• Title/Summary/Keyword: Arthroscopic debridement

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Arthroscopic Debridement of the Knee Joint (슬관절의 관절경적 변연절제술)

  • Suh, Jeung Tak;Park, Byung Guk;Song, Jin Heon
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.159-163
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    • 1998
  • We reviewed the cases of 35 knees of 34 patients who had arthroscopic debridement for degenerative osteoarthritis of the knee. The patients were followed up for an average of 29 months (range: 13 months to 45 months). The mean age of the patients at operation was 54 years (range: 44 years to 75 years). At the time of follow up, the patients were evaluated using the nine-point scale by Baumgaertner et al. We divided the knee into 4 stages according to the classification system by Jackson et al. Satisfactory results were achieved in 80%(stage I), 75%(stage II), 55.6%(stage III) and 25%(stage IV) of the patients. Arthroscopic debridement is of significant value in the earlier stages of degenerative osteoarthritis (stage I and II) for the symptom relief as a simple procedure with rare complication as well as in the later stages(stage III and IV) as a time buying procedure before the total knee arthroplasty.

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Arthroscopic Treatment of an Acute Septic Arthritis after Meniscal Allograft Transplantation - A Case Report - (반월상 연골 동종 이식술 후 발생한 화농성 관절염의 관절경적 치료 - 증례 보고 -)

  • Kim, Yeub;Yoon, Jung-Ro;Suh, Dong-Hoon;Jang, Hyoung-Won
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.63-67
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    • 2009
  • We report the case of a 21-year-old man with acute septic arthritis of the knee after meniscal allograft transplantation, which was successfully treated with repeated arthroscopic debridement and irrigations. Our procedures included arthroscopic debridement and irrigation with 10L normal saline, repeated arthroscopic irrigations (5 times), and intravenous antibiotics. Our decision to repeat the debridement was based on clinical and laboratory results. The significance of this case is that early aggressive arthroscopic debridement and repeated irrigations as part of a treatment protocol of acute septic arthritis after meniscal allograft transplantation can be an effective treatment option in selected cases.

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Medial Retracted Large Rotator Cuff Tears (내측으로 퇴축된 대범위 회전근 개 파열)

  • Ko, Sang-Hun;Cha, Jae-Ryong;Kim, Tae-Won
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.212-219
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    • 2009
  • Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

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Prospective Comparative Study of Arthroscopic Repair Versus Debridement for the Full-Thickness Tear of Upper Subscapularis (상부 견갑하 건 완전파열의 관절경 하 봉합술과 변연절제술의 전향적 비교)

  • Ko, Sang-Hun;Cha, Jae-Ryong;Lee, Chae-Chil;Park, Han-Chang;Shin, Seung-Myeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.79-85
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    • 2010
  • Purpose: To evaluate the results from arthroscopic repair versus debridement for full-thickness tears of the upper subscapularis tendon. Materials and Methods: Ninety-nine patient outcomes were evaluated and compared prospectively. Sixty-nine patients with full-thickness tears of the upper subscapularis tendon underwent arthroscopic repair (group I) and thirty patients underwent simple debridement (group II) between May 2003 and October 2007. In all patients, the tear was localized to the superior one third of the upper subscapularis tendon. The results of the treatment were assessed by evaluating the UCLA, ASES, and VAS for pain and internal rotation strength scores before and after the operation. Results: In groups I and II, UCLA, ASES, VAS, and internal rotation muscle power (perfect score = 5) scores were improved after surgery. In comparing group I and group II, the UCLA and VAS scores were not significantly different (p>0.05), while the ASES and internal rotation strength scores were significantly different (p<0.05). Conclusion: The arthroscopic repair of full-thickness tears of the upper subscapularis tendon was a better surgical method than simple debridement.

Arthroscopic Decompression of Subacromial Impingement Syndrome (관절경적 감압술에 의한 견봉하 충돌증후군의 치료)

  • Kim Seong Jae;Kim Beom Su;Choe Nam Hong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1995.05a
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    • pp.13-13
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    • 1995
  • The authors performed the arthroscopic decompression and cuff debridement on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome from July 1990 to January 1994. The summarized results are as follows. 1. 47 cases in 45 consecutive patients had arthroscopic decompression for the subacromial impingement syndrome. 2. There were 31 males and 14 females and the mean age was 40 years for men and 46years for women. 3. The follow up duration was from 3 years 9 months to 1 year (average 2 years 1month). 4. Among 47 cases, 19 cases were found to have no cuff tear (stageII) 13 cases partial thickness cuff tear (stage IIIa) 10 cases complete tear on cuff less than 3 cm long (stage IIIb) and 5 cases complete tear on cuff more than 3 em in length (stage IIIc). 5. The arthroscopic subacromial decompression and rotator cuff debridement was a good treatment method in stage II and stage IIIa and stage IIIb. in the case of stage IIIc rotator cuff tear, it was useful for pain relief and improvement of shoulder function.

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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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Prognostic Factors for Arthroscopic Subacromial Decompression (관절경적 견봉하 감압술에 영향을 미치는 예후 인자)

  • Kim Sung-Jae;Shin Sang-Jin;Park Moon-Soo
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.93-98
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    • 1999
  • Purpose: The purpose of this study was to analyze the prognostic factors for arthroscopic subacromial decompres­sion and rotator cuff debridement in impingement syndrome. Materials and Methods : Arthroscopic subacromial decompression with or without rotator cuff debridement was performed in 46 cases of 44 consecutive patients with either stage n or stage ill impingement syndrome. The patients were classified by Neer's stage and size of tear according to the criteria of Cofield. The results were assessed with UCLA rating scale. We used repeated measures ANOVA and Chi-square test to assess correlation between the results and six variables including stage, rotator cuff tear size, age at the operation, duration of symptom, throwing sports activity, and trauma history. The follow-up period averaged 53 months(range, 27 to 92 months). Results: Lower stage by Neer's stage was correlated with higher postoperative scores and with significant difference between preoperative and postoperative scores of UCLA rating scale. However, other factors did not show significant influence upon the results. The patients with complete rotator cuff who showed satisfactory results after procedures were older and had shorter symptom duration, small cuff size. Conclusions : In patients with impingement syndrome treated by arthroscopic debridement and subacromial decompression, superior results were obtained when belonged to a lower Neer stage and when the rotator cuff was only partially tom. In cases with complete rotator cuff tear, higher success rates were obtained with smaller tear sizes. Age at operation, duration of symptoms, throwing athlete, traumatic tear did not affect the results.

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Debridement or Tuberoplasty for Massive Rotator Cuff Tear (광범위 회전근 개 파열에 대한 변연절제술 및 결절성형술)

  • Cho, Nam-Su;Oh, Hyun-Sup;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.146-152
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    • 2010
  • Purpose: The purpose of this article was to review the effectiveness of arthroscopic debridement and tuberoplasty, and to evaluate the clinical and radiologic results of our series for irreparable massive rotator cuff tears in the elderly. Materials and Methods: We reviewed articles that focused on the treatment options and decision making for irreparable massive rotator cuff tears. In particular, we summarized the reported results of arthroscopic debridement and tuberoplasty for irreparable massive rotator cuff tears in the elderly. Among consecutive patients who had arthroscopic tuberoplasty for irreparable massive rotator cuff tears in our series, thirty-two patients available for clinical and radiological evaluation at a mean follow-up of 29 months (range, 13-52 months) were enrolled and reviewed for the analysis. Results: At the last follow-up, the range of active forward flexion increased significantly with excellent pain relief and improvement in the ability to perform the activities of daily living. However, the group with less than 2 mm in preoperative acromiohumeral distance showed inferior postoperative results. Conclusion: Arthroscopic tuberoplasty may be an alternative option in irreparable massive rotator cuff tears for pain relief and improvement of range of motion. However, good results can not be expected if the acromiohumeral distance is less than 2 mm preoperatively and decreases postoperatively, or when the preoperative range of motion is less than $90^{\circ}$ on flexion and abduction.

Treatment of the Septic Shoulder after Arthroscopic Rotator Cuff Repair in Diabetes Mellitus - A Case Report - (당뇨병 환자에서 관절경적 회전근 개 봉합술 후 발생한 화농성 견관절염의 치료 - 증례 보고 -)

  • Park, Jae-Hyun;Choi, Won-Ki;Kim, Se-Sik;Choi, Chang-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.72-76
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    • 2009
  • Two diabetes mellitus patients treated by arthroscopy and associated procedure for an infection after arthroscopic rotator cuff repair were involved. The time interval from rotator cuff repair to symptom development was 18 days in average and arthroscopic debridement and associated procedure for infection applied in average 65 days after symptom development. Patient evaluation was done according to the KSS, ASES, UCLA and Constant Score. We used antibiotics for average 22.5 days after arthroscopic debridement and associated procedure, the infection was treated in average 4 months. At final follow-up, the mean KSS score was 82 points, the mean UCLA score was 33 points, the mean ASES score was 91 points, the mean Constant score was 71 points. All infections following arthroscopic rotator cuff repair were cured by arthroscopy and associated procedure. ROM and functional results were much improved, the pain and satisfaction were also much improved.

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