• Journal of the Korean Society of Physical Medicine
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• v.3 no.1
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• pp.27-37
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• 2008

Purpose : Today, it enjoys a sports and a leisure where the anterior cruciate ligament(ACL) injury patient increase. The knee joint is important means of human body movement and to do an important duty when it encounters ACL injuries of the knee joint and the many restriction follows in the life which is ordinary. When it is damaged ACL, it comes to determinate that ACL reconstruction and preservation treatment that the according to condition of ligament and knee joint. After ACL reconstruction, that is the fact which already becomes known the exercise treatment advances a recovery and to reduce a sequela. Methods : we researched the method of exercise treatment after anterior cruciate ligament reconstruction operation by journal of science direct and KISS in daecu university. Results : The representative exercise treatment is isometric exercise, isokinetic exercise isotonic exercise and complex exercise but what kind of exercise treatment most is effective, it revealed and support it was not. The method of exercise treatment is very various, so It causes a confusion made to the therapist and patients. So it executes once again it sought the kinetic therapeutic method which is efficient from this research and it tried to observe preceding research after ACL reconstruction. To operation a various the exercise treatments, operation only the treatment which is general compared to it was effective in muscular power and muscle functional improvement. But this like improve despite with the exercise treatment consequence which is continuous from research of most the pain leg compares to the health leg, it appeared the discrepancy which is a muscular power, a muscular endurance and a hypertrophy muscle etc, to the health leg or before operating 100% of muscular power to having gets the many therapy time was the recovery rate. Conclusion : Therefore after ACL reconstruction, it will become the many research continuously which is improve the muscle functional and ROM of the exercise treatment method and From therapeutic site of the patients it does to memorizes knowledge in advance about ACL injuries and the application the isokinetic treatment or exercise program are the set of necessary, frequency and amusement that considers complex what kind of therapeutic exercise becomes accomplished with the patient take care of attention.

• Journal of the Korean Arthroscopy Society
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• v.2 no.1
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• pp.51-58
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• 1998

Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using the central one third bone patellar tendon bone(BPB) autograft versus a quadrupled semitendinosus/gracilis(ST) autograft in patients with "isolated" ACL tears. Materials & Methods : A strict criteria to identify isolated ACL tears was used which included : no previous surgery, no other ligamentous injury, no history of patellofemoral symptoms, no patellofemoral malalignment, no meniscal pathology, no chondromalacia or chondral injury and no limitation of motion of the injured knee. 30 patients (15 BPB, 15 ST) with a mean age of 27.4 years were available for a mean follow up of 18 months (between 12 months and 26 months). Preoperatively, there was no significant difference between the two groups with respect to age, sex and degree of laxity. Results : Postoperatively, we couldn't find significant differences between the two groups with respect to subjective Lysholm score, objective laxity including Lachman test, pivot shift test and KT-2000 measurements. Mean side to side difference of KT-2000 scores at 20lbs were 1.5mm for the BPB group and 1.4mm for the ST group. Positive Lachman test was found in 26.7% and 33.3% and positive pivot shift was found in 20% and 33.3% of the patients in the BPB and ST groups, respectively. Anterior knee pain (33.3%) was more common in the BPB group. There were 80% of the patients in both groups above nearly normal grade according to the IKDC grade. Conclusions : In patients with "isolated" ACL tears, the overall results, ligamentous stability for the patellar tendon and the quadrupled semitendinosus/gracilis were comparable. We consider that the quadrupled autogenous hamstring tendon is a good alternative substitute in ACL reconstruction together with the bone patellar tendon bone.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.135-140
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• 1998

From 1989 to 1994, authors have reconstructed the posterior cruciate ligament(PCL) in 51 knees with an autogenous central one-third of the patellar tendon by transtibial two tunnel technique, but there were not a few cases of unfavorable results. So from January 1995, we have reconstructed the PCL deficient knees by "modified tibial inlay technique" to avoid the grafted tendon abrasion at the posterior opening of the tibial tunnel(killer turn). Purpose of this study was to compare the results of two surgical techniques and what its advantages and disadvantages are. We could follow up 39 cases of transtibial two tunnel techique group(group A) more than one year, average being 23.7 months and 21 cases of modified tibial inlay technique group(group B) more than 12 months, average being 14.7 months. The clinical results were evaluated by the OAK knee scoring system ($M{\ddot{u}}ller$'s criteria) and the posteror stress roentgenography (push view) with Telos stress device compared with the uninjured knees. The arthroscopic second-look findings were also evaluated. In group A : The $M{\ddot{u}}ller$'s knee score was average 80.1 points, the posteror displacement in push view was average 4.4mm at the last follow up. There were 17 cases(44%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view. Among the 19 cases of arthroscopic second look examinations, nearly normal PCL appearances of the grafted tendons were noted only in 9 cases(47%). In group B : The $M{\ddot{u}}ller$'s knee score was average 86.7 points, the posterior displacemnet in push view was average 3.6mm at the last follow up. There were 5 cases(23.8%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view but 4 out of 5 cases showed 6mm posterior displacement in push views. Among the 7 cases of arthroscopic second-look examinations, 6 cases(86%) showed nearly normal PCL appearances of the grafted tendons. In modified tibial inlay technique of PCL reconstruction, it was easier to pull out the BPTB and in cases of remained laxed meniscofemoral ligament it was easier to preserve the remained structures than transtibial two tunnel technique. We expect the "modified tibial inlay technique" may solve the problem of grafted patellar tendon abrasion at the posterior orifice of tibial tunnel and may contribute to the successful PCL reconstruction.

• Journal of Korean Foot and Ankle Society
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• v.20 no.1
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• pp.12-18
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• 2016

Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.988-994
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• 1998

Background: Chest wall tumors can classified into soft tissue tumors and bone tissue tumors and can be subclassified into benign and malignant tumors. Materials and methods: We report an analysis of 68 patients with primary chest wall tumors treated at the department of thoracic and cardiovascular surgery at Hanyang University Hospital from January, 1973 to September 1997. Results: Among a total of 68 patients 33(48.5%) were males and 35(51.5%) were females. The ages of the patients ranged from 10 to 79 years with a mean age of 39.3 years. According to the age distribution, 23 patients (33.8%) were from the 4th decade, 12 patients(17.6%) were from the 6th decade, and 10 patients(14.7%) were from the 5th decade. Among the primary chest wall tumors, 53 cases were benign and 15 cases were malignant. Among the benign tumors, 17 cases(32.1%) were in the 4th decade and among the malignant tumors, 6 cases(40%) were in the 4th decade. In both malignant and benign tumors the most common ages were in the 4th decade. The most common tumors were fibrous dysplasia and chondroma, each with a total of 14 cases(26.4%). Osteochondroma and lipoma each had 8 cases(15.1%). Among malignant tumors, osteosarcoma was most common with 8 cases (53.3%). According to location, 49 cases occured in both bone and cartilage tissue, 19 cases occurred in cartilage. Among the presenting symptoms, palpable mass was present in all cases. Fifty-one patients complained of tenderness and among cases with involvement of the lung, 3 patients had complained of respiratory distress. Among the malignant tumors 6 cases underwent a radical operation and 4 cases of benign tumors underwent a radical operation. Postoperativly, there was one case with recurrence from a desmoid tumor. There were no deaths postoperativly and no deaths due to complications(and their postoperative courses were uneventful). Conclusions: Most patients with primary chest wall tumors initially present with mass at admission. Resection is sufficient treatment for benign tumors but in malignant tumors wide resection of the chest wall is needed and mchest wall reconstruction.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.199-216
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• 2005

치주치료의 가장 중요한 목적은 상실된 치주조직의 형태적, 기능적 재건이다. 법랑기칠 단백질 유도체(enamel matrix derivative: EMD)는 치주 병소에 사용시 상피세포의 증식을 억제하며 치주인대 및 백악아세포를 활성화시켜 무세포성 백악질 및 치주인대와 골조직의 생성을 유도한다고 보고되고 있다. 또한 법랑기질 단백칠 유도체는 골모세포의 증식 및 분화를 촉진시키며 alkaline phosphatase의 활성 및 mineralized nodule의 형성을 촉진시킨다고 보고되고 있다. 이에 본 연구에서는 토끼 두개골 결손부에 법랑기질 단백질 유도체와 이종골 이식재를 이식한 후 골밀도를 방사선학적으로 분석하고, 신생골 형성 및 주변 조직 반응을 조직학적으로 관찰, 평가하고자 하였다. 토끼 두개골에 6mm trephine bur(외경 8mm)를 이용하여 경뇌막에 손상을 주지 않도록 하면서 4개의 결손부를 형성하였다. 아무것도 이식하지 않은 군을 음성 대조군으로, 이종골 이식재 ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland)을 이식한 군을 양성 대조군으로 설정하였다. 법랑기질 단백질 유도체 ($Emdogain^{(R)}$, Biora, Inc., Sweden)만 이식한 군과 법랑기질 단백질 유도체와 이종골 이식재를 혼합하여 이식한 군을 설험군으로 설정하였다. 각각의 재료를 이식한 후 비흡수성 차폐막 ($Tefgen^{(R)}$, Lifecore Biomedical, Inc., U.S.A.)을 위치시키고 흡수성 봉합사로 일차봉합을 시행하였다. 각 군당 술 후 1, 2, 4주의 치유기간을 설정하였다. 동물을 희생시킨 후 두개골을 절제하여 먼저 방사선학적인 골밀도측정을 시행한 후 10% formalin에 고정한 후 통법에 따라 조직표본을 제작하여 광학현미경으로 관찰하였다. 1. 방사선학적인 평가에서 1, 2, 4주에 대조군과 법랑기질 단백질 유도체만 이식한 군과 비교해 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군에서 더 큰 골의 밀도를 보이고 있었다 (P<0.01). 하지만, 동일한 시기에 대조군과 법랑기질 단백질 유도체만 이식한 군과의 차이는 발견할 수 없었으며 (P>0.05), 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군의 차이 또한 발견할 수 없었다 (P>0.05). 2. 조직학적인 평가에서 1, 2, 4주에 대조군과 법랑기질 단백질 유도체만 이식한 군과 비교해 이종골 이식재만 이식한 군과 이종골 이식재에 법랑기질 단백질 유도체를 이식한군에서 골의 형성이 더 진행됨을 알 수 있었다. 법랑기질 단백질 유도체만 이식한 군이 대조군보다 2주에서 더 많은 신생골을 볼 수 있었으며, 이종골 이식재에 법랑기질 단백질 유도체를 이식한 군이 이종골 이식재만 이식한 군보다 1, 2주에서 더 많은 신생골을 관찰할 수 있었다. 이상의 결과에서 법랑기질 단백질 유도체는 토끼 두개골 결손부 치유단계에서 초기 골 형성을 촉진하는 것으로 사료되며 골 이식시에 법랑기질 단백질 유도체를 적용하는 것은 유용한 술식으로 사료된다.