Arthroscopic treatment of chronic calcific tendinitis with intraosseous migration: a case report

Jung Uk Kim,Pei Wei Wang 대한견주관절학회 2024 대한견주관절의학회지 Vol.27 No.2

We present a case of calcific tendinitis in the shoulder, where calcifications were observed within both the tendon and the adjacent bone. At the time of acute onset, radiographs (including a plain radiograph) and magnetic resonance imaging revealed calcific tendinitis with intraosseous migration. The patient’s symptoms did not improve after 5 months of conservative treatment. The patient underwent arthroscopic debridement of the calcific deposits, and the defect was repaired using the double-row repair technique. The patient’s symptoms improved 3 months after arthroscopic treatment. We share our unusual experience with arthroscopic debridement in the treatment of chronic calcific tendinitis with intraosseous migration.

Arthroscopic Treatment of Femoroacetabular Impingement Syndrome: An Updated Review

Jung-Wee Park,Jung-Mo Hwang,Jeong Joon Yoo 대한정형외과학회 2024 Clinics in Orthopedic Surgery Vol.16 No.4

Treatment strategies for femoroacetabular impingement (FAI) syndrome have evolved in tandem with increased comprehension of FAI’s impact on hip joint health. Early intervention, including arthroscopic surgery, has gained popularity due to its potential to delay the progression of osteoarthritis. Arthroscopic surgery has demonstrated significant efficacy in treating FAI syndrome, with robust evidence from randomized controlled trials and systematic reviews supporting its use. Despite arthroscopic surgery’s success, complications and reoperations are not uncommon. The incidence ranges from 1% to 31% and 4% to 13%, respectively. Adjunctive biologic treatments, such as bone marrow aspirate concentrates and platelet-rich plasma, have shown promise in chondral lesion management. However, robust evidence supporting their routine use in FAI syndrome is currently lacking. Among conservative treatment methods, intra-articular injections offer diagnostic and therapeutic benefits for FAI patients. While they may provide pain relief and aid in prognosis, their long-term efficacy remains a subject of debate. Comparative studies between conservative and arthroscopic treatments highlight the importance of personalized approaches in managing FAI syndrome. In conclusion, recent advancements in FAI syndrome management have illuminated various treatment modalities. Arthroscopic surgery stands as a pivotal intervention, offering substantial benefits in pain relief, function, and quality of life. However, careful patient selection and postoperative monitoring are crucial for optimizing outcomes. Adjunctive biologics and intra-articular injections show promise but require further investigation. Tailoring treatment to individual patient characteristics remains paramount in optimizing FAI syndrome management.

고관절 비구순 파열의 관절경적 치료 : 2~7년 추시 결과 2 to 7 Year Follow Up

황득수,김영모,김경천,안성환 대한고관절학회 2004 Hip and Pelvis Vol.16 No.1

퇴행성 슬관절염의 관절경적 치료

성상철(Sang Cheol Seong),장진대(Jin Dae Jang),조현철(Hyun Chul Jo),유재호(Jae Ho Yoo),이명철(Myung Chul Lee) 대한슬관절학회 2001 대한슬관절학회지 Vol.13 No.1

Purpose: To evaluate the efficacy and the prognostic factors in arthroscopic treatment of degenerative arthritis of the knees Materials and Methods: The results of 115 knees in 110 patients had been treated arthroscopically from Jan. 1990 to June 1999 were analysed. Mean age was 56 years old and mean follow-up period was 1 years 9 months(range: 1 year-7 year). Pain, Range of motion, Lysholm score, and changes of subjective symptoms were assessed for clinical evaluation, Preoperative and postoperative X-rays of the knees and arthroscopic findings were also reviewed and statistical analysis was performed. We tried to find out the clinical results and prognostic factars in arthroscopic treatment of the degenerative arthritis. Results: The best clinical improvement was observed in postoperative 1-2 year period and the clinical improvement was continued by 3 years after surgery. Sixty two percents of patients had significant improvement of subjective symptoms for 1-2 year postoperatively, and 52% for at least 3 years after surgery. The patients of younger age, normal weight, normal alignment of lower leg(1°-7° degree of tibio-femoral angle) and shorter duration of preoperative symptoms showed better clinical results. Eighty percents of improvement of subjective symptoms has been obseved in the group of patient who had the mechanical symptoms preoperatively. In the knee with mild cartilage degeneration(according to Jack- sons classification, stage I or g ) and with torn meniscus showed better clinical improvement after surgery compared with those of severe cartilage degeneration or intact menisci. Conclusion: Arthroscopic treatment can be considered as a succesful treatment method for temperary relief of symptoms in the degenerative arthritis of knees. However, careful selection of patients looks mandatory for favorable results. The favorable prognostic factors in the study were younger age, no obesity, shorter duration of symptoms, nearly normal alignment of knees, less cartilage degeneration, mechanical symptoms, and torn meniscus.

견관절 전방 불안정에 대한 관절경적 최신 치료 경향

서재성 영남대학교 의과대학 2003 Yeungnam University Journal of Medicine Vol.20 No.1

In the past, the report of shoulder instability undergoing open shoulder stabilization had satisfactory outcomes of greater than 90%. However, the functional loss of open procedure is severe in abduction and external rotation especially. Current arthroscopic techniques for shoulder instability result in success rate equal to open surgical procedure when the labrum is properly fixed to the glenoid rim using suture anchors, the capsule is tightened, and associated bony and soft tissue pathology is addressed. The arthroscopic surgery facilitates the view within shoulder joint for more accurate diagnosis, reduces operating time, minimises postoperative pain, reduces operative morbidity, improves shoulder function, and provides the possibility to perform other procedure simultaneously. However, to accomplish a successful arthroscopic stabilization procedure and to prevent complications, numerous advanced arthroscopic skill must be mastered. Although the arthroscope provides means to visualize new lesions, the pathomechanism and biomechanical explanation is not clear yet. Further studies are necessary to develop for shoulder reconstruction.

견인강선을 이용한 경골극 견열 골절의 관절경적 치료

김현곤,김성재,한명훈,강용호,정환용,Kim, Hyun Kon,Kim, Sung Jae,Hahn, Myung Hoon,Kang, Yong Ho,Jung, Hwan Yong 대한관절경학회 1998 대한관절경학회지 Vol.2 No.1

Recently, a variety of arthroscopic techniques have been reported for the treatment of the displaced tibial eminence fracture. The purpose of this study was to describe details of arthroscopic technique using pull-out wire and to evaluate the results. Eleven patients with irreducible type II and type III tibial eminence fractures underwent the arthroscopic reduction and internal fixation using double strand pull-out wiring. The anterior cruciate ligament tibial drill guide was utilized for the reduction of fracture and passage of the guide pins. The tibial eminence fracture was firmly fixed with double strand 26-gauge pull-out wire(0.45mm diameter). Fracture union was achieved at 7.2 weeks (range, six to eight weeks) after operation. All cases were united at the last follow-up. Subjectively, nine patients had no pain and no restriction of daily activities. Two patients with combined injuries had limitation of knee motion(10 to 130 degrees, respectively) and one patient showed mild anterior laxity. Early rehabilitation was enabled without loss of reduction and breakage of pull-out wire. The arthroscopic reduction and internal fixation using pull-out wire showed good results including early rehabilitation, early fracture union, minimal morbidity, and no requirement of the second operation for hard ware removal.

Cam형 대퇴비구 충돌의 관절경적 치료: 단기 추시 결과

장세앙 ( Se Ang Jang ),조영호 ( Young Ho Cho ),변영수 ( Young Soo Byun ),박기홍 ( Ki Hong Park ),김한상 ( Han Sang Kim ),정정철 ( Chul Jung ) 대한고관절학회 2014 Hip and Pelvis Vol.26 No.1

목적: 증상이 있는 cam형 대퇴비구 충돌에 대해 관절경으로 치료한 환자들의 단기 추시 결과를 알아보고자 하였다. 대상 및 방법: 2010년 11월부터 2012년 12월까지 고관절 동통을 동반한 cam형 대퇴비구 충돌 중 보존적 치료에 실패하여 관절경 치료 후 최소 12개월 이상 추시 관찰된 환자들에 대해 임상적 및 방사선적 결과를 알아보고자 하였다. 남자는 19명, 여자는 6명, 평균 연령은 32.9세(19-57세), 평균 추시 기간은 17.2개월(13-31개월)이었다. 알파 각, offset, 변형된 Harris 고관절 점수 및 visual analogue scale (VAS)을 조사하였다. 결과: 알파 각은 평균 64.8°에서 39.9°, offset은 평균 0.8 mm에서 7.6 mm로 호전되었다. 비구순 파열은 전상방 구획에서 변연부 종파열 및 방사형 소섬유성 파열이 가장 많았다. 비구 연골 손상은 14예에서 확인되었다. VAS는 술 전 평균 6.3에서 0.9로, 변형된 Harris 고관절 점수는 51.7에서 73.6으로 호전되었다. 수술과 관련된 합병증으로 관절경 삽입 시 발생한 대퇴골 두 연골 손상이 3예, 회음부 신경 손상이 2예, 외측 대퇴피 신경 손상이 2예였다. 결론: 관절경을 이용한 cam형 대퇴 비구충돌의 단기 추시 결과는 만족할 만하였으나, 관절경 술식과 관련된 합병증을 줄이기 위해 좀 더 세심한 주의를 필요로 하며, 관절염 발생을 줄일 수 있는지에 대한 장기적인 연구가 필요하리라 생각된다. Purpose: We evaluated the short term results after treatment of cam type femoroacetabular impingement (FAI) by arthroscopy. Materials and Methods: We evaluated the clinical and radiological results of arthroscopic ally treated cam type FAI in patients who had failed conservative treatment with hip pain, with at least 12 months follow-up, from November 2010 to December 2012. There were 19 males and six females. Mean age of patients was 32.9 years (19-57 years) and mean follow up period was 17.2 months (13-31 months). We analyzed the alpha angle, head neck offset, visual analogue scale (VAS), and modified Harris hip score (MHHS). Results: Mean alpha angle improved from 64.8。to 39.9。and mean head neck offset also improved from 0.8 to 7.6 mm. Peripheral longitudinal and radial fibrillated labral tear was the most common in the anterosuperior quadrant. Damage to ace tabular cartilage was identified in 14 patients. Mean VAS improved from 6.3 to 0.9 and mean MHHS improved from 51.7 to 73.6. Complications associated with the operation included three cases of femoral head articular cartilage injury, two cases of pudendal nerve injury, and two cases of lateral femoral cutaneous nerve injury. Conclusion: Although the short term results for arthroscopic ally treated cam type FAI were satisfactory, care must be taken to reduce the complications associated with arthroscopy and long term follow is needed in order to determine whether or not it can reduce osteoarthritis of the hip.

Case Reports : Arthroscopic Treatment of Subchondral Bony Cyst in Early Osteoarthritis of the Hip Joint Using Allogeneic Bone Graft: A Report of Two Cases

( Gi Soo Lee ),( Deuk Soo Hwang ),( Chan Kang ),( Jung Bum Lee ),( Chang Kyun Noh ) 대한고관절학회 2015 Hip and Pelvis Vol.27 No.2

Subchondral bony cyst, large solitary or multiple cysts in acetabular dome usually exacerbate progression to degenerative osteoarthritis in the hip joint. But it can be treated through arthroscopic intervention. We report two cases that treated by arthroscopic curettage and bone graft for subchondral bony cysts in early osteoarthritis of the hip joint, and it may delay progression to moderate osteoarthritis.

감염성 슬관절염의 관절경적 치료 이후 예후 인자에 대한 분석

강상우(Sang-Woo Kang),최의성(Eui-Sung Choi),김동수(Dong-Soo Kim),정호승(Ho-Seung Jung),홍석현(Seok-Hyun Hong),고반석(Ban-Suk Go) 대한정형외과학회 2019 대한정형외과학회지 Vol.54 No.1

목적: 관절경적 수술을 시행받은 감염성 슬관절염 환자들에서 성별, 나이, 기저질환, 증상 발생 후 수술까지 걸린 기간, 발병 전 침습적 시술의 시행 여부, 관절 천자액의 세균 배양, Gächter 분류를 통한 세균 감염의 정도가 치료 예후에 미치는 영향에 대해 알아보고자 한다. 대상 및 방법: 2014년 6월부터 2016년 12월까지 감염성 슬관절염으로 관절경적 수술을 시행받은 51명의 환자를 대상으로 하였으며, 평균 추시 기간은 14.2±2.1개월(12-20개월)이었다. 남자가 27명(52.9%), 여자가 24명(47.1%)이며, 평균 나이는 55.1±17.6세(13-84세)였다. 수술 전 시행한 관절 천자검사상 백혈구 수가 50,000개 이상, 다형핵 백혈구 수의 비율이 95% 이상인 환자를 감염성 슬관절염으로 진단하고 수술을 시행하였다. 모든 환자에서 관절경적 수술과 수술 후 지속적인 관절 세척을 시행하였다. 결과: C-반응 단백의 초기 평균 수치는 9.55±6.76 mg/dl (1.51-31.06 mg/dl)에서 최종 평균 수치는 0.74±1.26 mg/dl (0.08-6.77 mg/dl)로 감소하였으며, 평균 C-반응 단백의 정상화 기간은 27.6±18.9일(8-93일)이었다. 관절경적 수술과 항생제 사용 후 발열, 동통, 부종 등의 임상증상이 호전되고 C-반응 단백의 수치가 0.5 mg/dl 이하로 감소하여 감염성 슬관절염의 완치 판정을 받은 환자는 51예 중 44예(86.3%)이며, 최종적으로 두 번 이상의 관절경적 수술을 시행한 환자가 5예, prosthesis of antibiotic-loaded acrylic cement 후 인공관절 치환술로 전환한 환자가 2예이다. 결론: 지금까지 문헌들에서 알려진 것처럼 증상 발생 후 수술까지 걸린 기간과 Gächter 분류에 따른 병기는 감염성 슬관절염의 치료 성공 여부에 유의하게 영향을 주었다. 하지만 이외의 인자들은 통계적으로 유의한 상관관계가 없었다. 단 관절 천자액에서 세균이 배양된 환자군은 대조군보다 유의하게 C-반응 단백의 정상화 기간이 짧아 치료 기간을 반영하는 것으로 보인다. Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gächter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.

Arthroscopic Treatment of Lateral Discoid Meniscus in the Knee

Sohn,Sung Won,Kim,Dong Geun 啓明大學校 醫科大學 1995 계명의대학술지 Vol.14 No.3

최근에 원판형 연골의 치료에 있어, 관절경적 수술이 많이 이용되고 있으나, 좁은 슬관절 내 공간으로 인해 기술적으로 어려운 단점이 있다. 이 연구의 목적은 원형판 연골의 임상적 특징과 추시관찰에 따른 효과적 치료방법의 연구에 있다. 1989년에서 1993년까지 본원에서 관절경으로 확진된 35례의 슬관절 원판형 연골을 대상으로 하였다. 경한 증상을 가지고 있거나 손상이 없었던 4례에서는 특별한 시술없이 그대로 두었고, 후방부착에 안정성이 있는 종파열, 횡파열 등이 12례에서는 관절경적 부분 절제술을 시도하였으며, 나머지 예에서는 관절경적 또는 반관절경적 전절제술을 시도하였다. 평균 30개월의 추시관찰 결과는 관절경적 전절제술과 반관절경적 전절제술의 결과에 큰 차이가 없었으며, 전절제술과 부분절제술 사이에도 큰 차이가 없었다.Ikeuchi의 grading에 따라 30%에서 우수, 46.7%에서 양호, 23.3%에서 보통의 결과를 얻었으며, 불량의 결과는 없었다. 만족치 못한 결과는 동반손상이 있는 경우가 많았다.