• Title/Summary/Keyword: 슬개-대퇴 관절

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The Changes of Patellofemoral Alignment after Anterior Cruciate Ligament Reconstruction (전방 십자 인대 재건술후 슬개-대퇴 관절 선열의 변화)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Kwon Gi-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.128-133
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    • 2000
  • Purpose : To compare the changes of the patellar height, patellofemoral alignment and subjective symptom and to compare the effects of patellar tendon harvest after anterior cruciate ligament(ACL) reconstruction using autograft and allograft. Materials and Method : ACL reconstruction was performed on 87 patients who were followed up for minimum 1 year. The group I was 52 patients who were operated with bone-patellar tendon-bone autograft and the group II was 35 patients who were operated with bone-patellar tendon-bone allograft and achilles tendon allograft. At the time of follow-up, the authors evaluated the patellar height by Blackburne-Peel method, Merchant congruence angle, Lateral patellofemoral angle and subjective symptoms were assessed. Results : The patellar heights were significantly decreased from 0.86 preoperatively to 0.80 postoperatively in the group I and from 0.87 preoperatively to 0.83 postoperatively in the group II. There were no significant differences in the lateral patellofemoral angles between the both groups but in the Merchant congruence angle, significant differences were observed in the both groups, from$-1.43^{\circ}$ preoperatively to-$5.43^{\circ}$ postoperalively in the group I and from$-1.53^{\circ}$ preoperatively to$-3.65^{\circ}$ postoperatively in the group II. Conclusion : After ACL reconstruction, the patellofemoral alignment was changed and this kind of changes may be caused by multiple factorials such as harvest of autografts, ACL reconstruction itself, and quadriceps muscle atrophy.

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Functional Anatomy and Biomechanics of the Patellofemoral Joint (슬개대퇴 관절의 기능적 해부학 및 생체역학)

  • Kim, Hyoung-Soo;Park, Sang-Joon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.74-78
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    • 2005
  • Even though, anterior knee pains are most frequently encountered in knee clinics, many physicians use a 'recipe'-type of approach to their treatment. But many predisposing factors have been included internal rotation of the femur, valgus knee alignment, external rotation of the extensor mechanism, patellar alta, a flat trochlear groove, patella with poor congruence and ligatmentous laxity. Many scientific principles on which these commonly used treatment are based, can lead to refinements and improvement in treatment. We reviewed and summarized the recent functional anatomical and biomechanical data that are most relevant to the contemporary treatment of patellofemoral joint disorders.

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Badminton Player's Huge Cartilage Defect of Medial Femoral Condyle Due to Both Medial Patellar Plica Syndrome (배드민턴 선수의 양측 슬개 내 추벽 증후군에 의한 대퇴골 내과의 거대 연골 결손 - 1례 보고 -)

  • Moon, Chan-Sam;Noh, Haeng-Kee;Kim, Jong-Min;Kim, Hyung-Gyu;Hong, Seong-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.259-263
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    • 2009
  • The plica is a remnant of the synovial folds during fetal development. The plica is classified suprapatellar, medial patellar, infrapatellar, and lateral patellar plica according to the anatomic site. The one most likely cause of clinical problem is medial patellar plica. There are many reports of problems caused by medial patellar plica syndrome. But there has been no documented case report of Outerbridge classification Grade III-IV, above $2{\times}1.5\;cm$ sized huge cartilage defect of both medial femoral condyle, due to medial patellar plica. So we report this unusual case with a review of relevant literatures.

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All-inside Arthroscopic Capsular Imbrication and Lateral Release in Patellofemoral Instability (Operative technique) (슬개대퇴관절 불안정성에서의 관절경적 All-inside 관절막 중첩술 및 외측 지대 유리술 (수술 술기))

  • Kim, Jae-Hwa;Cho, Duck-Yun;Yoon, Hyung-Ku;Kim, Jung-Ryul
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.118-122
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    • 2006
  • Purpose: We introduce a technique of all inside arthroscopic capsular imbrication and lateral release used to treat patellofemoral instability. Methods: With the arthroscope in the anteromedial portal for best viewing, the arthroscopic scissor is placed through superolateral portal for proximal to distal release. The release performed 5mm to 1cm from the edge of the patella. After completion of the procedure, with the arthroscope in anterolateral portal, we inserted 5mm cannula in superolateral portal and made working portal from superomedial portal. Medial reefing was performed with all inside technique by using curved needle of the spectrum suturing system and No. 1 monofilament PDS suture is passed through the superomedial portal percutaneously and retrieved through a superolateral portal. Conclusion: Several methods for arthroscopic patella realignment have been proposed, but they have consisted primarily of arthroscopically assisted techniques using a medial incision. We believe that our procedure is preferable to arthroscopically assisted methods commonly used, in that an incision is avoided and the vastus medialis obliqqus is not violated. Our technique is minimally invasive and is easy to control the tightness of the medial patellofemoral ligament (MPFL) under direct vision.

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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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슬개 대퇴 불안정성에 대한 진단적 접근 방법

  • Kyung, H.S.;Hwang, J.K.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.84-94
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    • 2008
  • 슬개 대퇴 불안정성의 진단은 정확한 해부학적 지식을 바탕으로 역동적인(dynamic)기전을 이해하여야 한다. 슬개골의 저명한 탈구는 쉽게 진단되지만, 경미한 외상으로 슬개골이 탈구되어 정복된 후에는 올바른 진찰(dynamic study)없이 방사선 검사(static study)만으로는 진단을 놓치는 경우가 많다. 그러므로 정확한 진단을 위해서는 병력, 이학적 검사, 방사선 검사, 전산화 단층 촬영, 자기 공명 영상 그리고 관절경 검사까지 다양하게 필요할 수 있다.

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