• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.131-137
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• 2002

Purpose: To evaluate and compare the functional results, activity status, and anterior stability between conservative group with partial ACL injury and reconstruction group with bone-patellar ten-don-bone autograft in ACL total rupture. Materials and Methods: Thirty-eight patients with ACL injury were diagnosed and treated with arthroscopy and followed for more than two years. The number of patients with partial injury was 12(mean age; 38.3) and reconstruction group was 26 (mean age; 25.3). Objective stability was estimated under anterior loading of 15 lb and 20 lb by KT-2000 Arthrometer (MED metric, USA). Functional evaluation using Lysholm score and Tegner activity score were performed. Results: Average functional score of Lysholm was 88.5 in partial injury group and 89.3 in reconstruction group. Average score of Tegner was 5.3 in partial injury group and 5.1 in reconstruction group(P<0.05).Average anterior displacement compared with normal side. Under loading of 20lb, 1.7$\pm$4.3 mm in partial injury group, 2.3$\pm$1.9 mm in reconstruction group were anterior displaced (P<0.05). Under loading of 15lb, 1.2$\pm$1.0 mm in partial injury group, 1.4$\pm$1.5 mm in reconstruction group were dis-placed (P<0.05). There were giving way, effusion, instability and anterior knee pain in complication. Giving way was the frequent complication in the partial injury group. Conclusions: Clinical results of both group were similar. Functional evaluation of Lysholm was good and status of Tegner activity was maintained to physical fitness activites (jogging, regular bik-ing) in both groups on average. The results of conservative treatment for the partial ACL injury (less than 50$\%$) was satisfactory and equivalent to that of reconstructive treatment for the total ACL injury.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.44-50
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• 2012

Purpose: The purpose of this study is to analyze the relationship between acute anterior cruciate ligament (ACL) injury and bone bruise using the survey for location and incidence of bone bruise. Materials and Methods: From Jan. 2006 to Feb. 2010, 87 knees from who had complaint a traumatic knee pain were diagnosed as acute ACL tear using MRI evaluation. Associated injury, location and incidence of bone bruise were analyzed using MRI. The location of bone bruise on the MRI was classified as medial, central and lateral area on anteroposterior and lateral view of femur and tibia. The bone bruise was classified with Costa Paz classification. Results: Bone bruise of injury during daily living activity were located at medial area on coronary view and anterior area on sagittal view of distal femur, at medial area on coronary view and anterior area on sagittal view of proximal tibia (p=0.024, p=0.021, p=0.025 and p=0.029, respectively). Bone bruise of injury during sports activity were located at lateral area on coronary view and central area on sagittal view of distal femur, at lateral area on coronary view and posterior area on sagittal view of proximal tibia (p=0.014, p=0.015, p=0.018 and p=0.017, respectively). Bone bruise patterns due to traffic accident were inconclusive (p=0.264, p=0.254, p=0.229 and p=0.267, respectively). Conclusion: Injury mechanism of acute ACL injury from activities of daily living or sports activities compared to that of traffic accident showed a more consistent bone bruise patterns. Special attention to acute ACL tear must be paid in case of bone bruise at lateral tibial plateau and lateral femoral condyle.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.125-131
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• 2011

Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

• 대한관절경학회:학술대회논문집
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• 2007.10a
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• pp.19-19
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• 2007

• 대한관절경학회:학술대회논문집
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• 2006.11a
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• pp.98-99
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• 2006

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.85-91
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• 2001

Purpose : The purpose of this study was to determine the clinical outcome of meniscal repairs according to tern location and combined injury. Materials and Methods : From 1994, 73 meniscal repairs were underwent by arthroscopy and followed more than 1 year. The locations of torn meniscus were 29 red-red Bone, 36 red-white zone, 8 white-white zone. Twenty-six patients also had combined lesion including ACL injury 17 cases and treated simultaneously. Clinical result was evaluated by OAK system. Result : Healing rates(above good) were $94\%$ in isolated injury and $88\%$ in combined injury, especially $94\%$ in ACL injury. The result according to tern location were $90\%$ in red-red zone, $91\%$ in red-white zone, all in white-white zone. Conclusion : Meniscus tear with ACL injury should be repaired by arthroscopy, simultaneously. The meniscal tear of white-white zone could be healed by arthroscopic meniscal suture.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.156-160
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• 2002

Purpose : To evaluate the results and usefulness of meniscal repair using meniscal arrows with ACL reconstruction. Material and Methods : Among cases of the simultaneous meniscal arrow fixation and ACL recontruction performed between May, 1997 and September, 2000, 17 cases could be evaluated. The average follow-up were 18.5 months. Twelve cases were medial meniscus, 5 cases, lateral meniscus. All cases were longitudinal tear. Meniscal tear were seen at red-red zone in 13 cases, red-white zone in 5 cases. The results were analyzed by pain, joint line tenderness, locking, McMurray test, the Marshall knee scoring scale and complications. Results : Postoperatively two patients had mild joint line tenderness without pain on joint motion or weight bearing. No patient had locking or positive McMurray test. At last follow-up, 15 cases $(88\%)$ were 'excellent' or 'good' according to the Marshall knee score scale. There were two complications which are soft tissue irritation sign on active knee motion and a femoral chondral injury due to protruded T-shaped head of meniscus arrow. Conclusion : Meniscus arrow can be one of the options in repairing the associated meniscus tear, especially the posterior horn of medial meniscus, during ACL reconstruction. However, surgeons using meniscus arrow should be aware of its potential complications such as pain due to soft tissue irritation and chondral damage of the femoral condyle.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.294-304
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• 2020

Anterior cruciate ligament (ACL) reconstruction is a successful procedure independently by patient selection, timing of surgery, surgical technique, choice of graft, and fixation methods. Among these factors, graft selection and fixation methods might be the most critical yet controversial questions for surgeons. Although recent studies showed that grafts have advantages and drawbacks, there is still no ideal graft. Similarly, many fixation methods of femoral and tibial tunnels have been proposed over the last few decades, with no clear superiority of one technique over another. Surgeons should be familiar with a variety of grafts, fixation techniques, and their specific associated surgical procedures as well as the advantages and disadvantages of each. Therefore, this article summarizes the current literature and discusses the current state of graft selection and fixation methods in the treatment of an ACL injury.

• 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

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.93-101
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• 2005

일반적으로 전방 십자인대 손상의 치료만큼 관심과 논쟁의 대상이 되는 분야도 드문 것으로 알려져 있다. 치료 방법으로는 과거에는 보존적 요법이나 일차 수복술, 관절외 재건술 등이 시행되었으나, 근래에는 관절경하에 재건술이 가장 보편화되고 선호되는 방법으로 발전되어 왔다. 현재까지 400개 이상의 전방십자인대 재건술의 방법이 문헌상 발표되고 있으나 아직까지도 이상적인 방법은 없는 것으로 알려져 있다. 재건술의 성공을 위하여 환자의 선택, 수술시기, 수술방법 재건술의 기본원칙에 대한 이해 등이 중요한 요인으로 인정되며, 이에 대한 문헌고찰과 최근경향 등에 대하여 논하고자 한다.