• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.65-69
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• 2005

It is well known that the two main variants of the anterior cruciate ligament (ACL) ruptures in an adolescent include tibial eminence fractures and midsubstance tears. Authors report a case of 17-year-old girl with simultaneous bilateral anterior cruciate ligament ruptures at the ligamento-osseus junction of tibial attachment which was treated with arthroscopic primary repair.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.109-114
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• 2002

Propose : The purpose of this retrospective study was to test the posterior cruciate ligament (PCL index) for diagnosis of a tear of the anterior cruciate ligament (ACL) by means of MR imaging. Materials and Methods : From Mar. 1997 to Feb. 2001, concomitant magnetic resonance imaging (MRI) and knee joint arthroscopy were performed in 56 patients of either pain or instability of the knee. The shortest distance between the femoral and tibial attachment of PCL (X) and the distance from that line to the tip of the arc marked by the PCL (Y) on the sagittal plane images were measured. The quotient of these two parameters (Y/X) defined the PCL index. Results : Using MRI diagnosis, there were 35 patients diagnosed with ACL rupture and 21 patients were ruled out of ACL injury. Using arthroscopy, 32 of the 35 patients diagnosed by MRI showed ACL rupture, and 20 of the 21 patients were ruled out of ACL injury. The mean PCL index was 0.40 in the 33 patients diagnosed with ACL rupture through arthroscopy. The mean PCL index was 0.23 in 23 patients with an uninjured ACL through arthroscopy. In 33 patients with ruptured ACL, this value exceeds 0.31. The index value was 0.31 in 3 patients with uninjured ACL. The value of the index was not above 0.31 with an uninjured ACL. PCL index on MRI had a sensitivity of $91\%$ and a specificity of $94\%$ for determining the status of the anterior cruciate ligament. Conclusion : Injury to the ACL changes the PCL index markedly. In diagnostically unreliable MR images, amelioration of the PCL index could help in the diagnosis of ACL injury.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.225-228
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• 2008

Pretibial cyst formation is a rare occurrence after anterior cruciate ligament (ACL) reconstruction. We report this complication after ACL revision surgery using tibialis anterior allograft. This complication seems to be the consequence of a direct communication between the joint and the cyst through the tibial tunnel. In the present study, the authors report that there is a pretibial cyst formation after a revisional ACL reconstruction.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.141-144
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• 2014

Two dogs (Case 1 weighing 27 kg, Case 2 weighing 42 kg) were referred with hindlimb lameness. On physical examination, there was moderate pain on stifle joint testing and mild cranial translation on cranial drawer testing in Case 1. This translation was obvious when the patient was under general anesthesia. Case 2 showed discomfort during hyperextension of the stifle joint, but no significant cranial translation under general anesthesia. Joint effusion was detected on radiography in both cases. Based on physiologic and radiographic examinations, cranial cruciate deficiency was suspected, so exploratory arthroscopy was performed. Arthroscopy revealed partial rupture of the cranial cruciate ligament (CrCL) in both cases. Case 1 showed unstable partial CrCL rupture, while Case 2 had stable CrCL rupture. Tibial tuberosity advancement (TTA) was carried out as planned. Seroma occurred one week postoperatively in Case 2, and was removed surgically. The patients returned to satisfactory weight-bearing ambulation 5 months after initial surgery. Based on the results of these cases, TTA appears to be a useful procedure in the treatment of CrCL partial rupture.

• The Journal of the Petrological Society of Korea
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• v.15 no.1 s.43
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• pp.10-24
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• 2006

Staurolite grains in staurolite, kyanite and sillimanite zones occurred in the Littleton Formation, Northcentral Massachusetts have interpreted to form by Barrovian-type metamorphism during Acadian orogeny. However, various occurrence of staurolite in the three zones, (a) porphyroblast, (b) randomly oriented and coarse-grained muscovite pseudomorph after staurolite, (c) recrystallized staurolite at the margin of garnet porphyroblast and within the pseudomorph, indicates that they have resulted from polymetamorphism. Staurolite in these three metamorphic zones can be formed by demise of chlorite or chloritoid that depends on difference of bulk-rock compositions and changes of P-T conditions. Staurolite modal proportion calculated in MnNCKFHASH system using THERMOCALC program reveals that staurolite could have grown with garnet with increasing pressure and temperature, if it coexist with chlorite. After demise of chlorite and appearance of biotite, staurolite mode decrease with increasing pressure and temperature. Therefore, based on the previous P-T paths for the Acadian metamorhism, staurolite porphyroblast grew with garnet during 400-370 Ma. Randomly oriented and coarse-grained muscovite pseudomorphs after staurolite probably have grown due to heating with appearance of kyanite and sillimanite. Consequently, pseudomorphisrn of staurolite occurred by heating derived from locally intense Alleghanian shearing (ca. 320-300 Ma) overprinted the Acadian metamorphism. Recrystallized fine-grained staurolite in sillimanite zone observed between the grain boundaries of muscovite in the pseudomorphs and at the edge of garnet porphyrobasts has formed during decreasing temperature and pressure (ca. 300-280 Ma) after peak temperature (ca. $700^{\circ}C$) of the Allegllanian metamorphism.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.87-96
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• 2009

최근 전방십자인대 손상의 치료에 남아있는 인대 다발이 이식건의 생물학적 치유를 도우며 고유 수용감각(proprioception) 기능을 유지할 뿐만 아니라 슬관절의 전방 전위 억제의 생역학적 기능을 가지는 것으로 연구되고 있다. 이러한 이론을 바탕으로 남아있는 전방십자인대를 보존하는 노력들은 다양하게 시도되고 있다. 전방십자인대 손상의 자연 경과는 아직도 논란이 되고 있으나 선택적인 환자에 있어서 보존적 치료는 비교적 좋은 결과를 얻을 수 있으므로 불필요한 재건술을 줄일 수 있다. 최근 시도되고 있는 선택적 다발 재건술 및 남아있는 다발을 보존하는 전방십자인대 재건 수술 수기들은 다양한 방법으로 시도되고 있으며 남아있는 다발을 보존하는 장점이 있으나 협소한 적응증을 가진다. 저자들의 남아있는 다발을 보존하는 전방십자인대 재건술은 자가 슬괵건을 이용한 단일다발 재건술을 시행하면서 잔존하는 이완된 다발에 봉합사를 통과시킨 후 봉합사를 추가적인 터널 없이 bioabsorbable cross pin (RIGIDfix system, Mitek, Johnson & Johnson, USA) 구멍을 통하여 당기고 고정하는 방법이다. 전방십자인대 재건술시 남아있는 다발을 보존하는 방법은 이식건의 생물학적 치유을 촉진하고 또한 경골 부착부에 남아있는 기계수용체를 보존하므로 기능적 회복에 도움이 될 것으로 기대된다. 저자들의 방법은 비교적 광범위한 적응증을 가지며 적은 합병증으로 남아있는 다발을 효과적으로 보존할 수 있는 술식으로 전방십자인대 수술시 좋은 치료 선택의 하나로 사료된다.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.140-145
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• 2011

후방십자인대 손상의 이상적 치료는 아직까지도 확립되지 않았다. 과거 몇 십 년간 후방십자인대에 대한 지식과 슬관절 안정성에 대한 후방십자인대의 생역학에 대한 지식이 증가하였다. 특히 이중 다발에 대한 지식이 증가하고 이러한 모든 노력들은 후방십자인대의 해부학적인 특징을 최대한 복원하기 위해 이루어졌다. 재건술의 수술 방법은 특정 손상 양상에 따라 그에 맞게 이루어지는데 만성 손상의 경우나 remnant가 거의 존재하지 않는 경우에는 이중 다발을 재건하는 것이 만족스러운 결과를 보인다. 아직까지 이중 다발 후방십자인대 재건술의 결과에 대해서는 논란이 많은 것은 사실이나 장기 추시가 가능해지면 이중 다발 후방십자인대 재건술이 해부학적으로나 생역학적으로 더욱 정상에 가깝기 때문에 더 나은 장기적 결과를 보여줄 것으로 예상된다.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.62-65
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• 2012

Avulsion fractures of the intercondylar eminence of the tibia are uncommon. This kind of fracture is most commonly found in adolescents, with an increasing incidence for those involved in competitive athletics. Recently, an arthroscopic procedure is preferred to reduce the operation-related morbidity. Screws, K-wires, Suture anchor have been described as fixation devices. Cannulated screw fixation is a simple method, but this instrument has the risk of causing damage to the growth plate. The authors report good results using cannulated screw in arthroscopic treatment for pediatric anterior cruciate ligament avulsion fracture.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.26-32
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• 2009

Purpose: This study was performed to compare the strength of ligamentous attached sites of cadaveric distal femur and to obtain reliable biomechanical data to use in ligamentous reconstruction or augmentation. Materials and Methods: Fifteen cadaveric distal femurs were used for this study. After measuring the bone density, 5.0 mm cannulated screw (Experiment 1) or reconstructed porcine ligament (Experiment 2) was inserted into the each ligamentous attached sites of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). In experiment 2, reconstructed porcine graft was fixed with bioabsorbable screw in ligamentous insertion sites. And we measured the maximal pullout force of each ligamentous attached sites of cadaveric distal femur. Results: Average bone mineral density was $1.205{\pm}0.137\;g/cm^2$ in experiment 1, $1.236{\pm}0.089\;g/cm^2$ in experiment 2, which showed no statistically significant differences. In experiment 1, average pull-out strength of ACL, PCL, MCL and LCL group were $519.1{\pm}111.7$ N, $638.9{\pm}144.4$ N, $169.7{\pm}56.0$ N, $225.6{\pm}61.5$ N respectively. In experiment 2, the average pull-out strength were $310.6{\pm}31.0$ N, $379.9{\pm}47.4$ N, $104.0{\pm}14.4$ N, $131.5{\pm}21.9$ N respectively. In experiment 1, there was no significant difference between ACL and PCL group and between MCL and LCL group. However, the maximal pullout strength of MCL and LCL group were significantly lower than that of ACL and PCL group (p<0.01). Experiment 2 showed the same results of experiment 1. Conclusion: Because stiffness of MCL and LCL attached sites are much lower than that of ACL and PCL attached sites, we may consider augmented fixation in ligamentous reconstructions of MCL and LCL.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.39-44
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• 2006

Purpose: The object of this study is to compare the Insall-Salvati ratio and Carton index between the patients who have an anterior cruciate ligament (ACL) tear and the patients who have no ACL tear. Materials and Methods: The study group included 114 patients who had an ACL tear and received arthroscopic reconstruction. The group I was acute ACL tear group, within 3 weeks after injury. The group II was chronic ACL tear group who had MRI was done after 3 weeks from injury. The group III was normal control group. We measured the Insall-Salvati ratio and Carton index on Magnetic Resonance Images (MRI) for all patients. Results: The Insall-Salvati ratio of control group was $1.02{\pm}0.12$ and Carton index of control group was $1.14{\pm}0.16$. The ACL-tear study group was $0.91{\pm}0.12\;and\;0.89{\pm}0.20$ respectively. The Insall-Salvati ratio and Caton index in ACL tear group was significantly less than those of control group. There were no significant differences in comparing with acute and chronic ACL tear group. Conclusion: Our study show that patella baja has an association with ACL tears, therefore in patients with an ACL tear who had patella baja, ideal graft for reconstruction was seriously considered.