• Title/Summary/Keyword: Knee surgery

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Histopathological Study of Cartilage in the Bone Bruise of the Lateral Femoral Condyle Associated with Anterior Cruciate Ligament Rupture (전방 십자 인대 파열시 손상된 대퇴골 외과 연골의 병리조직학적 연구)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;Kim, Hee-Seon
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.154-161
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    • 2005
  • Purpose: to describe the histologic appearance of the type III bone bruise in knees which had sustained an acute anterior cruciate ligament (ACL) rupture. Materials and Method: Twenty-five patients who sustained acute ACL rupture were prospectively enrolled in this study. On MRI, 14 patients demonstrated type III bone bruise on lateral femoral condyle, and 11 patients didn't demonstrated bone bruise. Arthroscopic evaluation and biopsy of the articular cartilage and subchondral bone wert performed before ACL reconstruction. Histologic and immunohistochemical evaluations were done. Results: There was no difference between the bone bruise and control group in the hematoxylin-eosin staining for cell distribution, Masson's trichrome staining for collagen and immunohistochemical staining for type I and type II collagen (p>0.05). But in the safranin-O staining for glycosaminoglycan distribution, the bone bruise group had an evidence of decreased staining at the superficial and middle layers, compared with the control group (p<0.05). We also found fatty change of bone marrow in calcified zone of the bone bruise group with safranin-O staining. Conclusion: We suggest that the type III bone bruise found on MRI indicates a substantial damage to normal articular cartilage homeostasis, and may induce further damage of the articular cartilage.

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Arthroscopic Repair for the Acute Anterior Cruciate Ligament Tears (급성 전방 십자 인대 파열의 관절경적 봉합술)

  • Choi, Chong-Hyuk;Yoon, Han-Kook;Kim, Hyung-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.137-142
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    • 2005
  • Purpose: The purpose of this study is to evaluate the results of arthroscopic anterior cruciate ligament(ACL) repair with minimal incision and to review prognostic factors according to ACL tear patterns and the presence of associated injury Materials and Methods: Thirty eight patients (thirty nine knees) with acute ACL tear were given arthroscopic ACL repair between January 2001 and December 2002 and were followed up at least over six months. Intraoperative findings such as ACL tear pattern and the presence of synovial or concomitant medial collateral ligament injuries were recorded. Each knee was then postoperatively re-evaluated with aid of KT-1000 arthrometer and Lachman test and Lysholm score. Results: Postoperative limitation of motion was significant when combined typed ACL tear was present with concurrent medial collateral ligament(MCL) injury. In contrast, in the case where there were sole proximal ACL tear or no evidence of synovial injury, the limitation of motion was not significant. Anterior laxity was significantly associated with the presence of combined typed ACL tear or concurrent synovial injury, but was not significant when there were sole proximal ACL tear. Conclusion: In the case where there is sole proximal ACL tear without concurrent synovial injury, arthroscopic ACL repair can be considered as a treatment modality for the treatment of acute ACL injury.

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Bony Contusion of the Knees with Isolated Traumatic Meniscal Tears (외상성 반월상 연골 단독 손상에서 골타박)

  • Kim, Kyung-Chul;Lee, Ho-Jin;Koo, Bon-Seop
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.9-13
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    • 2004
  • Purpose: We studied the incidence rate and patterns of bony contusions of the knees with isolated traumatic meniscal tears. Materials and Methods: We analyzed retrospectively MRI scans and medical records of forty-two patients(42 knees) which had undergone operations for isolated traumatic meniscal tears. Mean age, 33.7 years, the number of patients with lateral, medial or both meniscal tears were 19, 18 and 5, respectively. Bony contusions were examined according to incidence, Location, and in relation to the types of meniscal tears. Results: Bony contusion was identified in 5 cases (11.9%) which had medial meniscal tear (4 cases0 or both meniscal tear (1 case). It was always located on the medial compartment of the joint. Bony contusion was found in the knee with various type of traumatic meniscal tears. Conclusion: Bony contusions in thd knees with isolated traumatic meniscal tear have very low incidence and they seem to disappear at or less than 12 months after the trauma. The bony contusions are mainly related to medial meniscal tear and located in the medial compartment of the joint.

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Osteosarcoma in an 8 Month-Old Infant treated with Limb Sparing Operation (8개월된 유아 골육종 환자에서의 사지 보존술)

  • Kim, Jae-Do;Kwon, Young-Ho;Kang, Myung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.100-104
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    • 2005
  • Osteosarcoma is the most common tumor in malignant bone tumors. The peak age incidence in osteosarcoma is between 10 to 14 years of age. This tumor rarely develops under 6 years of age and the youngest patient in the previous literature was a 13 months old girl who had an osteosarcoma involving the second metacarpal bone. We report a case of an 8 month old male infant, who had an osteosarcoma involving the right proximal tibia. This patient was treated by wide excision with transepiphyseal resection and reconstruction with allograft. At 20 months after operation, the varus deformity was developed at the proximal junctional site of allograft. Thereafter, the revision was performed with correction of deformity and augmentation with the proximal fibula transfer. At 51 months after operation, he has been remained as free of disease, and he has recovered the knee motion ranged from 15 degree to 75 degree. The osteosarcoma in infant is very rare but it should be considered the osteosarcoma in the differential diagnosis of any bone lesion. Instead of amputation, the limb sparing operation and the solutions for limb length inequility in growing period should be carefully considered in the infantile osteosarcoma.

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The Effect of Long Chain n-3 Polyunsaturated Fatty Acids on Development of Collagen-induced Arthritis in Rats (흰쥐에서 다족쇄 n-3 다불포화지방산이 콜라젠-유도 관절염의 발생에 미치는 영향)

  • Shin, Kyung-Ho;Kim, Se-Dong;Jeon, Hwan-Jin;Jang, Eung-Chan;Lee, Suck-Kang
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.39-48
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    • 2002
  • Background: The treatment of rheumatoid arthritis still depend on conserve therapy in major. Recent studies report that n-3 polyunsaturated fatty acids(PUFA) could modulate the incidence and progress of arthritis. The purpose of this study was to investigate the effects of n-3 PUFA on the development of collagen-induced arthritis in rats. Materials and Methods: Female Louvain rats were used for this experiment. Rats were randomly assigned into either normal (n=8) or collagen-immunized groups, and collagen immunized groups were divided into control(n=8, normal diet) and n-3 PUFA(n=8, 5% n-3 PUFA in diet) groups. One week after feeding n-3 PUFA to rats, they were immunized with type II collagen emulsified in incomplete Freund's adjuvant into tail and back. Development of arthritis was confirmed by x-ray and microscopic examination. Results: Incidence of arthritis at the 5th week after immunization was 38% in control and 0% in n-3 PUFA. Rats with arthritis showed edema in hind paws and inflammation in synovial membrane of the knee joint. Plasma glucose and insulin were not changed by both of immunization and diet. Plasma triglycerides and cholesterol concentrations were decreased by n-3 PUFA. Conclusion: n-3 PUFA may prevent or treat collagen-induced arthritis m rats. Further studies are needed for action mechanism of it.

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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 Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.70-76
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    • 2005
  • Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

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All-Inside Meniscal Repair Using FasT-Fix (FasT-Fix를 이용한 All-Inside 반월연골판 봉합술)

  • Jung, Yu-Hun;Choi, Nam-Hong;Kim, Byeong-Yeon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.24-28
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    • 2013
  • Purpose: All-inside meniscal repair using FasT-Fix (Smith & Nephew Endoscopy, Andover, Massachusetts, USA) is a popular method for the meniscal tear. However, there was no report after all-inside repair using FasT-Fix for the meniscal tear in Korea. Therefore, the purpose of this retrospective study was to report clinical outcomes after all-inside meniscal repair using FasT-Fix. Materials and Methods: 25 consecutive patients underwent meniscal repairs using FasT-Fix for tears of the posterior horn of the medial or lateral menisci combined with hamstring anterior cruciate ligament (ACL) reconstructions. Postoperative evaluations included Lysholm knee score and Tegner activity scale. Using clinical criteria, a repaired meniscus was considered healed if there was no effusion or joint line tenderness, negative McMurray test, and no sense of giving way. Results: The average follow-up was 47.9 months (range, 40 to 61 months). At follow-up, the mean Lysholm score was 91.8 and the mean Tegner activity scale was 5.6. According to clinical criteria, 20 (80%) menisci was healed, and 5 (20%) failed. Conclusion: All-inside meniscal repair using FasT-Fix showed satisfactory results in patients with hamstring ACL reconstructions.

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Operative Treatment of Tibial Plateau Fractures (경골과 골절의 수술적 치료 결과)

  • Shin, Duck-Seop;Seong, Byeong-Yeon;Kim, Dong-Won
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.187-198
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    • 2001
  • Background: The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures. Materials and Methods: The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment. Results: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. Conclusion: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.

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Resection and Reconstruction for Liposarcoma Involving Popliteal Fossa and Antero-lateral Compartment of Lower Leg - A Case Report - (하퇴 슬와부 및 전외측 구획을 침범한 지방육종 환자의 절제 및 재건술 - 증례보고 -)

  • Won, Ho-Hyun;Hong, Youn-Seok;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.69-74
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    • 2009
  • Soft tissue sarcomas of popliteal fossa are rare, accounting for less than 5% of all soft tissue sarcomas of the extremities. In an extracompartmental space such as the popliteal, cubital fossa and inguinal space, where major vessels and nerves traverse, performing resections with wide margin is difficult and sometimes marginal margin is inevitable for limb salvage. For popliteal tumor resection, posterior approach would be a classic method. For tumors with small size and not adherent to surrounding structures, tumor is easily resected by this approach and dissection of nerve sheath or adventitia of vessel. On the contrary, tumors of large size and infiltrating the posterior structure of knee joint may show difficulty in en-bloc resection itself. These cases were candidates for amputation. Furthermore, tumors involving both popliteal fossa and anterior compartment usually had no choice but to have an amputation to prevent local recurrence. We regarded soft tissue sarcoma showing this kind of presentation as bone tumor having extraosseous mass. We performed wide en-bloc resection of proximal tibia and fibula along with sarcoma involving both compartment on liposarcoma of 47-year old man.

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