• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.7-13
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• 2002

Purpose : Preliminary report of the technique and trial of double bundle PCL reconstruction using Achilles allograft. Materials and Methods : From May 1999 to July 2000, 8 cases of PCL insufficient patients were treated with Achilles allograft reconstruction using the double bundle and double femoral tunnel technique. The tibial tunnel was prepared anteromedially. All other combined injuries within the knees were treated accordingly. Minimal follow-up period was 1 year. The results was assessed from the point of function and stability using Lysholm knee score and KT-2000 arthrometer. Results : Up to present follow up. 8 patients showed good sign of recovery with no instability (translation less than 2 mm) except olio that has been grafted-ligament rupture. In addition, none showed any sign of infection nor ROM limitation. Two complications were seen, which one had grafted-bone fracture and the other grafted-ligament rupture. The former occurred during operation and the latter occurred due to improper protection. Conclusion : Presently the follow up period is too short to draw any conclusive opinion but it is essential to select healthy and well sterilized allografts fur successful outcome. Double femoral tunnel technique seems to be more physiologic in PCL reconstruction. With these prerequisites, it seems to be a good alternative to use Achilles allografts fur the reconstruction of PCL. However, a longer follow-up is needed.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.111-116
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• 2000

Purpose : We reviewed the results of arthroscopic posterior cruciate ligament reconstruction using Achilles tendon allograft, and the efficacy of the surgical technique using gradual tibial tunneling and posterior transseptal technique. Materials and Methods : From september 1997 to September 1999, 8 patients with complete PCL injury were treated by arthroscopic PCL reconstruction using Achilles tendon allograft. Mean follow-up period was 21.7 months. Mean preoperative posterior laxity was 14mm. The clinical outcome was assessed by Telos stress test, Lysholm knee score and IKDC score. Result : There was no complication such as infection and neurovascular injury. Posterior translation using Telos device was less than 5mm in 6 cases$(75\%)$, and between 6 to 10mm in 2 cases$(25\%)$. The mean Lysholm knee score was 45 preoperatively and improved to 87 postoperatively. In IKDC system, 2 of 8 patients were group A and 6 were group B. Conclusion : Arthroscopic PCL reconstruction using achilles tendon allograft and posterior transseptal technique shows reliable stability, short operative time and minimizing donor site morbidity but needs more long term follow-up.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.159-164
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• 2006

Purpose: To evaluate the clinical stability and function after one-stage revision anterior cruciate ligament (ACL) reconstruction using fresh-frozen Achilles tendon allograft Materials and Methods: Thirteen patients who underwent one-stage revision ACL reconstruction using Achilles tendon allograft could be evaluated. The average time from primary procedure to revision surgery was 61.8 months. The mean follow-up period was 38.4 months. The bone defects of pre-constructed femoral and tibial tunnels were filled with calcaneal bone attached to Achilles tendon and the new femoral and tibial tunnels were created. Evaluations included the causes of failure of primary ACL reconstruction, Lysholm knee score, Lachman test, pivot shift test and KT-1000 arthrometer measurement. Results: The most common causes of failure of ACL reconstruction were poor surgical techniques in 10 cases (76.9%). Ten patients (76.9%) were good or excellent on the Lysholm score. Twelve patients (92.3%) had negative or 1+firm end Lachman test. Eleven patients (84.6%) had negative pivot shift test. Nine patients (69.2%) had less than 3 mm difference of manual maximum by KT-1000 arthrometer. Conclusion: One-stage revision ACL reconstruction with fresh-frozen Achilles tendon allograft, creating new tunnels after filling bone defects, resulted in a reliable and predictable outcome in terms of stability.

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.9-16
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• 1999

Purpose : We have evaluated the outcome of the operative treatment of PCL rupture using the achilles tendon allograft. Materials and Methods : A retrospective study was completed for 30-PCL reconstruction cases, using the achilles tendon allograft from september 1996 to march 1998. There was an average follow up of 24 months, with range of 12 to 50 months. Results : The active range of motion was improved postoperatively. The Lysholm Knee Score was improved from a mean of 54 points preoperatively to 87 points postoerative 18 months. The "Cybex 340 isometric test" revealed satisfactory results compared with autograft. Conclusions : Use of allograft for recostruction of the PCL is an attractive option because it precludes the harvesting of autogenous tissue in a knee that is already at risk for patellofemoral and tibiofemoral osteoarthrosis.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.132-136
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• 2005

Purpose: The purpose of this study was to compare the clinical results of the arthroscopic anterior cruciate ligament reconstruction used by Bone-Patella tendon-Bone autograft and Achilles tendon allograft. Materials and Methods: We reviewed the results of patients who had been managed with arthroscopic anterior cruciate ligament reconstruction using different graft such as Bone-Patella tendon-Bone autograft and Achilles les tendon allograft. 60patients (average age, 33.5 years)were retrospectively evaluated. The one group(average age, 33.4 years) was 32 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Bone-Patella tendon-Bone autograft. The other group(average age, 32.1 years) was 28 patient who had been managed with arthroscopic anterior cruciate ligament reconstruction using Achilles tendon allograft. 2 groups were evaluated subjectively by Lysholm knee scoring scale and objectively by KT-2000 arthrometer. The follow-up period was more than a year(average, 18 month). An early rehabilitation protocol was instituted. Results: On Lysholm knee scoring scale, the final evaluation was nearly normal in all patients. We could not find statistical difference among the two groups by KT-2000TM arthrometer. Conclusion: The use of allografts may be an acceptable choice for ACL reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.105-110
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• 2000

Purpose : The purpose of this study was to evaluate the clinical results of fresh-frozen achilles allograft PCL reconstruction. Materials and Methods : 34 patients(35 cases) who was reconstructed PCL arthroscopically using achilles allograft were analyzed subjective and objective parameters, Telos stress arthrometer and Modified Feagin Scoring System. The average age was 36.2 years old($16\~57$ year) and average follow up period was 18.5 months($12\~27$ months). Result : The mean Lysholm Knee Scoring was improved from 47.5 to 87.4. Posterior translation by Telos arthrometer decreased to 2.3mm from 7.1mm. The modified Feagin scoring system showed 32 cases$(91.5\%)$ with excellent and good result. Conclusion : Clinical results of PCL reconstruction by Achilles allograft revealed good result as to scales. Achilles allograft provided enough initial tension with length and minimized the complication of using autograft. Therefore achilles fresh-frozen allograft in PCL reconstruction is a good substitute material for autograft.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.139-146
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• 2008

Purpose: The purpose of this study is to introduce the double bundle posterior cruciate ligament(PCL) reconstruction using Achilles allograft by the tibial inlay method and evaluate the clinical results of 11 cases who had PCL reconstruction using this method and were followed for more than 2 years after surgery. Materials and Methods: Our series consists of 11 cases of PCL reconstruction due to chronic posterior instability of knee and acute PCL rupture. The clinical results were assessed using the IKDC(International Knee Documentation Committee) scoring system, posterior stress radiographs and the maximum posterior displacement using a KT-1000TM arthrometer. Results: The average preoperative posterior displacement in 90 degree flexion stress radiograph was measured 13.4 mm and in 10 degree flexion the average posterior displacement using the KT-1000TM arthrometer was measured 11.4 mm. Postoperatively the 13.4 mm reduced to 4.4 mm and the 11.4 mm reduced to 3.9 mm. According to IKDC scoring system, 9 cases(81.8%) were satisfied. One case showed limitation of flexion with mild stiffness in the knee and another one case was not improved the posterior instability sufficiently and no complication of allograft was noticed. Conclusion: The double bundle PCL reconstruction using Achilles allograft by the tibial inlay method is a useful method for acute PCL rupture and chronic posterior instability of the knee including failed PCL reconstruction, because it will also make the posterior stability in the extension and 90 degree flexion position, and avoid the grafted tendon abrasion by acute turn of tibial tunnel.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.102-108
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• 2009

Purpose: The purpose of this study is to report a result of the technique that reconstruct posterior cruciate ligament (PCL) and posterolateral corner (PLC) simultaneously using a fresh-frozen Achilles tendon allograft. Materials and Methods: Forty two patients (45 legs) underwent PCL and PLC reconstruction were included. There were 38 males and 4 females. Mean age was 39 years. Used graft was a fresh frozen Achilles tendon allograft, which was divided by two size, larger one (${\emptyset}$ 10 mm) for PCL reconstruction and smaller one (${\emptyset}$ 8 mm) for PLC reconstruction. Arthroscopic reconstruction of the PCL was performed using transtibial, single incision, and single bundle technique with 10mm fresh frozen Achilles allograft tendon first. After PCL reconstruction, reconstruction procedure for posterolateral instability was performed using modified figure of "8" technique using smaller gtaft. For clinical evaluation, range of motion, posterior drawer test, varus stress test, prone external rotation (dial) test, Lysholm score, Tegner activity scale and posterior stress radiograph were used. Mean follow up period was 25 months. Results: Preoperatively posterior drawer test was 5 cases in grade II and 40 cases in grade III posterior instability. At final follow-up 22 cases returned within normal condition, 18 cases grade I and 5 cases grade II posterior instability. Though all patients showed positive result over 10 degrees in dial and varus stress test preoperatively, but only 9 cases showed positive both test at final follow-up. The range of motion deficit over $10^{\circ}$ flexion was 3 cases. Lysholm score was improved from mean 50 preoperatively to mean 83(p<0.05) and Tegner activity scale improved from mean 2.1 preoperatively to mean 4.6(p<0.05). In posterior stress radiographs, posterior displacement was improve from mean 16mm preoperatively to 4.1mm after treatment(p<0.05). All patients had improved compared to their pre-operative status as measured by physical examination such as posterior drawer test, varus stress test, dial test. Conclusion: We had successful results by combined reconstruction of the PCL & PLC with a fresh frozen Achilles tendon allograft in patients with PCL and posterolateral rotatory instability at a time.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.111-116
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• 2007

Purpose: To assess the clinical results of ACL reconstruction with a fresh frozen Achilles allograft, retrospectively and the findings of the graft in second look arthroscopy. Materials and Methods: Twenty-eight ACL reconstructions using fresh frozen Achilles tendon allograft were included in this study between March 1999 and February 2003. The average age was 31.2 years old and the average follow-up was 16.6 months(range: 12-26 months). The clinical evaluation was done by KT-1000 arthrometer, Lysholm knee score, range of motion, Lachman and pivot-shift test. Results: In the last follow-up of Lachman test, 21 cases showed normal, 5 cases grade 1, 2 cases grade 2 and 1 case grade1. The results of pivot-shift test data, 23 cases(82.1%) were normal, 4 cases(14.3%) grade 1, 1 case(3.6%) grade 2. The mean maximum side-to-side difference was improved from 6.75mm preoperatively to 2.46mm in the last follow-up. Lysholm knee score was improved from 73.5 preoperatively to 91.6 in last follow-up. Re-rupture of the ACL graft was found in one case and one case of wound infection in the tibial incision was found. The 6 cases showed the good synovialization of the ACL graft. Conclusion: The anterior stability was restored with ACL reconstruction using fresh frozen Achilles allografts and the good synovialization was found in the second-look arthroscopy

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.107-113
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• 2012

Purpose: The purpose of this study was to evaluate the posterior cruciate ligament (PCL) reconstruction with single bundle, single-incision technique using Achilles tendon and tibialis anterior allograft with ligament remnant preservation. Materials and Methods: Twenty six patients underwent PCL reconstruction was included. There were 21 males and 5 females. Mean age was 32 years. Used graft was a fresh frozen Achilles tendon allograft (group I, 14 cases) and tibialis anterior allograft (group II, 12 cases). Arthroscopic PCL reconstruction was performed using transtibial, single-incision and single bundle technique with remnant preserving as possible. For clinical evaluation, range of motion, posterior drawer test, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) grade and posterior stress radiograph were used. The mean follow-up period was 21.6 months (12-40 months). Associated injuries were 5 medial collateral ligament injuries, which were treated by conservative method. Results: Range of motion (ROM) was returned to normal range in 24 cases, but ROM deficit under $10^{\circ}$ flexion was 2 cases at final follow-up period. Preoperative posterior drawer test was 17 cases in grade II and 9 cases in grade III. At final follow-up 13 cases returned within normal grade, 7 cases grade I and 6 cases grade II posterior instability. Lysholm mean score was improved from preoperatively 62 to 90 at final follow-up period. Tegner activity mean scale improved from preoperatively 3.5 to 5.6 at final follow-up period. IDKC grade was grade A was 3 cases, grade B 17 cases, grade C 6 cases. In posterior stress radiograph, posterior displacement was improved from mean 12 mm preoperative to 4.5 mm at final follow-up. There were no statistical differences between two groups in clinical evaluations. There were two cases of re-rupture of graft at the bone-tendon junction in group I. Conclusion: We had successful results of PCL reconstruction with single-incision, single bundle technique using Achilles and tibialis anterior allograft without difference between two groups in patients with PCL injury. There were more re-rupture of graft in Achilles tendon group.