.1% (n=95), and 29.0% (n=67) of cases, respectively. In 145 out of 231 cases (62.8%), the decision was changed after inspecting the footprint after internal rotation of the arm, and the treatment method was changed in 116 (50.2%) cases. Conclusions: In a subscapularis tendon partial-thickness tear, inspecting the footprint of the subscapularis tendon is essential to diagnosing and deciding on the appropriate treatment. In addition, simply internal rotating the arm during surgery when using the traditional posterior portal and $30^{\circ}$ arthroscope can be a valuable method.

• Journal of Yeungnam Medical Science
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• 제20권1호
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• pp.13-27
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• 2003

In the past, the report of shoulder instability undergoing open shoulder stabilization had satisfactory outcomes of greater than 90%. However, the functional loss of open procedure is severe in abduction and external rotation especially. Current arthroscopic techniques for shoulder instability result in success rate equal to open surgical procedure when the labrum is properly fixed to the glenoid rim using suture anchors, the capsule is tightened, and associated bony and soft tissue pathology is addressed. The arthroscopic surgery facilitates the view within shoulder joint for more accurate diagnosis, reduces operating time, minimises postoperative pain, reduces operative morbidity, improves shoulder function, and provides the possibility to perform other procedure simultaneously. However, to accomplish a successful arthroscopic stabilization procedure and to prevent complications, numerous advanced arthroscopic skill must be mastered. Although the arthroscope provides means to visualize new lesions, the pathomechanism and biomechanical explanation is not clear yet. Further studies are necessary to develop for shoulder reconstruction.

• Clinics in Shoulder and Elbow
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• 제19권4호
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• pp.237-240
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• 2016

Retear patterns after arthroscopic rotator cuff repair are classified into two patterns according to retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method. Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope.

• 대한관절경학회지
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• 제2권1호
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• pp.93-96
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• 1998

We treated 10 cases of the medial malleolar fracture of the ankle by open reduction and internal fixation from June 1997 to December 1997. After the rigid internal fixation, we measured the gap of the fracture site and the step off of the articular surface by special instrument under the ankle arthroscopy whether it was reduced anatomically or not. And we tried to know the necessity of the arthroscopically assisted reduction and fixation in the medial malleolar fracture of the ankle. Under the arthroscopic view, all 10 cases were anatomically reduced as less than 1 mm of gap of the fracture site and less than 1mm of step off of the articular surface after open reduction and internal fixation in the medial malleolar fractures. In conclusion, through the arthroscopic management, it has advantage in finding and treating the accompanying intraarticular lesion, but also has disadvantage in setting the arthroscope and prolonging the operation time.

• 대한관절경학회지
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• 제3권1호
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• pp.51-53
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• 1999

특별한 외상을 알 수 없이 슬관절 동통을 호소하는 4세 된 남아에서 방사선사진상 슬관절 내측에 이물질이 보였다. 저자들은 관절경으로 찢어진 반월판 연골 및 골연골의 변연절제술과 동시에 유리조각을 제거함으로써 성공적으로 치료하였기에 보고하고자 한다.

• 대한임상전기생리학회지
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• 제2권1호
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• pp.93-100
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• 2004

Shoulder impingement syndrome is cause by the collision of acromion, acrominoclaviclar joint, coracoacromino ligament, coracoid process and synovial sac, biceps brachiialis tendon, rotator cuff muscle. Treatment for Shoulder impingement syndrome is genetally classified into two different methods; preservative method and operational method. Operational method includes rotator cuff sutura, anterior acromioplasty, arthroscope decompression. Preservative method includes rest, medicinal therapy, physical therapy. Physical therapy concentrates on pain control, functional recovery and prevention of disease progress. It is also important for physical therapy to maintain the strength of rotator cuff. Strengthening rotator cuff decreases the collision and helps the stability of shoulder joint. In conclusion, it must be aware that shoulder impingement syndrome and some other shoulder problem demand different treatment, which results in a better outcome.

• 대한족부족관절학회지
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• 제16권1호
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• pp.1-8
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• 2012

Major technologic advances in fiberoptic light transmission, video cameras, and instrumentation have allowed great advances in small-joint arthroscopy. Arthroscopy in particular is now well established procedure for accurate diagnosis and operative management of certain ankle disorders. The small size of the ankle and significant periarticular soft tissue structures make placement and advancement of the arthroscope and instrumentation more difficult than in larger joints. Successful arthroscopy of the ankle requires knowledge of the regional anatomy and a familiarity with the available arthroscopic portals. This review article is going to describe the gross and arthroscopic anatomy of the ankle as it relates to current arthroscopic techniques. Particular emphasis is placed on the anatomic relations of the important osseous and soft tissue structures for a safe, reproducible approach to arthroscopic treatment of ankle pathology. Also, current arthroscopic equipment and instruments are included.

• 대한관절경학회지
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• 제10권1호
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• pp.118-122
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• 2006

목적: 슬개대퇴관절 불안정성에 대한 치료 방법 중 하나인 관절경적 all inside 관절막 중첩술 및 외측 지대 유리술을 소개하고자 한다. 방법: 슬관절의 관절경적 기본 검사 후, 관절경을 전내측 도달법을 개설하여 위치한 후, 외측 지대의 근위부에서 원위부까지 유리술을 시행하기 위하여 상외측 도달법을 개설하여 관절경 scissor를 위치한다. 슬개골의 가장자리부터 5 mm에서 1 cm정도에서 외측 지대 유리술을 시행한다. 외측 지대 유리술 후, 관절경을 전외측 도달법을 개설하여 위치한 후, 상외측 도달법을 개설하여 5 mm 배관을 삽입하고, 조작용 상내측 삽입구를 개설한다. 경피적으로 만곡 침을 상내측 삽입구를 통해 통과시킨 후 봉합사를 상외측 삽입구를 통해 회수하는, all inside 수기로 시행된다. 결론: 근위부 재정렬을 위한 여러 가지 관절경적 방법이 제시되었지만, 대부분이 내측 절개를 이용한 관절경 보조수기 방법들이었다. 관절경적 all inside 관절막 중첩술 및 외측 지대 유리술은 기존의 관절경 보조 수기 방법들에 비해 내측 절개를 피함으로써 내측 광사근에 손상을 주지 않는 점에서 장점을 가진다. 이 수기는 최소 침습적이면서 직접 관찰하면서 내측 슬개대퇴 인대의 긴장의 정도를 조절하기가 쉬운 수술 수기로 사료된다.

• 대한관절경학회지
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• 제6권2호
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• pp.183-187
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• 2002

목적 : 재발된 슬개골전 점액낭염의 관절경적 절제술의 수기 및 그 결과를 보고하고자 한다. 대상 및 방법 : 2001년 3월부터 2002년 5월까지 본원에서 치료받은 4례에 대하여 조사하였으며, 추시 기간은 6개월에서 20개월로 평균 14 개월이었다. 원인으로는 급성외상이 3예, 반복적인 경미한 외상에 의한 것이 1예이었다. 모두 타 병원에서 천자 흡입, 스테로이드 주입, 압박 붕대 처치 등의 보존적 치료를 시행 후 일부 호전을 보이다가 재발한 경우이었으며, 1례는 수술적 치료를 받은후 재발한 예이었다. 수술 방법은 생리식염수를 주입하여 점액낭을 팽창시킨후 4 mm 직경의 관절경을 위한 삽입구를 점액낭에서 약 1 cm 떨어진 곳에 피부 천자를 가하여 위치하게 한다. 점액낭의 절제는 피하부위를 먼저 절제하고, 깊은 부위를 나중에 절제하였다. 점액낭 상층 피부와 점액낭의 심부 조직간을 같이 묶는 몇 개의 경피적 연차봉합(percutaneous mattress suture)을 하고, 압박 처치를 술 후 2주까지 유지하였다. 결과 : 종창의 재발과 동통 및 압통의 종상 없이 4례 모두 양호한 결과를 얻었다. 합병증으로는 2례에서 피부-점액낭 하부조직의 봉합 부위에서 경미한 유착에 의한 피부 함몰이 관찰되었다. 결론 : 슬개골전 점액낭염의 관절경적 절제술은 재발성 슬개골전 점액낭염의 치료에 새로운 수술 수기로 사료되며 재발에 대한 장기간의 추시가 요구된다.