• Journal of the Korean Arthroscopy Society
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• v.7 no.1
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• pp.92-95
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• 2003

A 34-year-old man with ACL total rupture due to slip down injury, had received ACL reconstruction using autogenous hamstrings tendon with cross-pin femoral fixation. Postoperative course was as usual. But postoperative 3 months later, he complained posterolateral knee pain, recurrent effusion and mild instability. He was managed repeatitive aspiration and nonsteroid antiinflammatory drugs but was failed to relieve symptoms & signs. In CT scans, perforation of posteromedial femoral cortex of lateral femoral condyle was found. In second look arthroscopy, two pieces of broken femoral cross pin were found in between tibiofemoral Joint which was badly injured cartilage. We considered malposition of pins was the main cause of failure. We propose that femoral tunnel must be made more acute angle and femoral cross-pin guide must be positioned more external rotation 10-20 degree than transepicondylar axis made confirm the cross-pin tunnel position in order to avoid posterior cortex perforation and early failure.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.694-703
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• 2019

This study was to investigate the effect of therapeutic exercise with electrical stimulation on knee joint pain, range of motion and muscle strength in patients who underwent anterior cruciate ligament reconstruction. The subjects of this study were recruited who diagnosed with anterior cruciate ligament rupture and undergoing anterior cruciate ligament reconstruction, total of 20 patients were randomly divided to the 10 control groups and 10 experimental groups. The therapeutic exercise was carried out for 3 weeks with three exercises made by referring to the previous study. The measurement tools used were knee joint pain measurements were made using the visual analogue scale, range of motion was measured using a goniometer, and the muscle strength was measured using a handheld dynamometer. In the statistical analysis, to compare about pre and post test the difference in each same groups was accomplished by using the paired t-test, and compare the difference between the different each groups was accomplished by using the independent t-test. The results of the study showed that the experimental group showed significantly enhanced results than the control group(p<.05). Based on these results, it is concluded that it is effective for the recovery of the patient if the therapeutic exercise with electrical stimulation in parallel with knee joint therapy are performed for the patients with anterior cruciate ligament reconstruction.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.91-97
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• 2010

Purpose: The purpose of this study was to evaluate the results of treatment for longitudinal meniscal tear in ACL rupture patients by clinical evaluation and $2^{nd}$ look arthroscopy. Materials and Methods: Among the patients who underwent surgery due to ACL rupture and longitudinal meniscal tear between 2002~2009, 32 patients were selected for the study. The patients were devided into three groups; group 1 had repair, group 2 had partial menisectomy due to impossible to repair, group 3 had conservative treatment due to stable meniscus. Comparative retrospective analysis was applied with KT 1000 arthrometer, Lysolm' score, Tegner activity score, IKDC subjective score, and $2^{nd}$ look arthroscopy. Results: Lysolm' score, Tegner activity score, IKDC subjective score showed no statistical difference in all three groups. KT-1000 side to side difference improved from 6.2, 6.15, 6.38 before surgery to 2.56, 2.49, 2.58 after surgery in group 1, 2, and 3, respectively. In group 1, second-look arthroscopy revealed complete healing in 12 patients, incomplete healing without any clinical symptoms in 2, and healing failure in 1. In group 2, second-look arthroscopy showed partial regeneration on margin of meniscectomy. In group 3, second-look arthroscopy revealed complete healing in 2 patients, while 4 showed incomplete healing so that have repaired. Conclusion: In the study, the outcome was better when the stable longitudinal meniscal tear on posterior horn with ACL rupture had active treatment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.37-42
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• 2002

Purpose : To report a short-term clinical results and technical method of thermal shrinkage with radiofrequency device for anterior and posterior cruciate ligament laxity which is not suitable to indications of reconstructive surgery. Materials and Methods : Nine cases of anterior cruciate ligament injuries (ACL), 5 cases of posterior cruciate ligament (PCL) injuries and 3 cases of combined anterior and posterior cruciate ligament injuries, in which the condition is not indicated as reconstructive surgery, are investigated. The follow-up period averaged 6 months. Results : Instability in living activity, limping and pain were improved with excellent results. But, posterior cruciate ligament thermal shrinkage revealed as recurrent knee laxity progressively Conclusions : The result of thermal shrinkage for partial tear of cruciated ligament was excellent. We believe this procedure is applicable to partial tear of the ACL or PCL which reconstructive surgery is not indicated. Long-term follow-up results were needed.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.165-169
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• 2009

The lateral meniscus is morphologically more variable than the medial meniscus. An abnormal lateral meniscus also varies with respect to its size, shape and stability, and such variations can occur in any patient of any age. The most common variant is a discoid lateral meniscus. We recently encountered a patient with a discoid lateral meniscus for which the anterior horn of the meniscus was anomalously inserted into the anterior ACL. The patient was forty five years old women who had persistent pain for three to four years without any specific trauma history. She was preoperatively diagnosed as having discoid lateral meniscus by MRI, and was confirmed the presence of the complex tear and anomalous insertion of the anterior horn of the discoid lateral meniscus into the anterior ACL by arthroscopic examination. Arthroscopic subtotal meniscectomy was performed and the symptoms were improved after surgery.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.14-18
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• 2004

Purpose: To compare the mid-term follow-up results of anterior cruciate ligament(ACL) reconstruction with the bone-patellar tendon- bone(BTB) autograft to those with the BTB allograft. Materials and Methods: Retrospective study was performed in 59 cases with BTB autograft and 42 cases with BTB allograft. Evaluations include Lysholm score, 2000 IKDC subjective knee score, Shelbourne patello-femoral pain score , Lachman test, pivot shift test, KT-1000 arthrometer test and 2000 IKDC knee examination. Results: There were no significant statistic differences between two groups in Lysholm score and 2000 IKDC subjective knee score of more than 70 (p<0.05). Five cases(8.5%) showed the patello-femoral pain score less than 80 according to Shelboume with autograft group and two cases(4.8%) with allograft group (p<0.05). Lachman test, pivot shift test and KT-1000 arthrometer test showed no significant statistic differences between two groups(P<0.05). Fifty-four cases(91.5%) were normal or nearly normal according to the 2000 IKDC knee examination with autograft group and thirty-eight cases(90.4%) with allograft group(p<0.05).Conclusion: BTB allograft as well as BTB autograft is considered to be an acceptable choice for ACL reconstruction.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.149-150
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• 2009

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.201-205
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• 2003

Purpose : Authors experienced cases of chronic ACL tear with spur-like lesion on the tibial condyle which is different from the lateral capsular sign and degenerative change and evaluated the significance of 'spur-like lesion' in relations with chronic ACL injury. Material and Method : We have 5 patients with spur-like lesion on the lateral tibial condyle in simple radiogram. The location, shape and size of the lesion were studied using radiogram and MRI. Cause of injury, associated injury and chronicity of the ACL tear were analyzed. All 5 patients were male, and mean age was 33.8 $(17\~46)$ years. Result : The spur-like lesion was located from 3.8 mm(avg.) below the articular surface of the lateral tibial condyle to the apex of the fibular head and protruded laterally or inferolaterally from just posterior to the Gerdy's tubercle with a round or sharp-end triangular shape. Average length was 6 mm and average width ortho base was 9.2 mm. The cause of injury were sports jnjury 4 cases and traffic accident in one. The chronicity of the ACL tear was average 10.7(8 months$\~$23 years) years and medial meniscus tear was shown in all cases and lateral meniscus tear in three. Conclusion : We suggest that a patient who has a history of trauma with spur-like lesion on the lateral tibial condyle of the knee is expected to have chronic ACL tear.

• 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 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.