Biomedical subjects
Publications and source records attributed to Sung-Jae Kim.
We present a case of synovial chondromatosis originating from the quadriceps tendon sheath, which caused a complete quadriceps tendon rupture. The patient was treated using marginal excision. The ruptured quadriceps tendon was repaired. This is the first description of a quadriceps tendon rupture associated with synovial chondromatosis.
Arthroscopy of the stiff elbow joint is a technically difficult procedure because of the decreased joint space of the elbow joint, even to experienced surgeons. Problems encountered include limited access of instrument to the intra-articular space and an increased risk of cartilage injury in the contracted elbow joint. This study describes a novel transarticular approach for elbow arthroscopy that allows the safe and effective creation of the proximal medial and lateral portals.
The cyclops lesion at the tibial attachment of the reconstructed ligament has been known to cause loss of knee extension. We present a case of knee extension loss because of a cyclops lesion caused by Kennedy ligament augmentation device synovitis at 10 years after ACL reconstruction in a 33-year-old man.
Arthroscopic debridement and drainage was done in 10 patients with septic arthritis of the hip. Staphylococcus aureus was the most commonly identified organism. All patients were placed in the supine position on a fracture table and three arthroscopic portals were used during the procedure. No major complication related to the arthroscopy of the hip resulted. The average followup was 4 years 11 months. All patients had excellent results.
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The purpose of this article is to present the suitable location of portals during knee arthroscopy in various situations. It includes universal portal, meniscal lesions, discoid meniscus, 1-incision technique of posterior and of anterior cruciate ligament reconstructions, stiff knee, transseptal posterior portal, and far midpatellar portal. These specific descriptions in each situation are drawn from the accumulated experience of more than 4,000 cases of arthroscopy. Our philosophy on the positioning of knee portals can be emphasized from 2 perspectives: first, the location of portals should flexibly suit the surgeon's need rather than a fixed location; second, the higher the portal position is in knee arthroscopy, the wider view it generally provides inside the joint.
The fenestra type of infrapatellar plica was noted arthroscopically in a 57-year-old patient with flexion contracture of the knee. It was found to be thickened and fibrotic and to have lost its normal elasticity. The pathologic plica was impinged at the intercondylar notch and trochlea, blocking further extension beyond 25 degrees of knee flexion. After excising the plica, the knee gained a further extension of 17 degrees; however, full extension could not be obtained. The knee gained full extension after notchplasty on the roof at 2 months postoperatively. This is the first report of a pathological infrapatellar plica in an older patient.
PURPOSE: This study compared the clinical results of modified biceps femoris tenodesis with posterolateral rotatory instability (PLRI) injuries and PLRI combined with PCL injuries. TYPE OF STUDY: Case series. METHODS: Of 46 patients treated for PLRI, 21 had isolated PLRI (group 1), and 25 had PLRI with PCL injuries (group 2). The most common cause of injury was motor vehicle accident. The PCL was reconstructed using an arthroscopic 1-incision technique. The advantages of the modified Clancy technique include fixation of the biceps tendon to the isometric position and reduced surgical damage to the iliotibial band by dissection to the lateral femoral epicondyle through the interval between the iliotibial band and biceps muscle. RESULTS: All knees tested positive in the preoperative reverse pivot shift test, and 43 patients (93%) tested negative postoperatively. The side-to-side difference of an average external rotation thigh-foot angle (ERTFA) at both 30 degrees and 90 degrees of knee flexion was 15 degrees and 11 degrees in group 1 and 21 degrees and 26 degrees in group 2 preoperatively. Postoperative ERTFA tested at 30 degrees and 90 degrees of knee flexion were 10 degrees less than the uninvolved knee in both groups. At a mean follow-up of 40.3 months, the postoperative Lysholm knee score was 93.6 in group 1 and 90.4 in group 2. The postoperative HSS mean value was 91.1 in group 1 and 87.9 in group 2. A correction loss of more than 5 degrees was found in 3 patients of group 1 and in 5 patients of group 2 at an average 12 months after surgery. In 5 of 8 patients, severe scar tissues were found at the insertion site of the biceps tendon to the fibula during surgery. These tissues were associated with damage of the involved structures at the time of injury. CONCLUSIONS: Based on our experience, we recommend the modified biceps tenodesis for the reconstruction of both PLRI injuries and PLRI combined with PCL injuries except in patients with severe damage at the attachment site of the biceps tendon.