• Title/Summary/Keyword: 인대 재건술

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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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Computer-Assisted Orthopaedic Surgery in Bone Tumor (항법장치를 이용한 골종양 수술)

  • Cho, Hwan-Seong;Park, Il-Hyung;Mun, Jong-Uk;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.1-6
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    • 2009
  • The usefulness and accuracy of computer-assisted surgery have been evaluated clinically in many orthopedic fields, such as, joint replacement arthroplasty, cruciate ligament reconstruction, and pedicle screw placemen. Recently several preliminary reports have been issued on the application of navigation to bone tumor surgery. The main advantage of navigation-assisted bone tumor surgery is that it provides highly accurate three-dimensional radiological information for intraoperative guidance. In particular, distances from tumors to resection margins can be precisely determined using intraoperative three-dimensional images. Accordingly, the technique allows preservation of function to be maximized by minimizing unnecessary resection. However, surgeons should recognize that the accuracies of navigation systems in bone tumor surgery have some hidden pitfalls. Here, based on our clinical results, we describe the surgical techniques used and include some cautionary notes.

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Autogenous Transplantation of Third Molar to Replace Hopeless Tooth (예후 불량한 치아를 대체하는 제3대구치를 이용한 자가치아이식술)

  • Song, Il-Seok
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.29 no.1
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    • pp.13-24
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    • 2020
  • Autotransplantation is the surgical repositioning of an autogenous erupted or unerupted tooth from one site to another in the same individual. This treatment is indicated in traumatic tooth loss, teeth with severe caries, congenitally missing teeth, teeth with bad prognosis and in case of developmental anomalies of teeth. The following 2 cases describe the potential to utilize autotransplantation to replace hopeless teeth with sound wisdom teeth.

Separation of tip from the bipolar radiofrequency system in the arthroscopic surgery - Case Report - (Bipolar radiofrequency system 사용 중 발생한 Tip의 분리 - 증례 보고 -)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Park, Ji-Kang;Bae, Seung-Whan
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.66-68
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    • 2008
  • Recently, devices using radiofrequency energy have been developed for arthroscopic soft tissue ablation, cauterization and shrinkage. After ACL reconstruction operation, articular metallic foreign body was found in the post-operative radiographs. It was proven to be the tip of bipolar radiofrequency system after foreign body removal. After that we experienced 2 more cases during the acromioplasty procedure. We requires attention to prevent the separation of the tip from the body in the arthroscopic surgery using bipolar radiofrequency system.

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The effects of functional movement recovery of physical therapy after ACL reconstruction with MCL injury (물리치료가 슬관절 내측측부인대 손상을 동반한 전방십자인대 재건술 후 운동기능 회복에 미치는 영향)

  • Kim, In-Sup;Lim, Weon-Sik;Vae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.14 no.1
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    • pp.27-37
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    • 2002
  • This is the study of the knee joint injured patients at the orthopaedic surgery clinic where is located in Daejon, who has MCL combine injured ACL reconstruction caused by sport activity and accident during the period from Jan. 2001 to Oct. 2001. By comparing with groups between 7th case of I-group for MCL combined stitch and II-group for ACL reconstruction since 6weeks cast. We have been concluded with that following results. 1. Range of motion for the knee was not limited at 5th case(37%) of I-group, 6th case(42%) of II-group and the cases of Flexion deficit less then 10 -degree were 2nd case(13%) of I-group and II-group 1st case(8%) with no extension deficit more then 5 -degree. 2. The level of activity that tells you whether you are capable of exercise for six month after operation. It han been divided by 3 levels. The case of capable of doing low risk exercise(swimming, cycling, etc.) was 5th case of I-group, the case of capable of doing medium risk exercise(jogging, etc.) was 3rd case of I-group and 4th case of II-group and the case of capable of doing high risk exercise(football, etc.) were 3rd case of I-group and 3rd case of II-group. 3. The timing of the return to their job were average 6.4 weeks for I-group and average 22.9 weeks for II-group(P<.05, statistical difference). 4. There was no statistical difference between I-group and II-group for the timing of the return to their job(P>.05). 5. By using VAS to compare them there was no statistical difference between I-group and II-group of clinical results according to Lysholm scale.

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Results of the Reconstruction of Anterior Cruciate Ligament with Freshfrozen Achilles Allograft and of the Second-look Arthroscopy (신선 동결 동종 아킬레스건을 이용한 전방 십자인대 재건술 후 2차 관절경소견)

  • Yoo, Jae-Doo;Kim, Sung-Il
    • 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

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The Resolving Method of Graft-Tunnel Mismatch in Arthroscopic ACL Reconstruction Using Bone-Patellar Tendon-Bone Graft (골-슬개건-골을 이용한 관절경적 전방십자인대 재건술시 이식물-터널 길이의 부조화를 줄이는 방법)

  • Cho, Se-Hyun;Park, Hyung-Bin;Ha, Sung-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.97-101
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    • 1999
  • Purpose : The purpose of this study is to prevent thc graft-tunnel mismatch by measuring the patellar tendon length, intertunnel distance, tibial tunnel length and by obtaining appropriate bone block length. Materials and Methods : Authors analyzed 15 patients who had taken the anterior cruciate ligament reconstruction from March 1997 to June 1999. Tibial guide was always set on the "endo" $40^{\circ}$ position(Acufex, MA, USA). We measured the following indices, intertunnel distance(X), tibial tunnel length(T), patellar tendon length(N), tibia bone plug length(Y). Both of the femoral tunnel length(F) and the patellar bone plug length(P) were made in 25mm. The appropriate tibial bone plug length was simply calculated by subtracting the patellar tendon length from the sum of the intertunnel distance and thc tibial tunnel length(Y=X+T-N). Results : The average indices were as follows ; the intertunnel distance(X) was $23.4{\pm}1.4mm$, the tibial tunnel length(T) was $43.6{\pm}1.7mm$, the patellar tendon length was $40{\pm}2.4mm$, and the tibia bone plug length was $27{\pm}2.4mm$. Conclusion : In authors' endoscopic technique, establishment of individually determined optimal tibial bone plug length, based on total tunnel length and patellar tendon length could prevent the problem of graft-tunnel mismatch.

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Geometry of Resident's ridge with Multidetector-Row Computed Tomograph Image (다중검출기 컴퓨터 단층 영상 분석을 이용한 Resident's ridge의 형태학적 연구)

  • Roh, Jeong-Ho;Min, Byoung-Hyun;Park, Jeong-Wook;Ahn, Byung-Moon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.40-44
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    • 2008
  • Purpose: The purpose of this study was to report the real geometry of Resident's ridge doing in anterior cruciate ligament reconstruction Materials and Methods: From Jan 2007 to Aug 2007, 48 cases which had normal distal femoral condyle analyzed with Multidetector-Row Computed Tomography. Resident's ridge was defined as change of height above 1 mm in lateral wall of intercondylar notch. Anterior-posterior length of intercondylar notch, length and height of Resident's ridge, distance of Resident's ridge from posterior cortex were estimated with 3-D reconstruction using $Lucion^{(R)}$ program. Results: Cases were $59{\pm}16$ years olds and male was 16 cases, female was 32 cases. 9 cases had no Resident's ridge, anterior-posterior length of intercondylar notch was $25.4{\pm}3.5$ mm, average of length and height of the Resident's ridge was $8.2{\pm}2.6,\;3.5{\pm}1.5$ mm. Distance of the Resident's ridge from posterior cortex was $7.6{\pm}2.6$ mm. Conclusion: Resident's ridge was used as landmark in anterior cruciate ligament reconstruction, which presented in many cases and which had distinct length and height.

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The Effect of Cyclic Load on Different Femoral Fixation Techniques in Anterior Cruciate Ligament Reconstruction (전방십자인대 재건시 이식건의 대퇴골측 고정에 대한 주기성인장부하의 효과)

  • Song Eun-Kyoo;Kim Jong Seok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.28-36
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    • 2003
  • Purpose: To determine and to compare the effects of cyclic loading on the fixation strength of different femoral fixation methods in ACL reconstruction. Materials and Methods: Biomechanical test using an Instron(R) machine (Model No.5569. Mass, U.S.A) were carried out to compare the pull out strength of six different femoral fixation techniques after a cyclic loading in 72 Yorkshire pig knees. The graft-bone complex was cyclically loaded between 30N and 150N at 50 mm/min rate for 1000 cycles and maximal tensile testing was performed. A preload of 30N was applied to the graft along the axis of the tunnel 15 minutes. ANOVA and the Duncan multiple comparison test was used for the statistical analysis. Results: The mean maximum tensile strength of femoral fixation before and after the cyclic loading test were 1003.4$\pm$145N and 601.1$\pm$154N in hamstring-LA screw(R) group, 595.5$\pm$104N and 360.7$\pm$56N in hamstring-Bioscrew(R) group, 1431.7$\pm$135N and 710.7$\pm$114N in hamstring-Semifix(R) group, 603.6$\pm$54N and 459.1$\pm$46N in hamstring-Endobutton(R) fixation group, 1067.4$\pm$145 and 601.8$\pm$134N in the BPTB-Titanium interference screw group, and 987.1$\pm$168N and 588.7$\pm$124N in the BPTB-Bioscrew(R) group. And these data illustrated that cyclic loading reduces the maximum tensile strength by 40 $\%$, 39 $\%$, 50 $\%$, 24 $\%$, 44 $\%$, 40 $\%$ respectively. Conclusions: With the results of these experiments it should be emphasized that rehabilitation exercises after anterior cruciate ligament reconstruction should be executed with precaution as the repetitive flexion and extension of the knee would compromise the maximum tensile strength of the graft tendon.

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Anterior Cruciate Ligament Reconstruction using the Autogenous Bone-Patellar Tendon-Bone Graft (관절경적 전방십자인대 재건술)

  • Jung, Young-Bok;Yum, Jae-Kwang
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.47-51
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    • 1997
  • A torn anterior cruciate ligament(ACL) is the most common serious ligamentous injury to the knee joint. The incidence of ACL tears seems to be increasing, at least partly as a result of the increasing participation of individuals of all ages in high-risk sports. The most commonly used graft source for ACL reconstruction is the autogenous bone-patellar tendon-bone graft unit. Despite a good success record. postoperative complications, such as infection, patellar contracture/patellar baja, patellar fracture, rupture of the patellar tendon, graft failure without reinjury, can occur following ACL surgery. The purpose of this paper is to provide guidelines regarding the key points of the reconstructive procedure in a sequence and how to prevent or minimize the complications that can follow ACL reconstructive surgery. We want this knowledge can help orthopaedic surgeons to understand the reasons for previous and current successes and failures of reconstruction of the ACL, and it can help them to plan the care of patients who have an injury of the ligament.

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