Recurred Multiple Intraarticular Synovial Hemangioma of the Knee: Case Report / 대한정형외과연구학회지

Synovial hemangioma is a rare benign intraarticular tumor. Synovial hemangioma of the knee joint has unspecific symptoms, which are pain, limitation of motion and hemarthrosis, often seen as an internal derangement of the knee. A 24-year-old woman presented with intermittent joint effusion and pain of the left knee joint and physical examination revealed slight atrophy of the quadriceps and tenderness around lateral joint line of knee. The patient was performed arthroscopic surgery due to synovial hemangioma about 17-years ago. Magnetic resonance imaging (MRI) showed the synovial hemangioma from Hoffa fat pad to anterior aspect of lateral meniscus, and thus surgical treatment was planned. Arthroscopic excision was performed and additional lesion was observed in lateral gutter, suprapatellar pouch of the knee. The biopsy confirmed the diagnosis of synovial hemangiomas. After 3 year, the patient was completely asymptomatic and showed no signs of recurrence.

Arthroscopic Fragment Excision of Pipkin Type I Displaced Femoral Head Fracture: A Case Report / 대한고관절학회지

There has been a variety of options for treatment of femoral head fracture with hip dislocation according to the Pipkin classification. Pipkin type I fractures with minimal displacement have been treated conservatively. However, in cases where the fracture was displaced or reduced incongruently, it has been treated by open fragment excision or fixation after reduction. In our case, the patient was a 62-year-old man who sustained a displaced fracture of Pipkin type I. We achieved a satisfactory outcome by arthroscopic excision of a displaced bony fragment and small bony fragments that could not be confirmed by pre-operative imaging study. Therefore, we report on the case with a review of the literature.

Symptomatic Posterior Cruciate Ganglion Cyst Causing Impingement between Posterior Root of the Medial Meniscus and Anterior to the Posterior Cruciate Ligament

There are several reports of symptomatic ganglion cysts near the posterior cruciate ligament (PCL), but no reports of a symptomatic ganglion originating from the anterior aspect of the PCL in the deep recess between the posterior root of the medial meniscus and the PCL, bulging into the posteromedial joint space. In this report, we present the clinical features of a patient with a symptomatic ganglion cyst treated successfully by arthroscopic excision.

A Case of Arthroscopic Excision of Synovial Hemangioma with Dual Coagulation Shaver

A 17-year-old male patient visited our hospital with a palpable mass on the lateral aspect of the knee joint of five years duration without any related trauma history. The patient felt tenderness around the mass and had limitations in doing flexion exercises. Magnetic resonance imaging of the knee suggested the possibility of synovial hemangioma, and thus surgical treatment was planned. A tumor within the knee joint was found by arthroscopy, and a resection was carried out by dual coagulation shaver. The biopsy confirmed the diagnosis of a synovial hemangiomas. The patient presented months later at the out-patient clinic with no evidence of recurrence.

A Case of Localized Tenosynovial Giant Cell Tumor in the Infrapatellar Fat Pad of the Knee

Localized giant cell tumor of the tendon sheath (GCTTS) usually occurs in extensor an tendon sheath of the fingers and toes. It has rarely been observed in the fat pad of the knee joint. We treated a case of a 2.5x3x4 cm mass arising from the infrapatellar fat pad, which presented with extension limitation and knee pain due to lateral femorotibial joint impingement. The tumor was successfully treated using arthroscopic excision with a motorized shaver. Histologic findings were diagnosed as localized GCTTS. Herein we report this case with a literature review.

A Case of Synovial Hemangioma of the Knee

We report an unusual case of a 17-years-old male with complaints of pain and swelling of the left knee for the last 3 years with limitation of movement. He presented with spontaneous hemarthrosis of the knee joint. Magnetic resonance imaging revealed an intra articular mass. Arthroscopic excision was performed and the histology was characteristic of synovial hemangioma. After 1 year, the patient was completely asymptomatic and showed no signs of recurrence.

Arthroscopic Resection of the Chondroma in the Supraspinatus of the Shoulder / 대한정형외과학회잡지

Soft-tissue chondroma is rare a benign soft-tissue tumor that occurs mainly in hands and feet. There have been no reports of a chondroma in the supraspinatus tendon. We describe the clinical, histological and radiological features of the intratendinous chondroma of the supraspinatus occurring in a 30-year-old man who was managed arthroscopically and a review of the relevant literature review.

Synovial Impingement after Total Knee Replacement Arthroplasty: A Case Report

A thickened soft tissue impingement after total knee replacement arthroplastyis a complication that causes pain and is usually developed between patella and femoral component such as patellar clunk syndrome. But we experienced a case that medial and lateral synovial tissues were impinged between femoral component and polyethylene liner after total knee replacement arthroplasty with medial pivot prosthesis for degenerative arthritis and were treated with arthroscopic excision. We report this case with literature review.

Treatment of Os Trigonum Syndrome using Subtalar Arthroscopy: A Case Report / 대한족부족관절학회지

Os trigonum syndrome is a clinical disorder characterized by posterior ankle pain which occurs in excessive plantar flexion. The pain is elicited by the impingement of os trigonum between the calcaneus and the posterior edge of tibial plafond. Mostly, symptoms can be improved with nonsurgical management, however surgery is required for refractory cases. We report of a case of os trigonum syndrome in a female ballet dancer, which was successfully treated with subtalar arthroscopic excision of os trigonum.

Caso clínico: resección artroscópica de osteoma osteoide de cuello del talo / Arthoscopic excision of an osteoid osteoma at the talar neck

The case of a 17-year-old boy with osteoidosteoma of the talar neck with a 2-year history of persistent ankle pain is presented. The diagnosis was made on the basis of clinical appearance, radiography, CT scan, technetium-99m scintigraphy, and magnetic resonance imaging findings. He underwent arthroscopic excision of the lesion using a motorized trefina and radiofrequency ablation. The pathological study of the arthroscopic excision confirm the preoperative diagnosis. He ad no recurrence during a follow-up period of 24 months. We concluded that the arthroscopic excision of an osteoid osteoma on the talar neck is an appropriate surgical intervention and an excellent therapeutical choice.

Se presenta el caso de un paciente de 17 años con un osteoma osteoide del cuello del talo que presentaba una historia de dolor persistente de tobillo de 2 años de evolución. El diagnóstico se realizó en base a la historia clínica y a los hallazgos imagenológicos en radiografía, TAC, cintigrama óseo (tecnecio-99) y resonancia magnética. Se realizó un abordaje artroscópico de la lesión, siendo resecada en forma completa con trefina motorizada y ablación por radiofrecuencia en los bordes del lecho óseo. El resultado anatomopatológico confirmó el diagnóstico preoperatorio. La evolución del paciente ha sido satisfactoria a 24 meses de seguimiento. Concluimos que la resección artroscópica de un osteoma osteoide de cuello de talo es un procedimiento recomendable y una excelente alternativa terapéutica.

Analysis of Associsted Intra-articular Lesions in Popliteal Cyst under Arthroscope in Adults

PURPOSE: The authors tried to analyze the distribution of associated intra-articular lesions using the arthroscope in excision of popliteal cyst observed in adults. MATERIALS AND METHODS: The authors examined intra-articular lesions identified by arthroscopic examination on 113 adult patients(117 cases) who were diagnosed as having popliteal cyst that didn't respond to the conservative treatment. And for the operation, intra-articular examination using arthroscope was performed in supine position and the authors performed one-stage excision of cyst without position change of patients. RESULTS: In 104 cases(88.9%) of total 117 cases, combined intra-articular lesions were identified, Among these, most cases were 72 cases(69.2%) of degenerative chondral lesion and 31 cases(29.8%) of meniscus tear. Communication between cyst and joint was observed in 63 cases(53.8%). There was neither postoperative complication nor recurrence of cyst during out-patient follow-up periods. CONCLUSIONs: In cases of adult patient who have popliteal cyst that doesn't respond to the conservative treatment, possible associated intra-articular lesions should be considered., and arthroscopic examination and proper treatment far those associated lesions are thought to lower the recurrence rate.

Ganglion around the Cruciate Ligament in the Knee / 대한정형외과학회잡지

PURPOSE: To evaluate clinical diagnosis, treatment and results of the intraarticular ganglion of the knee joint. MATERIALS AND METHODS: From April 1996 to May 1999, nine patients were taken arthroscopic excision of the intraarticular ganglion. Diagnosis was based on history, thorough physical examination and MRI and confirmed by biopsy. RESULTS: As seen in the internal derangement of the knee, symptoms of the intraarticular ganglion were varied from asymptom to pain, effusion and limitation of motion. After arthroscopic excision, eight of nine patients were improved satisfactorily. CONCLUSION: The diagnostic rate of the intraarticular ganglion in the knee would be increased after the introduction of MRI and the results would be improved using arthroscopy. In the case of chronic nonspecific knee pain and limitation of motion, the possibility of the intraarticular ganglion might be considered.

Arthroscopic Excision of the Complete Type of Suprapatellar Plica

The suprapatellar plica is a remnant of the embryonic septum separating the suprapatellar pouch from the knee joint. Complete type of suprapatellar plica is rarely reported and its clinlical significance is controversial. The purpose of this study is to verify the complete type of suprapatellar plica as an important cause of anterior knee pain and to evaluate the clinical results after arthroscopic excisien of it. From September 1991 to April 1997, we studied prospectively 54 patients, 90 knees which were diagnosed as cornplete type of suprapatellar plica preoperatively. The mean age was 32 years (15-57 years) and sex distribution was 14 males and 40 females. For the preoperative diagnosis, we checked clinical symptom, past history, physical finding and plain X-ray routinely and performed bone scan, double contrast arthrogram and MRI, if necessary. All patients complained vague anterior knee pain at standing, sitting, stair climbing and exercise for long times. All 90 knees were examined arthroscopically. Among them, 80 knees had complete type of suprapatellar plica and remaining 10 knees had other findings. After all, positive predictive value of preoperative diagnosis for complete type of suprapatellar plica was 89%. Among 36 patients diagnosed as bilateral preoperatively, 33 patients(92%) were confirmed as bilateral in arthroscopic examination. After arthroscopic excision of plica, clinical results were total relief of pain in 19 knees(24%), improvement in 55 knees(69%), no change in 6 knees(7%) and none of worsening. In conclusion, complete type of suprapatellar plica should be considered as an important cause of anterior knee pain especially which is vague, intermittent and bilateral.

Arthroscopic Excision of Popliteal Cyst / 대한정형외과학회잡지

The origin of the popliteal cyst is the popliteal bursa and frequently combined with the intraarticular lesion. And open excision has been commonly used as a treatment. The authors reviewed 39 cases of popliteal cyst in 38 patients, mangaged with arthroscopic method at Department of Orthopedic Surgery, College of Medicine, Korea University Hospital from June 1989 to July 1993 and the following results were obtained. l. Among 39 cases, 35 cases(89.7%) were associated with intraarticular lesions of the knee joint; 25 cases(71.4%) were chondral injuries, 6 cases(17.1%) were meniscus tear, 2 cases(5.7%) were rheumatoid arthritis and 2 cases were plica syndrome. 2. 20 cases(51.2%) were shown to have the communication between cyst and joint. 3. During operation, position change of the patient and another draping was not necessary. And the blue stained wall enabled authors to remove more completely the popliteal cyst than other conventional operative procedures. 4. Becuase of the short skin incision, the operation time was saved and we were able to recommend early excercise of the knee joint and ambulation. The operative treatment of popliteal cyst with the arthroscopy is the one staged method to excise the cyst and to intervent the combined intraarticular pathology which develop the cyst, and is one of the recommendable method bacause of small skin incision, short hospitalization and early rehabilitation.

Ganglion Cysts of the Anterior Cruciate Ligament: Three cases report / 대한정형외과학회잡지

Ganglion cysts of the cruciate ligament are quite rare. Ganglion cysts on the anterior cruciate ligament(ACL) should be suspected in any patient having pain and clicking sensation during terminal knee extension. A few cases have been reported concerning ganglion cysts present on the surface of the anterior cruciate ligament. We report three cases of a ganglion cysts on the ACL that was treated with arthroscopic excision.