• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.42-43
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• 2009

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.128-133
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• 2012

Purpose: This study examined the relationship between graft appearance on follow-up magnetic resonance imaging (MRI) and knee stability after double bundle anterior cruciate ligament (ACL) reconstruction. Materials and Methods: For each patient, 1.5 tesla MRI's were obtained. The signal intensity of grafts was divided into 3 grades by Sononda's classification. The course of grafts was divided into two patterns: straight and curved. We assessed Lachman test, KT 2000 arthrometer and anterior drawer stress radiograph using Telos$^{(R)}$ in $30^{\circ}$ knee flexion for anterior stability and evaluated pivot shift test for rotatory stability. The correlation between graft appearance on MRI and the results of knee stability tests was evaluated. Results: The anteromedial (AM) graft was evaluated as being grade 1 in 66.7%, grade 2 in 26.7%, and grade 3 in 6.7% of the cases and the posterolateal (PL) graft was assessed as being grade 1 in 63.3%, grade 2 in 33.3%, and grade 3 in 3.3% of the cases according to the signal intensity. The AM graft was evaluated as being straight in 83.3% and curved in 16.7% of the cases, and the PL graft was assessed as being straight in 86.7% and curved in 13.3% of the cases according to the course. The course of AM graft was correlated with the results of anterior stability tests and the course of PL graft was correlated with the result of rotatory stability test. However, the signal intensity of grafts was not correlated with the results of anterior stability and rotatory stability tests. Conclusion: The course of AM is correlated with anterior stability and the course of PL is correlated with rotatory stability on follow-up MRI after double bundle ACL reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.7 no.1
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• pp.70-75
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• 2003

Purpose : A cyst-like lesion within and around the knee joint is very rare, with very few articles available in the literature. The aim of this study is to evaluate effectiveness of arthroscopic treatment of cyst-like lesion within and around the knee joint which reported rarely. Materials and Methods : We are reporting 14 cases of cyst-like lesion around the knee joint. Our cases include 3 ganglion cyst in infrapatellar fat pad, 1 fibroma, 1 giant cell tumor and 1 epidermoid cyst which have not yet been reported. The diagnosis of cyst-like lesion in Juxta-articular knee Joint was made only by MRI study and we confirmed pathology. Male was 9, female was 5 cases, average age was 24(11-43)year old. Follow up was average 45(12months-8years)months. Minimum follow up was 12 months. Results : All the patients were treated arthroscopic excisional debridements successfully. All the cases were excellent result in last follow up by functional criteria in Lysholm knee score average 98.9(95-100). All examimation was normal except 3 cases in last follow up. But all patients satisfied in arthroscopic treatment. Conclusion : Arthroscopic excisional debridement of the cyst-1ike lesion in juxta-arthcular knee joint is excellent method, but long term follow up needed in the future.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.78-85
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• 2008

Purpose: The findings of preoperative magnetic resonance imaging (MRI) and ultrasonography (US) examination in the diagnosis of rotator cuff tear were then compared with the findings of arthroscopic examination, and to evaluate the postoperative integrity of rotator cuff using serial US examination. Methods: Between February and May 2008, 29 patients with rotator cuff tear had undergone preoperative US and MRI examination and subsequent arthroscopic examination. And the results of MRI and US were compared with intra-operative results of the arthroscopic examination. We observed the postoperative integrity of rotator cuff using serial (postoperative 2 weeks, 6 weeks, 3 months) US examination. Results: The sensitivity of US and MRI for identifying rotator cuff tear were 100% and 100%. The sensitivity of US and MRI were 95% and 82% in full thickness tear, and 50%, 33% in partial thickness tear, respectively. Overall accuracy of US and MRI were 86%, 69%. Among 22 patients were operated for full thickness tear, intra-operative gap formation was identified in 11 patients (50%, small to medium 2 cases, large to massive 9 cases) which were identified at 2 weeks postoperative US. We could find 5 re-tears (23%, small to medium 1 case, large to massive 4 cases) on 6 weeks postoperative US after passive range of motion (ROM) exercise, and could also find 7 re-tears (32%, small to medium 2 cases, large to massive 5 cases)on 3 months postoperative US after active ROM exercise. Conclusion: Serial US after arthroscopic rotator cuff repair was useful to differentiate intra-operative gap formation from postoperative re-tear. We found 5 retears (23%) at 6 weeks and 7 retears (32%) at 3 months postoperative US, it was useful to make treatment plan during postoperative rehabilitation.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.191-197
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• 2008

Purpose: To evaluate the postoperative magnetic resonance image (MRI) findings of anterior cruciate ligament (ACL) reconstructed with a tension load technique using auto-Achilles tendon, and to compare the results with knees with a native ACL. Materials and Methods: We evaluated 21 postoperative MRI scan of 21 patients (group A) who had undergone ACL reconstruction between January 1995 and November 1996. The control group (group B) consisted of 50 patients whose meniscus tear had been operated by arthroscopy and whose ACL was intact. We measured the orientation of the graft in the sagittal and coronal planes and compared it with that of the native ACL. Results: The mean sagittal angle of the ACL angle in group A ($55.7{\pm}5.6^{\circ}$, range $47.2{\sim}68.8^{\circ}$) was statistically lesser than group B ($58.7{\pm}3.8^{\circ}$, range $50.4{\sim}67.5^{\circ}$) (p=0.036). But there was no statistically significant difference between the two groups with regard to the mean ACL-Blumensaat line angle (group A: $8.1^{\circ}{\pm}4.9^{\circ}$, range $1.7^{\circ}{\sim}22.0^{\circ}$, group B: $8.6^{\circ}{\pm}3.6^{\circ}$, range $2.6^{\circ}-18.1^{\circ}$) and the mean coronal angle of the ACL (group A: $64.9^{\circ}{\pm}9.1^{\circ}$, range $46.9^{\circ}{\sim}76.4^{\circ}$, group B: $65.9^{\circ}{\pm}4.4^{\circ}$, range $57.7^{\circ}{\sim}75.2^{\circ}$)(p=0.88, p= 0.62). In the sagittal plane, the mean center of tibial insertion of the ACL graft in group A ($31.9{\pm}7.1%$, range 22.4-47.9%) was positioned more anteriorly than group B ($37.0{\pm}4.9%$, range $18.5{\sim}44.7%$)(p=0.005). But in the coronal plane, there was no statistically significant difference between the two groups(group A: $46.3{\pm}2.8%$, range $42.1{\sim}52.5%$, group B: $45.7{\pm}2.8%$, range $41.0{\sim}49.1%$)(p=0.392). Conclusion: We performed an ACL reconstruction with the tension load technique using auto-Achilles tendon and we found that the graft orientation in MRI was as good as that of the native ACL.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.163-171
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• 2008

Purpose: We analyze the characteristics of soft tissue sarcomas presented with hematoma, which were misdiagnosed as simple hematoma initially and the proper management were delayed. Materials and Methods: The 7 patients with histologically proven soft tissue sarcoma with hematoma presented since February 1997 were evaluated retrospectively. Neither patient had a medical history of bleeding tendency nor anticoagulant therapy. Two of them had minor traumas. There were 2 men and 5 women. Average follow up period was 58 months. MRI findings, provided treatments and oncologic outcome were reviewed with the reference of related articles. Results: Retrospective review of initial MR images revealed deep seated intramuscular masses with focal solid enhanced nodules at the peripheral margin. The diagnoses were delayed at least 1 month in 3 of them which included 2 cases of simple hematoma evacuation without biopsy initially. After histologic diagnosis of soft tissue sarcoma, wide resections were performed in 4 cases. one patient underwent above knee amputation and the remained 2 patients were managed with wide resection followed by amputation due to local recurrence. At last follow up there were CDF and NED in 2 cases, respectively and AWD in 3 cases. Conclusion: To avoid the delay of diagnosis and treatment of soft tissue sarcomas presented with hematoma, high degree of clinical suspicion, careful analysis of MR images and early biopsy were important.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.16-24
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• 2012

Purpose: This study was designed to investigate the rate of incidence, location and the clinical value of the rotator cuff retear by analyzing MRI scans, which was taken after an arthroscopic rotator cuff repair. Materials and Methods: This study included a total of 109 patients, who underwent a shoulder MRI scan after an average of 10.6 months later from the arthroscopic rotator cuff repair. We only defined the 'retear' when the Sugaya type IV and V was observed in the sagittal section of the MRI. The location of the retear was divided into the medial and lateral areas by the site, which was 1 cm medial to the anchor insertion. We investigated the incidence rate and the location of the retear, in terms of the age, sex, initial tear size and the suture method. Also, we compared the functional score of the retear group and the non-retear group, after an average of 13.9 months follow-up. Results: There were 38 of the 109 patients that showed the rotator cuff retear. Of these patients, 25 were male patients, and 13 were female patients. Of the 38 patients with the rotator cuff retear, 21 patients were included in the <3 cm retear group, and 17 were included in the ${\geqq}3$ cm retear group. At the end of the follow up period, all 109 patients showed a statistical significant improvement in the shoulder functional score. Conclusion: According to the follow up of the MRI scan, which was taken after the rotator cuff repair, the retear rate reached 34.9 %, and there were no significant differences on the age and the suture method. More rotator cuff retear occurred in male patients, and the initial tear size was positively correlated with the incidence rate of the rotator cuff retear. Also, the retear was more frequently observed at the medial side. That is because when the suture was performed, excessive tension was loaded on the medial side of the suture site.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.261-265
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• 2020

A lumbar juxtafacet cyst is a rare disease that causes low back pain, radiculopathy and neurological claudication by compressing the nerve roots. A 34-year-old male complained of severe low back pain and radicular pain in the right lower extremity. Magnetic resonance images revealed a cyst at the lateral recess of the spinal canal between the L3-4 disc and posterior facet joint that extended to the L4 body level. Under the guidance of an image intensifier, needle aspiration of the cyst was performed, which extracted 1.5 ml of serous, yellowish colored fluid. After the aspiration, the symptoms subsided dramatically. The follow-up magnetic resonance images showed no recurrence of the cyst. To the best of the author's knowledge, there are no reports of lumbar juxtafacet cyst treated with needle aspiration in Korea. This case is reported with a review of the relevant literature.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.148-154
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• 2003

Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation. Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months. Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change. Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.1
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• pp.69-71
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• 2010

Ganglionic cyst formation within the posterior cruciate ligament (PCL) of knee has not been reported. We describe a case of an intraligamentous ganglionic cyst of PCL. Arthroscopic technique through both the posteromedial and posterolateral portals was used for approach. Using probe, PCL was splitted and perforated ganglionic cyst at tibial attachement side. At 2 years follow up, the patient was free of symptoms with a full range of motion and follow-up MR image showed that there was no recurred ganglionic cyst.