• Title/Summary/Keyword: pull-out 봉합술

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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 Arthroscopic Modified Pull-Out Suture for Root Tear of Posterior Horn of Medial Meniscus (관절경하 내측 반월상 연골 후각부 뿌리 파열의 수정된 견인 봉합술후의 임상적 결과)

  • Cho, Jin-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.37-43
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    • 2012
  • Purpose: This study is to evaluate the clinical results of pull-out suture for root tear of posterior horn of medial meniscus. Materials and Methods: Between March 2006 and February 2011, We studied 40 cases with the root tear of posterior horn of medial meniscus which follow up more than 1 years. Mean age was 49.5 years old. We excluded osteoarthritis or varus deformity patients more than 5 degrees. pull-out suture was performed to the patients with grade 0-2 of Kellgren and Lawrence classification. According to Outerbridge classification, evaluation of cartilage damage was performed during arthroscopy. Evaluation of clinical result was used the Lysholm score. Results: The mean pre-operation Lysholm score was 63.9 and post-operation score was 86.3. The complete failure rate was 3 of 40 cases (7.5%). Twenty of 40 cases (50%) showed cartilage lesions in weight bearing portion of medial femoral condyle which were 12 cases in grade 1, 5 cases in grade 2 and 3 cases in grade 3 according to the Outerbridge classification. Conclusion: In the treatment of pull-out suture for root tear of posterior horn of medial meniscus, exclusion of more than moderate arthritis or varus deformity is very importment. Pull-out suture seems to be a useful treatment of the root tear of posterior horn of medial meniscus in mild osteoarthritis or varus deformity of middle ages.

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Arthroscopic Medial Plication using Pull-out Suture for the Treatment of Acute or Recurrent Patellar Dislocation - Technical Note - (급성 또는 재발성 슬개골 탈구의 치료에 있어서 견인 봉합술을 이용한 관절경적 내측 관절막 중첩술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Kim, Jae-Hoon;Ha, Hae-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.214-218
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    • 2006
  • Purpose: We describe a new technique of arthroscopic medial plication using pull-out suture with consideration of anatomical location of medial patellofemoral ligament for the treatment of acute or recurrent patellar dislocation. Operative technique: Under arthroscopic examination, sutures are passed through the medial capsule, at which medial patellofemoral ligament is located, from outside to inside of knee joint. Three guide wires are inserted from anterior surface of the patella to upper half of its medial border. Intraarticular portions of sutures are pulled out toward anterior surface of the patella through bony tunnels. Under appropriate tension, the sutures are tied after performing lateral retinacular release. Conclusion: As suturing medial patellofemoral ligament, this technique can maximize the effect of medial plication and can correct subluxation and tilt of the patella. It seems to be a minimally invasive, easy and effective method for the treatment of acute or recurrent patellar dislocation.

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Arthroscopic Pull-out Wire Fixation Using Cannulated Screw of Tibial Eminence Fractures (도관 나사못을 이용한 경골 과간 융기 골절의 관절경적 견인 봉합술)

  • Kim, Jong-Min;Kim, Hyung-Gyu;Park, Byeong-Mun;Song, Kyeong-Seop;Jung, Sung-Hoon;Noh, Haeng-Kee;Yoon, Jong-Joo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.254-258
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    • 2009
  • Tibial eminence fracture is caused by distortion, excessive flexion and extension, varus and valgus injury of the knee joint in the form of avulsion fracture. A failure over the exact anatomical reduction of fragment can lead to instability and limitation of joint motion. Recently, a variety of arthroscopic assisted reduction and fixation technique have been used. In the tibial eminence fracture, we created an arthroscopic pull-out wire fixation technique using a cannulated screw that is easy and more convenient than in the conventional technique. So we report this technique with a review of current literatures.

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Surgical Outcome of Primary Repair in Anterior Cruciate Ligament Rupture - Minimum 4-years follow-up - (전방 십자 인대 봉합술의 수술적 치료 - 최소 4년 이상 추시 결과 -)

  • Byun, Ki-Yong;Rhee, Kwang-Jin;Lee, Suk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.123-127
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    • 2000
  • Purpose : To evaluate of the surgical outcome of primary repair in anterior cruciate ligament rupture. Material & Method : Twenty-five patients underwent arthroscopic primary repair of ACL. We performed pull-out suture of ruptured ligament in 18 cases, and suture and augumentation with gracillis & semitendinosus in 7 cases. At follow up, the International Knee Documentation Committee(IKDC) scale & Lysholm score were used to grade outcome, and also the KT-2000 arthrometer was used to evaluate objective ligament laxity. Results : In analysis of IKDC scale, final evaluation group were group A in 3 cases, group B in 13 cases, group C in 9 cases. The mean value of Lysholm score was 83 points. In KT-2000 arthrometer examination, mean anterior translation was 3.9mm at 201b, 7.3mm at 30lb. The mean difference value between injured knee and uninjured knee was 1.1mm at 201b, 2.29mm at 301b. There was statistical significance in mean difference value between injured and uninjured knee. Conclusion : By analysis of clinical & objective data, we could confirm that the mid-term result of ACL suture is not satisfactory. So, we recommend that ACL reconstruction would be done in young active patient rather than suture.

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Arthroscopic Pull-out Suture Repair of Posterior Root Tear of the Medial Meniscus - Minimum 5 Years Follow-up Results - (내측 반월상 연골판 후방 부착부 파열의 관절경적 견인 봉합술 - 최소 5년 추시결과 -)

  • SaKong, Hyub;Shin, Hong Kwan;Lee, Young-Kook;Bae, Ki Cheor;Cho, Chul Hyun;Lee, Kyung Jae;Son, Eun-Seok;Kim, Doo Han
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.153-159
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    • 2012
  • Purpose: This study aims at evaluating our results with a 5-year follow up of arthroscopic pull-out suture repair of posterior root tear of the medial meniscus. Materials and Methods: This study enrolled 30 cases who underwent a arthroscopic pull-out suture repair to treat the posterior root tear of the medial meniscus from January 2001 to May 2005 and followed up at least 5 years. The average follow-up period was 76 months (range, 60-90 months). Clinical results by use of the Lysholm knee score and radiographic grade by use of the Kellgren-Lawrence classification were evaluated and second-look arthroscopy was done in all cases. The clinical results were compared with trauma history, obesity, varus deformity and time to operation. Results: At the last follow up, the Lysholm knee score improved from 55 points to 86 points. For the radiological results, 23 cases displayed maintenance or improvement of the medial joint space on the follow up X-ray, but 7 cases displayed decrease of the medial joint space, and 1 case was lately performed total knee replacement due to progressive osteoarthritic change. Conclusion: Arthroscopic pull-out suture repair has a good result at 27 cases (90%) in minimum 5 years follow-up. The clinical improvement was significantly reduced in more severe varus angle.

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Arthroscopic Treatment of Displaced Tibial Spine Fracture in Children (소아에서의 전위된 경골극 골절의 관절경적 치료)

  • Choi, Nam-Yong;Cheong, Hyung-Kook;Koh, Hae-Seok;Han, Suk-Ku;Nah, Ki-Ho;Song, Hyun-Seok;Kim, Bae-Gyun
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.148-153
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    • 2005
  • Purpose: To analyze the clinical result of the arthroscopic reduction and fixation for the displaced tibial spine fractures in children and report the utility of the arthroscopic treatment with the review of the literature. Methods: Between December 2000 and July 2004, five patients (average age 9.1 years) received an arthroscopic reduction and fixation of displaced tibial spine fracture. A male-to-female ratio was 3:2 and mean follow-up was 38.2$(13{\sim}56)$ months. All five patients were classified type III by Movers and McKeever classification. The average period from injury to operation was 4.8 days $(3{\sim}8days)$, the avulsed fragment was reduced by operative arthroscopy and fixated by pull-out suture in 3 patients and by cannulated screw in 2 patients. Postoperatively long leg cast was applied for 2 weeks, and then gradual range-of-motion exercise was permitted. Full weight-bearing ambulation was permitted after 6 weeks. The clinical evaluation was performed by range of motion, Lachman and pivot shift test, KT-1000 arthrometer, Lysholm knee score and the modified Feagin score. Results: All five patients had no symptom and recovered full range of motion of the affected knees. Lachman test was positive finding of 1+ laxity in one patient, the others were negative, and all patients were negative findings for pivot shift test. The result of KT-1000 arthrometric assessment is mean maximum side-to-side differences 1.9 mm. Average Lysholm knee score was 99.4. All patients had excellent results in modified Feagin score. Conclusion: Arthroscopic reduction and fixation of displaced tibial spine fracture in children showed excellent result without complication. Both pull-out suture fixation and cannulated fixation provide an effective treatment option for fixation of the displaced anterior tibial spine fracture.

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MRI Findings of the Repaired Anterior Cruciate Ligament (전방 십자 인대의 일차 봉합술 후 MRI 소견)

  • Kim, Jung-Man;Koh, In-Jun;Lee, Dong-Yeob;Lee, Yoon-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.14-21
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    • 2009
  • Purpose: To investigate MRI findings of the repaired anterior cruciate ligament (ACL). Materials and Methods: Seventeen of arthroscopic ACL primary repair with sutures pull-out technique were followed for 21.4 months (range: 12 to 60 months). Stability was assessed with physical examination and KT-1000 arthrometer (MED metric, San Diego, CA) and postoperative MRI checked with time. The patients were divided into 2 groups according to the location of tear which was defined with the location of remained synovial sleeve. Group I (11 patients) comprised that the tear was located within proximal 1/3 of ACL substance and group II (6 patients) comprised below proximal 1/3. MRI findings of the repaired ACL were evaluated by its course, sharpness, thickness and signal intensity using 3 grade system and correlated with its location of tear. Results: In all cases, Lachman test and flexion-rotation drawer test were negative, pivot-shift test was less than grade 1 and the mean side-to-side difference by use of KT-1000 arthrometer was 1.4 mm (range: -1.0 to 2.5 mm). The overall continuity of the repaired ACL was well maintained in all cases. However, mild sagging was observed in 10 cases(58.8%), mild obscure contour in 6 cases (35.3%), increased thickness in 8 cases (47.1%) and slight increased signal intensity in 5 cases (29.5%). There was no statistical significance in all parameters between 2 groups. And a focal defect at the femoral attachment site in sagittal image was observed in 7 cases (41.2%) of all patients which comprised 2 cases (18.2%) of group I and 5 cases (83.3%) of group II. It was observed more frequently in group II with statistical significance (p=0.035). Conclusion: Some abnormal MRI findings such as mild sagged course, obscure contour, increased thickness and signal intensity, the focal defect at femoral attachment site could be observed even though the stability was well maintained clinically. We thought that the focal defect was affected by the location of tear of ACL.

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