Methods of Treatment for Improving Joint Motion After Synovectomy in Tb. Knee / 대한정형외과학회잡지

In the treatment of Tb.knee, the preservation of mobility is an important issue, there are many difficulties due to pain and swelling in the trial of early ROM exercise, and various problems such as the recurrence of Tb. lesions, delayed wound healing and draining sinus formation. We analysed 30 cases of Tb. knee treated with synovectomy during 10 years since March, 1979. In Group I (25 cases), early ROM exercise were started about 4 weeks after synovectomy. And in Group II (5 csses), arthroscopic adhesiolysis was performed after minimum 6 month immobilization and chemotherapy following synovectomy. We compared the two Groups and the results were as followings: 1. Male was 15 patients and female was 15 patients, the average age was 28.1 years. 2. The average follow-up period was 18.3 months. 3. In Group I, the ROM exercise was performed before 4 weeks in 9 cases and after 4 weeks in 16 cases postoperatively. The average final ROM was 68.9° 4. Draining sinus formation was in 4 cases in Group I. 5. In Group II, arthroscopic adhesiolysis was performed in 5 cases after synovectomy and chemotherapy for average 8.8 months ranging from 6 to 14 months. 6. The average final ROM at follow-up was 111° in Group II. 7. In a case with the severe involvement of bone and cartilage in Tb. lesion at the synovectomy, ROM was reduced gradually to 50° after arthroscopic adhesiolysis. We could gain ROM of 120° by TKR. 8. Draining sinus formation was not found in Group II.

Arthroscopic Adhesiolysis of Partial Knee Ankylosis / 대한정형외과학회잡지

Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.

A Comparative Study of Arthroscopic Meniscectomy and Open Meniscectomy: A Review of 143 Cases / 대한정형외과학회잡지

We performed the partial or total meniscestomy in 143 cases with the meniscal injury by the arthroscopy or arthrotomy during the period from May, 1978. to November, 1987. There were 89 cases treated with arthroscopic partial, 11 csses treated with arthroscopic total, 16 cases with open partisl and 27 cases with open total meniscectomy. We did not include the cases of the discoid meniscus in the study. The statistic analyses were as follow ;1. The ratio of male to female was 106 to 37, and right to left was 79 to 64. 2. There were 82 cases in medial meniscus, and 61 cases in lateral meniscus. 3. The most common chief complaint and physical finding was pain, tenderness & McMurray(+). 4. The average period of hospitalization were 5 days in arthroscopic and 20 days in open meniscectomy. 5. The most cornmon associsted injury was the ACL injury in 36 cases. 6. The most common site and type of tear was the longitudinal tear at posterior horn. 7. In the preoperative arthrogram, the diagnostic accuracy was 78.3%. 8. The satisfactory results were 79.2% in arthroscopic and 64.7% in open meniscectomy.