• Title/Summary/Keyword: arthroscopic surgery

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Tuberoplasty for Irreparable Massive Rotator Cuff Tears (봉합할 수 없는 광범위 회전근 개 파열에 대한 결절 성형술)

  • Yi, Jin-Woong;Cho, Nam-Su;Cho, Seung-Hyun;Cho, Hyung-Jun;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.7-13
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    • 2009
  • Purpose: To evaluate the clinical and radiological results of arthroscopic tuberoplasty for irreparable massive rotator cuff tears. Materials and Methods: Eleven patients underwent arthroscopic tuberoplasty for irreparable massive rotator cuff tears between December 2004 and April 2007. The mean follow-up period was 17.3 months, and the average age at the time of surgery was 61.7-year-old. Five cases underwent arthroscopic tuberoplasty and 6 cases had arthroscopic subacromial decompression and tuberoplasty, simultaneously. Results: The average Constant score improved from 61.8 to 86.9 and the average UCLA score changed from 14.8 to 31.8 with 6 excellent, 3 good and 2 poor results (p=0.003). The active forward flexion improved from $111.8^{\circ}$ to $154.1^{\circ}$(p=0.011). The acromiohumeral interval increased from 3.94 mm preoperatively to 4.22 mm postoperatively (p=0.12). In the poor UCLA score group, the acromiohumeral interval changed from 1.67 mm preoperatively to 0.94 mm postoperatively. Conclusion: Arthroscopic tuberoplasty may be a second option to relieve the pain of irreparable massive rotator cuff tears and improve the range of motion. However, good results could not be expected if the acromiohumeral interval is < 2 mm preoperatively and decreased postoperatively.

Arthroscopic Osteochondroplasty of Osteochondral Lesion of the Talus (거골 골연골 병변에 대한 관절경적 골연골성형술)

  • Lee, Myung Jin;Kim, Sung Soo;Wang, Lih;Lee, Chul Won;You, Sung Gon;Hwang, Jin Soo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.134-139
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    • 2012
  • Purpose: To report the treatment results of arthroscopic osteochondroplasty in osteochondral lesion of the talus. Materials and Methods: This study included 32 patients who had osteochondral lesion of the talus treated with arthroscopic osteochondroplasty and were able to be followed up over 3 years from 1999 to 2007. The mean follow up period was 48 (38-108) months, and 22 male patients and 10 female patients with a mean age of 34 (20-56) years were included. Locations of lesion were evaluated with simple X-ray and magnetic resonance imaging (MRI), and severities of lesions were classified by Berndt and Harty classification. All cases were treated by arthroscopic debridement or microfracture. The treatment results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and subjective and functional score of Kailkkonen. The group treated by arthroscopic microfracture was compared with the group treated by arthroscopic debridement. Results: The mean AOFAS ankle-hindfoot scale was significantly improved 53 (${\pm}7$) points preoperatively to 84 (${\pm}8$) points postoperatively (P<0.001). The mean subjective and functional score was also improved 55 (${\pm}8$) points preoperatively to 88 (${\pm}8$) points postoperatively with statistical significant (P<0.001). There were no relations between the severity of lesions and the postoperative functional score of ankle (P>0.05). There were no significant differences in the clinical results between the group treated with arthroscopic microfracture and the group treated with arthroscopic debridement (P>0.05). Conclusion: Arthroscopic osteochondroplasty of osteochondral lesion of the talus shows excellent result in terms of patients' satisfaction. There were no significant differences in the clinical results between arthroscopic microfracture group and debridement group.

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Arthroscopic Distal Clavicle Resection for Chronic Stage 2 Acromioclavicular Dislocation - Preliminary Report of 6 Cases Study - (관절경하 원위 쇄골 절제술을 이용한 만성 제 2형 견봉쇄골 손상의 치료 - 6례에 대한 예비 연구 -)

  • Yoo Yeun-Sik;Yoon Young-Gon;Nam Il-Hyun;Moon Gi-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.171-176
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    • 2002
  • Purpose : To evaluate effectiveness of arthroscopic distal clavicle resection for chronic stage 2 acromioclavicular dislocation. Material: 6 patients who had failed to respond to physical therapy were evaluate more than 6 months prospectively, which were treated with arthroscopic distal clavicular resection from february 1998 to January 2001. Result : The median preoperative Constant score changed from 32 of 100 to 37 of 100 at 3 to 6 weeks, to 49 of 100 at 3 months and to 69 of 100 at 6months. Improvement was achived at mean follow up more than 6 months after surgery. Overal $83\%$ of patient were satisfied with this procedure. but the remained case was unsatisfied because symptom was not improved more than 6 months Conclusion : Arthroscopic distal clavicle resection is useful method to treatment for chronic stage 2 acromioclavicular dislocation.

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Clinical Outcome after Arthroscopic Capsular Release for Adhesive Capsulitis of the Shoulder

  • Yoo, Jae Chul;Koh, Kyoung Hwan;Shon, Min Soo;Bae, Kyu Hwan;Lim, Tae Kang
    • Clinics in Shoulder and Elbow
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    • v.21 no.3
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    • pp.127-133
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    • 2018
  • Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.

Age-related Outcome of Arthroscopic Repair of Isolated Type II Superior Labral Anterior to Posterior Lesions

  • Kwon, Jieun;Kim, Yeun Ho;Yeom, Tae Sung;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.36-42
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    • 2015
  • Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ${\geq}40years$. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.

Correlation between Results of Preoperative Impingement Test and Clinical Outcomes after Arthroscopic Rotator Cuff Repair

  • Park, Sung Bae;Seo, Joong Bae;Ryu, Jee Won;Shin, Yong Eun
    • Clinics in Shoulder and Elbow
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    • v.20 no.3
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    • pp.126-132
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    • 2017
  • Background: The aim of the present study was to determine the correlation between the amount of pain reduction after local anesthetic injection into the subacromial space preoperatively and clinical outcome after arthroscopic rotator cuff repair. Methods: A total of 127 patients who underwent arthroscopic rotator cuff repair and followed up at least 1 year were analyzed retrospectively. Preoperatively, a visual analogue scale (VAS) for pain was measured in all patients before and after the ultrasound guided impingement test. The participants were divied into four groups according to pain reduntion ater impingement test (Group A: >75%, Group B: 50%-75%, Group C: 25%-50%, Group D: <25%). VAS for pain, shoulder range of motion, shoulder isometric strength, ASES score were evaluated preoperatively and at 3, 6, 9, and 12 months postoperatively. Results: After surgery, the amount of pain reduction shows significantly at 3, 6 months in Groups A, B as compared to Groups C, D (p<0.05). Among the range of motion of shoulder joint, forward flexion was significantly improved in Group A at 3 months (p<0.05). The ASES score significantly improved at 3, 6 months in Groups A, B as compared to Group C, D (p<0.05). Conclusions: Preoperative degree of pain reduction after impingement test correlates with the improvement of pain after arthroscopic rotator cuff repair, especially in the early phase. Therefore, the impingement test could be effectively used.

Comminuted Radial Head Fracture in All-arthroscopic Repair of Elbow Fracture-dislocation: Is Partial Excision of the Radial Head an Acceptable Treatment Option?

  • Yang, Hee Seok;Kim, Jeong Woo;Lee, Sung Hyun;Yoo, Byung Min
    • Clinics in Shoulder and Elbow
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    • v.21 no.4
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    • pp.234-239
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    • 2018
  • Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.

Treatment of Os Trigonum Syndrome using Subtalar Arthroscopy (A Case Report) (거골하 관절경을 이용한 Os Trigonum Syndrome의 치료(1예 보고))

  • Ahn, Jae-Hoon;Baek, Chang-Hyun;Lee, Kwang-Won;Kim, Seung-Kwon;Choy, Won-Sik
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.267-270
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    • 2006
  • Os trigonum syndrome is a clinical disorder characterized by posterior ankle pain which occurs in excessive plantar flexion. The pain is elicited by the impingement of os trigonum between the calcaneus and the posterior edge of tibial plafond. Mostly, symptoms can be improved with nonsurgical management, however surgery is required for refractory cases. We report of a case of os trigonum syndrome in a female ballet dancer, which was successfully treated with subtalar arthroscopic excision of os trigonum.

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Usefulness of Arthroscopy on Treatment of Double disruption of Superior Shoulder Suspensory Complex - Two cases including Fracture of Glenoid - (상부 견갑 현수 복합체의 이중 분리의 치료에 있어 관절경의 유용성 - 관절와 골절을 동반한 2례 보고 -)

  • Kim Bo-Hyun;Kang Shin-Taek;Park Ill-Seok;Byun Jae-Yong
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.158-165
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    • 2005
  • The Superior Shoulder Suspensory complex (SSSC) maintains a normal stable relationship between the upper extremity and the axial skeleton. Traumatic double disruptions of the SSSC frequently create an unstable anatomic situation and is difficult-to-treat. When this double disruption is managed conservatively, significant displacement can occur at either or both sites and result in long-term problems and functional disabilities. Therefore surgical management is generally necessary. The authors experienced two cases of double disruptions of the SSSC treated with arthroscopic surgery & and reported good results.