• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.91-96
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• 1999

Purpose : The purpose of this study is to compare the clinical and radiologic results of the anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone unit with doubled semitendinosus and gracilis tendons. Materias and Methods : Clinical results of ACL reconstructions which were performed in 47 patients using doubled semitendinosus and gracilis were compared with those performed in 45 patients using bone-patellar tendon-bone autograft. There were no differences in preoperative parameters(age, sex, instability). Average follow-up period were 17 months and 19 months each. Results : There were no significant differences between two groups in functional results (Lysholm knee score), degree of laxity and range of motion at final follow-up. However, the parapatellar complication, especially anterior knee pain after long distance walking or exercise and quadriceps weakness less occurred in hamstring tendon group than in bone-patellar tendon-bone group. Conclusion : Although there were no significant differences in clinical results of ACL reconstruction using bone-patellar tendon-bone autograft and doubled semitendinosus and gacilis, parapateller complications occurred more in the bone-patellar tendon-bone autograft group than in the doubled semitendinosus and gracilis group. It is thought that the careful selection of patient, achivement of skillful technique and active rehabilitation are important to prevent the parapatellar complications.

• Journal of Veterinary Clinics
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• v.20 no.4
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• pp.443-448
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• 2003

To determine whether localization of tartrate-resistant acid phosphatase (TRAP) and cathepsin K was associated with rupture of the cranial cruciate ligament (CCL) in dogs. Tissue specimens were obtained from 30 dogs with CCL rupture during surgical treatment, 8 aged normal dogs, and 9 young normal dogs that were necropsied for reasons unrelated to this study and unrelated to musculoskeletal disease. The cranial cruciate ligament was examined histologically. $TRAP^+$ cells and cathepsin $K^+$ cells were identified by histochemical staining and immunohistochemical staining respectively. TRAP and cathepsin $K^+$ were co-localized within the same cells principally located within the epiligamentous region and to a lesser extent in the core region of ruptured CCL. Localization of $TRAP^+$ cells (P < 0.05) and cathepsin $K^+$ cells (P =0.05) within CCL tissue was significantly increased in dogs with CCL rupture, compared with aged-normal dogs, and young normal dogs (P < 0.05 - TRAP, P < 0.001 - cathepsin K). Localization of $TRAP^+$ cells and cathepsin $K^+$ cells within the CCL tissue of aged-normal dogs was also increased compared with young normal dogs (P < 0.05). Small numbers of $TRAP^+$ cells and cathepsin $K^+$ cells were seen in the intact ligaments of aged-normal dogs, which were associated with ligament fasicles in which there was chondroid transformation of ligament fibroblasts and disruption of the organized hierarchical structure of the extracellular matrix. $TRAP^+$ cells and cathepsin $K^+$ cells were not seen in CCL tissue from young-normal dogs. Localization of the proteinases $TRAP^+$ and cathepsin $K^+$ in CCL tissue was significantly associated with CCL rupture. Small numbers of proteinase positive cells were also localized in the CCL of agednormal dogs without CCL rupture, but were not detected in CCL from young-normal dogs. Taken together, these findings suggest that the cell signaling pathways that regulate expression of these proteinases in CCL tissue may form part of the mechanism that leads to upregulation of collagenolytic ligament remodeling and progressive structural failure of the CCL over time.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.483-489
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• 2014

This study describes a surgical technique and evaluates the clinical outcomes in small breed dogs with cranial cruciate ligament rupture (CCLR) treated with tibial plateau leveling osteotomy (TPLO). Seven skeletally mature dogs weighing less than 15 kg underwent unilateral TPLO to stabilize the stifle joint with CCLR. Clinical evaluation was performed via visual lameness score, range of motion (ROM), and thigh girth circumference (TC). Postoperative complications were recorded. All patients reached a grade 1 score at 1 week and grade 0 at 8 weeks postoperatively. The mean operated limb extension angle was 98.11%, 99.07%, and 98.73% of the mean extension angle of the contralateral limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. The mean operated limb flexion angle was 98.07%, 95.88%, and 96.35% of the mean flexion angle of the contralateral limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. The mean TC of the operated limb was 92.95%, 93.68%, and 95.44% of the mean TC of the normal limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. Our outcomes for TPLO in small breed dogs are not worse than those previously reported for large breed dogs. Based on the result in the present study, CCLR in small dogs can be successfully managed with TPLO, as done in large breed dogs.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.123-131
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• 2005

The central third of the patellar tendon and hamstring tendons(semitendinosus and gracilis) are the most frequently used tissues for intra-articular replacement of the anterior cruciate ligament(ACL). At present, many surgeons consider the central third patellar ten don graft to be the gold standard for replacement of the ACL. Recent prospective studies by Marder et at and Aglietti et al, however, have failed to show any statistically significant differences in knee stability and functional outcome between central third patellar tendon grafts and hamstring tendon grafts. The review of this article is to (1) review the historical use of hamstring tendon grafts for ACL reconstruction; (2) discuss indications for use of hamstring tendon grafts for ACL reconstruction; (3) describe our present operative technique using a combined double-looped semitendinosus and gracilis graft with $RIGIDFIX^{circledR}$ and $INTRAFIX^{circledR}$ and (4) review the results of hamstring ACL reconstructions.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.25-28
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• 2010

Most of bucket handle meniscal tears are associated with anterior cruciate ligament (ACL) deficiency. Lateral meniscus lesions are more common with acute ACL deficiency, where medial meniscus lesions are more associated with chronic ACL deficiency. We reported an ACL deficient knee with bucket handle tears of medial and lateral meniscus of the same knee. The report suggests the need for increased awareness of the possible presence of this. Additionally, we discuss injury mechanism, clinical symptoms, specific signs on Magnetic Resonance Imaging (MRI), and treatment options.

• Journal of Korean Ophthalmic Optics Society
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• v.13 no.4
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• pp.115-119
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• 2008

Purpose: To compare the tentative and final addition, a combination chart of cross-grid and red green with the final addition prescribed in presbyopia were used in this study. Methods: The study subjects were 60 persons with presbyopia who were 41 to 60 years (mean: 51.7 years). Tentative addition were determined using red green chart (RG), cross-grid chart (CG) and the combination chart (red green cross-grid chart, RGCG) of the above two. And the final addition for a 40 cm working distance was determined for each subject by adjusting the tentative addition. Results: It was found that there were statistically significant differences of the final addition and the tentative addition between the each different test method. This result indicated that using the red-green cross-grid chart is the higher repeatability. Conclusions: This study shows that red green cross-grid chart (RGCG) seems to be get proper data for determining addition in presbyopes, and this method would be helpful in the diagnostic evaluation of addition in binocular vision testing.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.93-97
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• 2021

Calcification in the tendon is a common disease especially in the rotator cuff. The condition can be treated conservatively in the chronic stage, but surgically in the acute stage. On the other hand there are few reports of calcification in the cruciate ligament of the knee joint, especially calcification of the posterior cruciate ligament. A 51-year-old patient with symptomatic calcification in the mid-substance of the posterior cruciate ligament was treated conservatively. The symptoms did not improve after eight months of conservative treatment, so arthroscopic surgery was performed. During arthroscopic removal of the calcification, the ligament was damaged beyond preservation. Eventually a posterior cruciate ligament reconstruction was performed. At two years after surgery, radiography confirmed no recurrence of the calcification, and the patient was free. We report this case study with a review of the relevant literature.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.47-53
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• 2011

Purpose: As the number of the anterior cruciate ligament (ACL) reconstruction has increased, the incidence of revision of ACL reconstruction due to reconstruction failure has been also increased. Therefore, authors analyzed the reason of the failure of ACL reconstruction and the clinical result of the ACL revision. Materials and methods: From February 1998 to July 2010, we selected 36 cases which was followed at least 12months after the ACL reconstruction failure. Duration from reconstruction to revision, the average duration was 60 months (5~334) and on first reconstruction, we used allograft on 23 cases (63.9%) and autograft on 13 cases (36.1%). For the main symptom of ACL reconstruction failure, instability was the most common symptom, and 35 cases (97.5%) were undergone only one reconstruction and 1case (2.5%) was undergone two reconstruction. Clinical results were evaluated by Lysholm knee joint score, pivot shift test, and Telos device. Results: Average follow-up duration of the patients was 21 months (12~40), and the reason for the ACL reconstruction failure, trauma was most common by 19 cases (52.8%), malposition of the femoral tunnel was 13 cases (36.1%), malposition of the tibia tunnel was 1case (2.8%), and failure of osteointegration was 3 cases (8.4%). On performing the ACL revision, we used allograft on 34 cases (94%) and autograft on 2 cases (6%), and 21 cases accompanied injury of the meniscus (medial meniscus 14 cases, lateral meniscus 7 cases). Lysholm knee joint score was improved from 66.5 points, preoperatively to 92 points on last follow-up (p<0.01). In most cases, patients were satisfied (92%) with the operation results. Tegner activity score was also improved from 2.0 points preoperatively to 6.2 points on the last follow-up. On Lachman and pivot sift test, 33 cases and 30 cases were improved to grade I respectively, and on stability test using Telos device, the bilateral difference was improved from mean 15.5 mm preoperatively to 4.5 mm on the last follow-up. Conclusion: After 1 year follow-up, Revision of ACL had a little anterior instability but it showed satisfactory result on clinical result and patient's subjective satisfaction.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.169-175
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• 2003

Purpose : The purpose was to evaluate the early result of revision of failed anterior cruciate ligament (ACL) reconstruction. Materials and Methods : From August 1997 to February 2002, this report presents the findings of 18 patients who had revision surgery for failed ACL reconstruction. There was an average of 39 $(7\~120)$months from index procedure to the time of revision. Allografts were used in 14 $(78\%)$cases and autografts were used in 4 $(22\%)$cases and the revision procedures were assisted by arthroscopic technique. The majority of chief complaints were instability in 16 $(89\%)$cases. Sixteen $(89\%)$ cases had 1 previous reconstruction, 2 $(11\%)$ cases had 2. Before and after revision, patients were evaluated by Lachman test, pivot shift test, KT 2000, radiographs, Lysholm score and HSS score and subjective satisfaction. Results : Average length of followup was 27 $(12\~60)$months. Preoperatively, all cases were positive in Lachman test and pivot shift test. After revision the majority of cases were negative. Objectively improving stability was confirmed by KT 2000 and all average KT 2000 was 7.75 $(3.5\~12.5)$mm preoperatively and 2.36 $(1.0\~6.0)$mm at final followup. Lysholm score and HSS score were also improved from 72.6 $(66\~77)$ and 72.5 $(68\~78)$ preoperatively to 89.2 $(80\~92)$ and 88.2 $(81\~92)$ at final followup. Most $(89\%)$ of patients were satisfied with their results. The most common causes of failed ACL reconstruction were malposition of femoral tunnel in 11 $(61\%)$cases. Conclusion : Arthroscopic revision ACL surgery with adequate graft for failed ACL reconstruction was successful in objectively and subjectively improving stability. However, considering the most common causes of failure after ACL reconstruction were errors in surgical technique, it is important that the primary ACL reconstruction should be performed with correct surgical technique.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2005.04a
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• pp.36-36
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• 2005