• Title/Summary/Keyword: Knee surgery

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Management of Multiple Ligament Injured Knee (슬관절 다발성 인대 손상의 치료)

  • Sim, Jae-Ang;Lee, Beom-Koo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.16-23
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    • 2013
  • Multiple ligament knee injury is defined as rupture to at least two of the four major knee ligament structures. Three or four knee ligament injury results in knee dislocation as complete disruption of the integrity of the tibiofemoral articulation. In multiple ligament knee injury, vascular and neurologic assessment should be performed meticulously and systematically. Emergency surgery should be needed if arterial injury is suspected. Surgical treatment rather than conservative management should be done and early surgery might be better than delayed surgery. Reconstruction of ACL and PCL, repair or reconstruction of MCL, and reconstruction of posterolateral corner are recommended, although many debates have occurred. Multiple ligament knee injury requires more aggressive management than single ligament knee injury.

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Intra-articular Synovial Hemangioma of the Knee - A Case Report - (슬관절의 관절내 활액막 혈관종 - 증례 보고 -)

  • Kim, Jin-Wan;Cho, Hyung-Lae;Ku, Jung-Hoei;Ko, Young-Chul;Hong, Seong-Hwak
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.91-94
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    • 2006
  • Synovial hemangioma of the knee joint has been reported as a rare cause of pain, limitation of motion and hemarthrosis, often seen as an internal derangement of the knee. A 39-year-old woman presented with spontaneous hemarthrosis of the left knee joint and physical exam revealed a small painful mass adjacent to the medial side of the patella. Magnetic resonance imaging revealed an intra-articular tumor. Arthroscopic excision was performed and the histology was characteristic of hemangioma. Through this case, we discuss the diagnosis and treatment options for the synovial hemangioma of the knee.

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Snow-Man Shaped Nodular Tenosynovitis in the Knee - Case Report - (슬관절내에 발생한 눈사람 형태의 결절성 건활액막염 - 증례보고 -)

  • Lee, Geon-Woo;Lee, Kun-Su;Song, Sang-Ho;Kim, Myeong-Ku;Yun, Sang-Hyeon
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.44-47
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    • 1999
  • The authors describe one case of a 25-year-old male with nodular tenosynovitis in left knee joint who did not have a history of joint trauma. He had joint pain and restricted flexion of the left knee at 100 degrees. After arthroscopic excision of mass, symptom was relieved completely and the patient had gained full range of motion of the left knee. No recurrence of symptom and loss of motion of the left knee were noticed during follow up period for 12 months.

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Before and After Cruciate Ligament Reconstruction Comparison of Isokinetic Muscle Strength for Knee Extensor Muscles (십자인대재건술 전과 후의 무릎신전근육에 대한 등속성 근력 비교)

  • Moon, Dal-joo;Kim, Jong-woo;Hwang, Byeong-jun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.2
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    • pp.37-43
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    • 2021
  • Background: The purpose of this study is to compare and analysis the changes in strength and endurance of the knee extensor muscles after Anterior cruciate ligament reconstruction. Methods: Twelve male subjects with ligament injury were seated on Biodex and the hip joint was flexed at 110°, and torso, lower extremities, and legs were fixed using Velcro. The resistance device was placed at a point 3cm above the ankle, and measurements were taken before and a surgery at 60°/sec and 180°/sec when the knee was maximally extended. The postures ingeniously combine forward-bending poses countered with backward-bending ones. Results: There was no significant difference in the comparison of muscle strength of 60°/sec and 180°/sec before surgery. But there was a significant difference after surgery. There was significant difference in muscle endurance both before and after surgery. There was a significant difference in the pre- and post- operative comparison values of muscle strength and endurance in isokinetic movements at 60°/sec and 180°/sec during knee extension on the injured side. Conclusion: For cruciate ligament tears, Orthopedic reconstruction is recommended. Correct alignment of the knee ligament after surgery can enhance the strength and endurance of the quadriceps femoris during knee extension rejuvenated.

Results of Anterior Cruciate Ligament Reconstruction with Unicondylar Arthroplasty for Medial Compartment Knee Osteoarthritis combined with Anterior Instability (전방 불안정성과 동반된 슬관절 내측 구획 진행성 관절염환자에서 전방십자인대 재건술 및 인공 관절 부분 치환술의 결과 - 3예 보고 -)

  • Lee, Chul Hyung;Song, In Soo;Ji, Jong Hun;Kim, Tae In
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.88-94
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    • 2013
  • Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

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Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes

  • Gerrard, Adam Daniel;Charalambous, Charalambos P.
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.356-363
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    • 2018
  • Purpose: A meta-analysis was performed to assess the outcomes following surgical intervention for medial knee plica. Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient-reported postoperative scores of "good" and "excellent". Meta-analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta-analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8-91.4). In those cases that had non-surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1-87). Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first-line treatment or when symptoms have not responded to non-surgical interventions. Level of Evidence: IV.

Soft Tissue Reconstruction Using Perforator Flap in Patients with Infected Knee Prosthesis

  • Lee, Jin Won;Kim, Sung Hoon;Yoo, Jun Ho;Roh, Si Gyun;Lee, Nae Ho;Yang, Kyoung Moo
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.70-75
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    • 2014
  • Purpose: Soft-tissue reconstruction in the knee area requires thin, pliable, and tough skin. The range of motion of the knee also acts as a limitation in using only local flaps for coverage. The author has successfully used various perforator flaps for soft tissue reconstruction around the knee while preserving its functional and cosmetic characteristics. Materials and Methods: Out of the twenty patients assessed from April 2009 to March 2011, seven received anterolateral thigh perforator flaps, four received medial sural perforator island flaps, four received lateral supragenicular perforaor perforator flaps, and five received medial genicular artery flaps. The age of the patients ranged from 44 to 79 and the size of the defects ranged from $4{\times}5cm$ to $17{\times}11cm$. Fifteen of the twenty patients had histories of total knee replacement (TKR) surgery. Results: There were no flap losses in any of the twenty patients assessed. Two patients showed partial losses in the distal area of the flap, but were treated through careful wound care. One patient presented with pedicle adhesion at the drainage site from a past TKR, but it did not hinder the flap survival. Primary closure at the donor site was possible in nine patients, while split skin graft was necessary for the other 13. Conclusion: In soft tissue reconstruction of the knee, various perforator flaps can be used depending on the condition of the preoperation scar, wound site, and size. It also proved to provide better functional and cosmetic results than in primary wound closure or skin grafts.

Total Knee Arthroplasty (슬관절 전 치환 성형술)

  • Lee, Dong-Chul;Sohn, Wook-Jin
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.1-11
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    • 2004
  • Total knee arthroplasty has become a common procedure for treatment of severe osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. In the past, failure of total knee arthroplasty was commonly attributable to aseptic loosening, often associated with component malalignment, soft tissue imbalance. With improved surgical instrumentation and soft tissue balancing techiniques, failure secondary to mechanical loosening has been minimal. But surgeons are still dissatisfied with implant malalignment. Correct tibiofemoral alignment seems to be particularly important since it is generally agreed that axial deviation and imprecise implantation may lead to loosening of the implant component. Navigation systems and robotic techniques could potentially solve problems of imprecision in traditional total knee arthroplasty. It is expected that the success rate and longevity of total knee arthroplasty will be improved during the twenty first century.

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Gait Study on the Normal and ACL Deficient Patients After Ligament Reconstruction Surgery Using Chaos Analysis Method (전방십자인대 재건수술 환자와 정상인의 보행 연구)

  • Ko Jae-Hun;Moon Byung-Young;Suh Jeung-Tak;Son Kwon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.30 no.4 s.247
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    • pp.435-441
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    • 2006
  • The anterior cruciate ligament(ACL) is an important stabilizer of knee joint. The ACL injury of knee is common and a serious ACL injury leads to ligament reconstruction surgery. Gait analysis is essential to identify knee condition of patients who display abnormal gait. The purpose of this study is to evaluate and classify knee condition of ACL deficient patients using a nonlinear dynamic method. The nonlinear method focuses on understanding how variations in the gait pattern change over time. The experiments were carried out for 17 subjects(l2 healthy subjects and five subjects with unilateral deficiency) walking on a motorized treadmill for 100 seconds. Three dimensional kinematics of the lower extremity were collected by using four cameras and KWON 3D motion analysis system. The largest Lyapunov exponent calculated from knee joint flexion-extension time series was used to quantify knee stability. The results revealed the difference between healthy subjects and patients. The deficient knee was significantly unstable compared with the contralateral knee. This study suggests an evaluation scheme of the severity of injury and the level of recovery. The proposed Lyapunov exponent can be used in rehabilitation and diagnosis of recoverable patients.

Pedicled Perforator Flaps for Reconstruction of Bilateral Knee Defects: A Case Report

  • Park, Joo Seok;Hong, Joon Pio;Oh, Tae Suk
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.101-104
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    • 2014
  • Reconstruction of soft tissue defects of the knee has always been a challenging task for plastic surgeons. Various reconstructive choices are available depending on the location, size, and depth of the defect relative to the knee joint. Defects on the knee joint have several characteristic features. The use of a free flap is preferred for reconstructions involving obliteration of large-cavity defects, but recipient pedicle isolation can be difficult because of the extent of the injury zone. Furthermore, the true defect during knee joint flexion is larger than during knee joint extension, and a durable flap is necessary for joint movement. We report for the first time on the use of pedicled perforator flaps for reconstruction of bilateral knee defects in a 76-year-old woman. The operative procedure required skeletonizing the perforators of an antero-lateral thigh flap and antero-medial thigh flap and rotating the flap in the defect. The patient returned to normal daily activity and had a full range of motion two months after the accident. The shorter operating time with decreased donor site morbidity and its durability make this flap a valuable alternative for soft tissue reconstruction of the knee.