• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.123-127
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• 2000

Purpose : To evaluate of the surgical outcome of primary repair in anterior cruciate ligament rupture. Material & Method : Twenty-five patients underwent arthroscopic primary repair of ACL. We performed pull-out suture of ruptured ligament in 18 cases, and suture and augumentation with gracillis & semitendinosus in 7 cases. At follow up, the International Knee Documentation Committee(IKDC) scale & Lysholm score were used to grade outcome, and also the KT-2000 arthrometer was used to evaluate objective ligament laxity. Results : In analysis of IKDC scale, final evaluation group were group A in 3 cases, group B in 13 cases, group C in 9 cases. The mean value of Lysholm score was 83 points. In KT-2000 arthrometer examination, mean anterior translation was 3.9mm at 201b, 7.3mm at 30lb. The mean difference value between injured knee and uninjured knee was 1.1mm at 201b, 2.29mm at 301b. There was statistical significance in mean difference value between injured and uninjured knee. Conclusion : By analysis of clinical & objective data, we could confirm that the mid-term result of ACL suture is not satisfactory. So, we recommend that ACL reconstruction would be done in young active patient rather than suture.

• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.70-76
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• 2005

Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.137-142
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• 2005

Purpose: The purpose of this study is to evaluate the results of arthroscopic anterior cruciate ligament(ACL) repair with minimal incision and to review prognostic factors according to ACL tear patterns and the presence of associated injury Materials and Methods: Thirty eight patients (thirty nine knees) with acute ACL tear were given arthroscopic ACL repair between January 2001 and December 2002 and were followed up at least over six months. Intraoperative findings such as ACL tear pattern and the presence of synovial or concomitant medial collateral ligament injuries were recorded. Each knee was then postoperatively re-evaluated with aid of KT-1000 arthrometer and Lachman test and Lysholm score. Results: Postoperative limitation of motion was significant when combined typed ACL tear was present with concurrent medial collateral ligament(MCL) injury. In contrast, in the case where there were sole proximal ACL tear or no evidence of synovial injury, the limitation of motion was not significant. Anterior laxity was significantly associated with the presence of combined typed ACL tear or concurrent synovial injury, but was not significant when there were sole proximal ACL tear. Conclusion: In the case where there is sole proximal ACL tear without concurrent synovial injury, arthroscopic ACL repair can be considered as a treatment modality for the treatment of acute ACL injury.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.114-120
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• 2012

Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.254-261
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• 2018

Purpose: Favorable results have been reported after the direct repair of chronic ulnar collateral ligament ruptures of the thumb metacarpophalangeal (MP) joint, but the results for radial ligament seem rather controversial. The purpose of this study is to compare the results of ligament reattachment between chronic rupture of the ulnar and the radial collateral ligament (RCL) of the joint. Methods: We reviewed retrospectively the radiologic and clinical results of ligament reattachment with suture anchors for chronic (more than 6 weeks) rupture of the collateral ligament of the thumb MP joint with averaged 22-month follow-up. The data between 6 radial and 8 ulnar ligament repairs were compared statistically. Results: The average of postoperative ulnar deviation angle was $13.3^{\circ}$ in radial ligament and $2.0^{\circ}$ in ulnar ligament (p=0.020) in the last follow-up plain X-ray. Postoperative ligament instability was positive in 4 out of the 6 radial repairs and no case with instability was observed in ulnar ligament. In postoperative follow-up, sustained joint subluxation was observed only in 2 out of the 6 radial repairs. Conclusion: The delayed repair of the RCL of the thumb MP joint resulted in less favorable outcomes and ligament instability was observed postoperatively in more than half of the cases.

• 대한관절경학회:학술대회논문집
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• 2006.11a
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• pp.27-27
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• 2006

• 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.4 no.2
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• pp.134-137
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• 2000

Purpose : To evaluate tile clinical results of resorbable meniscal arrow fixation for repairable meniscal tear with concurrent anterior cruciate ligament(ACL) reconstruction. Materials and Methods : Between April, 1997 and June, 1999, we performed resorbable meniscal arrow fixation and ACL reconstruction simultaneously for 18 cases of repairable meniscal tears with ACL injuries. Nine cases were acute injuries, 5 cases, subacute and 4 cases, chronic. The average follow-up was 21.5 months($12\~38$ months). Results : The healing rate was $89\%$ for acute injuries, $80\%$ for subacute injuries and $50\%$ for chronic injuries. Conclusion : Resorbable meniscal arrow fixation with concurrent ACL reconstruction is a good treatment modality for acute and subacute injuries.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.16-21
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• 2022

When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.46-52
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• 2008

Purpose: This study examined the outcomes of reconstruction of the coracoclavicular ligaments with using two suture anchors and performing coracoacromial ligament transfer in patients with acromioclavicular dislocation. Material and methods: Forty patients with complete acromioclavicular dislocation were included in this study. According to the preoperative radiographs, 5 patients with AC dislocations were diagnosed as type III, 4 patients as type IV and 31 patients as type V. Two 3.5mm suture anchors with four strands of nonabsorbable sutures were separately placed on the anterolateral and posteromedial portion of the base of the coracoid process to stabilize the distal clavicle. The coracoacromial ligament was then transferred to the undersurface of the distal end of the clavicle for augmentation. Results: At a mean follow-up of 28 months, the average Constant score improved to 97 points. All the patients returned to normal life at an average of 3.2 months postoperatively. At the last follow-up, 37 patients achieved anatomical reduction and three patients showed complete redislocation. However, the clinical results of the patients with redislocation were satisfactory. Conclusion: Anatomical coracoclavicular reconstruction using two suture anchors and coracoacromial ligament transfer for treating complete acromioclavicular dislocation is a safe, effective procedure for restoring a physiologically stable acromioclavicular joint.