• Title/Summary/Keyword: 외측 인대 불안정성

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Biceps Rerouting Technique(Modification of Clancy) for Posterolateral Rotatory Instability (대퇴이두건 전환술(Clancy 변형 술식)을 이용한 후외측 회전 불안정성의 재건)

  • Kim Sung-Jae;Shin Sang-Jin;Kim Jin-Yong;Rhee Dong-Joo
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.25-31
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    • 2000
  • Introduction : This study compared the clinical results with biceps rerouting fer the isolated posterolateral instability (PLI) and for the PLI combined with PCL injuries. Methods : 21 cases of isolated PLI (group I) and 25 cases of PLI combined with PCL rupture were included in the study. The PLI was reconstructed by modified biceps femoris rerouting technique with PCL reconstructions performed prior to the PLI correction in cases of combined injury The clinical results were reviewed and analyzed. Results : Pre-operatively positive reverse pivot shift test turned negative in 43 cases post-operatively. Increased preoperative external rotation thigh foot angle (ERTFA) showed significant differences between the two groups and all fell within normal limits post-operatively At a mean follow-up of 40.3 months, the average Lysholm knee score and. The Hospital for Special Surgery Knee Ligament Score for group I and group II revealed above 90 points without statistically significant difference between the groups. 3 cases of tenodesis failure developed and re-operation was performed. Discussion and Conclusion : The advantages of modified Clancy technique include reduced surgical damages to the iliotibial band and fixation of the biceps tendon at the isometric position. The modified biceps rerouting technique is recommended for the reconstruction of both isolated and combined PLI except in patients with severe damages at the attachment of biceps tendon.

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Rehabilitation after Posterior Cruciate Ligament, Posterolateral Rotatory Instability, and Multiple Ligament Reconstruction (후방십자인대,후외측 회전 불안정성 및 다발성인대 재건술 후 재활 치료)

  • Yoo, Jae-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.91-92
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    • 2008
  • 후방십자인대 및 후외측인대 재건술 후 결과는 많은 발전이 있었지만, evidence medicine의 측면에서 재활 방법에 관한 전향적 연구는 없다. 현재까지의 재활 방법은 다양하게 소개되었지만 전방십자인대 재건술처럼 가속 재활을 하는 것은 바람직스럽지 않다. 후방십자인대, 후외측인대 그리고 다발성 인대 재건술 후 재활은 수술 방법과 환자의 재건된 인대의 상태, 하지 정렬 등에 따라서 개별화하여 점진적으로 진행하여야 할 것이고, 재활기간 동안 의사의 세심한 관찰이 필요하다.

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LCL Augmentation and Popliteal Tenodesis for Lateral and Posterolateral Instability Of The Knee (슬관절 외측 및 후외측 불안정성에 대한 외측 보강술 및 슬와근 건고정술)

  • Park, Jin-Uck;Lee, Ju-Hyup;Sohn, Sung-Won
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.98-102
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    • 2004
  • Purpose: The purpose of this study was to make a report on the clinical prognosis of post traumatic lateral and posterolateral instability of the knee after LCL augmentation and popliteal tenodesis. Materials and Methods: The assessment was made among 21 cases who underwent augmentation of lateral collateral ligament(LCL) and popliteal tenodesis with allograft or artificial ligament (synthetic polyester, ABC ligament, Surgicraft, U.K.) at this Medical Center during the period from July 1996 to July 2003 and whose follow-up period was longer than one year. The authors recorded and analysed the physical findings (external rotation recurvatum test & posterolateral drawer test), stress roentgenograms(preoperative and postoperative) and Lysholm score. Results: The lateral and posterolateral instability of the knee were improved in 20 cases postoperatively, acccording to the clinical test and stress roentgenograms . Average Lysholm score was 52.5 preoperatively and 86.7 postoperatively .Conclusion: Our study found the surgery of lateral and posterolateral instability of the knee with augmentation of LCL and popliteal tenodesis using allograft or artiflcial ligament is simple technique. Taking these results into consideration, it seems to be one of effective methods of treatment.

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Chronic Varus Instability of the Hallux Interphalangeal Joint in College Taekwondo Athelete - A Case Report - (대학 태권도 선수의 족무지 지간 관절의 만성 내반 불안정성 - 1례 보고-)

  • Jung, Hong-Geun;Park, Sin-Hyoung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.142-145
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    • 2008
  • Forefoot injuries are common in runners or martial art athletes, but due to the anatomical stability, collateral ligament injury of the hallucal interphalangeal joint has been rarely reported. We report a college Taekwondo athlete with chronic varus instability of the hallucal interphalangeal joint due to chronic lateral collateral ligament rupture. The patient had been treated with lateral ligament reconstruction and achieved good clinical outcome.

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Posterior Cruciate Ligament and Posterolateral Structure Reconstruction using Bilateral Hamstring Tendons (양측 슬괵건을 이용한 후방 십자 인대 및 후외측 지대 재건술)

  • In, Yong;Kim, Seok-Jung;Lee, Gyu-Yeong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.167-173
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    • 2005
  • Purpose: The purpose of this study is to evaluate the clinical results of posterior cruciate ligament (PCL) and posterolateral structure (PLS) reconstruction using bilateral hamstring tendon autografts. Materials and Methods: From October 2002 to March 2004, ten patients were received PCL and PLS reconstruction simultaneously using bilateral hamstring autografts. PCL was reconstructed using ipsilateral hamstring tendon and fixed with cross pins and Intrafix (Mitek, Norwood, MA). PLS was reconstructed using contralateral hamstring tendon. The mean follow up was 17 months. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee (IKDC) evaluation form and posterior stress radiographs. External rotation of tibia was evaluated at $30^{\circ}\;and\;90^{\circ}$ knee flexion using Noyes and Barber-Westin's classification. Contralateral harvest site morbity was evaluated using IKDC evaluation form and flexion power of the knee. Results: Mean posterior displacement of tibia using stress radiographs was improved from 13.3 mm to 3.7 mm. In tibial external rotation evaluation, 7 patients were functional, 2 patients were partially functional and one failure. The average Lysholm knee score improved from 54 preoperatively to 86 postoperatively. At the final IKDC evaluation, 8 patients were graded as nearly normal, 2 were graded as abnormal. In contralateral harvest site morbidity evaluation, 2 patients complained of numbness around the wound but negligible. Conclusion: PCL and PLS reconstruction using bilateral hamstring autografts was considered as a good treatment method with minimal contralateral harvest site morbidity.

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Reconstruction of Chronic Ankle Instability with the Toe Extensor Tendon (족지 신전건을 이용한 만성 족관절 불안정성의 재건)

  • Ahn, Jae-Hoon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.88-91
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    • 2007
  • Persistent instability following an acute lateral ankle sprain eventually require ligamentous reconstruction in some cases. Over 50 surgical procedures have been described to reestablish lateral ankle stability varying from direct in situ repair of the anterior talofibular ligament and the calcaneofibular ligament to augmented reconstructions with either autograft or allograft tissue. The author describes the rationale and the technique of anatomic ankle ligament reconstruction with the 4th extensor digitorum longus tendon.

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Anterolateral Ligament of the Knee: Anatomy, Biomechanics, Techniques, and Clinical Outcome (슬관절 전외측인대의 해부학, 생역학, 수술법 및 임상적 결과)

  • Kim, Seong Hwan;Lee, Tae-Hyub;Park, Yong-Beom
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.281-293
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    • 2020
  • An anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgical procedures in the knee joint, but despite the better understanding of anatomy and biomechanics, surgical reconstruction procedures still fail to restore rotational stability in 7%-16% of patients. Hence, many studies have attempted to identify the factors for rotational laxity, including the anterolateral ligament (ALL), but still showed controversies. Descriptions of the ALL anatomy are also confused by overlapping nomenclature, but it is usually known as a distinctive fiber running in an anteroinferior and oblique direction from the lateral epicondyle of the femur to the proximal anterolateral tibia, between the fibular head and Gerdy's tubercle. The importance of the ALL as a secondary restraint in the knee has been emphasized for successful ACL reconstructions that can restore rotational stability, but there is still some controversy. Some studies reported that the ALL could be a restraint to the tibial rotation, but not to anterior tibial translation. On the other hand, some studies reported that the role of ALL in rotational stability would be limited as a secondary structure because it bears loads only beyond normal biomechanical motion. The diagnosis of an ALL injury can be performed by a physical examination, radiology examination, and magnetic resonance imaging, but it should be assessed using a multimodal approach. Recently, ALL was considered one of the anterolateral complex structures, as well as the Kaplan fiber in the iliotibial band. Many studies have introduced many indications and treatment options, but there is still some debate. The treatment methods are introduced mainly as ALL reconstructions or lateral extra-articular tenodesis, which can achieve additional benefit to the knee stability. Further studies will be needed on the indications and proper surgical methods of ALL treatment.

New Technique for Posterolateral Instability of The Knee: Posterolateral Reconstruction Using The Tibialis Posterior Tendon Allograft (슬관절 후외측 불안정성 치료의 새 기법: 동종 후경골건을 이용한 후외측 재건술)

  • Kim Sung-Jae;Ryu Sang-Wook;Cheon Yong-Min;Yong Suk-Won;Kim Bo-Ram
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.136-141
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    • 2003
  • Posterolateral instability of the knee is known as one of the most challenging injuries . Although several procedures have been designed for the posterolateral instability, there is no gold standard management yet. We present a technique for posterolateral instability of the knee using tibialis posterior tendon allograft, which reconstructed lateral collateral ligament and popliteal tendon.

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