• Title/Summary/Keyword: 전방 십자인대

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Clinical Evaluation of TightRope Cranial Cruciate Ligament Technique for Treatment of Cranial Cruciate Ligament Deficiency in Dogs (전방 십자인대 결손을 보이는 개에서 TightRope을 이용한 치료방법 평가)

  • Yoon, Hun-Young;Kim, Kyung-Hee;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.455-459
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    • 2012
  • Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in 9 dogs. Mediolateral radiographic projection revealed cranial subluxation of the tibial tuberosity in a tibial compression view. The right and left stifle joints were affected in 7 dogs and 2 dogs respectively. TightRope cranial cruciate ligament (CCL) technique for treatment of CCL deficiency was performed. Polyester and nylon were used to stabilize the stifle in 3 dogs and 6 dogs respectively. Suture sizes were 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ strands (n = 1) in diameter. Mean (${\pm}SD$) surgical duration was $48.3{\pm}8.5$ minutes (range 35 to 60 minutes). Preoperative and postoperative mean (${\pm}SD$) cranial drawer signs were $8.6{\pm}1.6$ mm (rage 7 to 12 mm) and $1.2{\pm}1.0$ mm (rage 0 to 3 mm) respectively. Immediate postoperative radiographs of the affected limb revealed no evidence of cranial subluxation of the tibial tuberosity in a tibial compression view of 9 dogs. Normal limb function was regained in 8 dogs within 8 weeks postoperatively. A consistent weight bearing lameness resolved in all dogs after TightRope CCL technique, but reoccurred in one dog (case No. 6) 2 weeks after surgery. Cranial subluxation of the tibial tuberosity was identified in a tibial compression test. During the second surgery, breakage of surgical button was identified and a tibial wedge osteotomy was performed. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.

슬개건을 이용한 전방 십자 인대 재건술

  • Lee Byung-Il;Choi Hyung-Suk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.100-105
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    • 2003
  • 자가 중간 1/3 슬개건골을 이용한 관절경적 전방 십자 인대 재건술은 슬관절의 안정성 회복 및 임상적 결과가 비교적 만족 할만 하나 슬개-대퇴간 동통 공여부 감각 소실 또는 저하 등의 슬개골 주위 합병증이 발생하므로 이러한 문제점을 가능한 줄이고 기능적 회복을 도모하는데 이식건 채취 방법에 있어서 분리된 절개를 이용하고 속이 빈 원형의 톱날 기구(Hollowsaw)를 사용함으로써 결과의 향상을 기대 할 수 있을 것으로 사료되나 추후 보다 면밀하고 장기적인 추시 관찰이 됫받침 되어야 할 것이다

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One-stage Revision Anterior Cruciate Ligament Reconstruction Using Achilles Tendon Allograft (동종 아킬레스 건을 이용한 한 단계 전방 십자 인대 재 재건술)

  • Cho, Sung-Do;Ko, Sang-Hun;Park, Moon-Soo;Jung, Kwang-Hwan;Cha, Jae-Ryong;Gwak, Chang-Youl;Eo, Jin
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.159-164
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    • 2006
  • Purpose: To evaluate the clinical stability and function after one-stage revision anterior cruciate ligament (ACL) reconstruction using fresh-frozen Achilles tendon allograft Materials and Methods: Thirteen patients who underwent one-stage revision ACL reconstruction using Achilles tendon allograft could be evaluated. The average time from primary procedure to revision surgery was 61.8 months. The mean follow-up period was 38.4 months. The bone defects of pre-constructed femoral and tibial tunnels were filled with calcaneal bone attached to Achilles tendon and the new femoral and tibial tunnels were created. Evaluations included the causes of failure of primary ACL reconstruction, Lysholm knee score, Lachman test, pivot shift test and KT-1000 arthrometer measurement. Results: The most common causes of failure of ACL reconstruction were poor surgical techniques in 10 cases (76.9%). Ten patients (76.9%) were good or excellent on the Lysholm score. Twelve patients (92.3%) had negative or 1+firm end Lachman test. Eleven patients (84.6%) had negative pivot shift test. Nine patients (69.2%) had less than 3 mm difference of manual maximum by KT-1000 arthrometer. Conclusion: One-stage revision ACL reconstruction with fresh-frozen Achilles tendon allograft, creating new tunnels after filling bone defects, resulted in a reliable and predictable outcome in terms of stability.

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ACL Reconstruction with Remnant Preserving Technique - Technical Note - (잔류조직 보존 술기를 이용한 전방 십자 인대 재건술 - 수술 술기 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Jeong, Ji-Young;Jeon, Hyung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.82-85
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    • 2009
  • Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

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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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The Changes of Patellofemoral Alignment after Anterior Cruciate Ligament Reconstruction (전방 십자 인대 재건술후 슬개-대퇴 관절 선열의 변화)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Kwon Gi-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.128-133
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    • 2000
  • Purpose : To compare the changes of the patellar height, patellofemoral alignment and subjective symptom and to compare the effects of patellar tendon harvest after anterior cruciate ligament(ACL) reconstruction using autograft and allograft. Materials and Method : ACL reconstruction was performed on 87 patients who were followed up for minimum 1 year. The group I was 52 patients who were operated with bone-patellar tendon-bone autograft and the group II was 35 patients who were operated with bone-patellar tendon-bone allograft and achilles tendon allograft. At the time of follow-up, the authors evaluated the patellar height by Blackburne-Peel method, Merchant congruence angle, Lateral patellofemoral angle and subjective symptoms were assessed. Results : The patellar heights were significantly decreased from 0.86 preoperatively to 0.80 postoperatively in the group I and from 0.87 preoperatively to 0.83 postoperatively in the group II. There were no significant differences in the lateral patellofemoral angles between the both groups but in the Merchant congruence angle, significant differences were observed in the both groups, from$-1.43^{\circ}$ preoperatively to-$5.43^{\circ}$ postoperalively in the group I and from$-1.53^{\circ}$ preoperatively to$-3.65^{\circ}$ postoperatively in the group II. Conclusion : After ACL reconstruction, the patellofemoral alignment was changed and this kind of changes may be caused by multiple factorials such as harvest of autografts, ACL reconstruction itself, and quadriceps muscle atrophy.

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