• Journal of the Korea Convergence Society
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• v.13 no.3
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• pp.327-335
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• 2022

This study aimed to compare functional recovery after rehabilitation exercise between isolated PCL reconstruction and combined PLC reconstruction. Patients were divided into two groups: those who had isolated PCL reconstruction (n = 16) and those who had combined PLC reconstruction (n = 16). We assessed knee joint ligament laxity, subjective questionnaires, and isokinetic muscle function before, after 12, and 24 weeks of a rehabilitation exercise program. In both groups, there were significant differences in knee joint laxity (p = 0.048), IKDC subject score (p < 0.001), Lysholm knee (p < 0.001), Tegner activity scale (p = 0.027), and isokinetic muscle deficit (p = 0.040) by estimated period. However, no significant difference between groups was observed (p > 0.05). These results suggest that rehabilitation exercise after isolated PCL and combined PLC reconstruction influenced structural, subjective, functional recovery positively.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.138-142
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• 2009

Purpose: The purpose of this study was to evaluate the result of anterior cruciate ligament (ACL) reconstruction using a fourstrand single semitendinous tendon to decrease the donor site morbidity due to harvest both semitendinosus and gracilis tendon. Materials and Methods: Thirty seven consecutive patients who had underwent ACL reconstruction using four-strand single semitendinosus tendon were evaluated. Mean age was 28.6 years old. Male was 34, female 3 patients. Time from injury to surgery was 5.4 months. Combined injuries were 10 meniscus injuries, 3 medial collateral ligament injuries and 1 osteochondral injury. Mean follow-up period was 16 months(12~18 months). Clinical evaluation was done using range of motion, Lachman test, pivot-shift test, Lysholm score & KT-2000 arthrometer. Results: All patients showed the normal range of motion of mean 150..at follow-up. Lachman test and pivot-shift test was negative in 35 cases. Lysholm score was improve from 84 to 92. Two cases had residual laxity due to poor compliance. Mean anterior translation compared to contralateral side by KT-2000 arthrometer improved from 6.7 mm preoperatively to 2.1 mm at follow-up. Conclusion: Reconstruction of the anterior cruciate ligament with use of a four-strand single semitendinosus tendon autograft showed good clinical results.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.167-173
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• 2005

Purpose: The purpose of this study is to evaluate the clinical results of posterior cruciate ligament (PCL) and posterolateral structure (PLS) reconstruction using bilateral hamstring tendon autografts. Materials and Methods: From October 2002 to March 2004, ten patients were received PCL and PLS reconstruction simultaneously using bilateral hamstring autografts. PCL was reconstructed using ipsilateral hamstring tendon and fixed with cross pins and Intrafix (Mitek, Norwood, MA). PLS was reconstructed using contralateral hamstring tendon. The mean follow up was 17 months. Clinical assessments consisted of Lysholm knee scores, International Knee Documentation Committee (IKDC) evaluation form and posterior stress radiographs. External rotation of tibia was evaluated at $30^{\circ}\;and\;90^{\circ}$ knee flexion using Noyes and Barber-Westin's classification. Contralateral harvest site morbity was evaluated using IKDC evaluation form and flexion power of the knee. Results: Mean posterior displacement of tibia using stress radiographs was improved from 13.3 mm to 3.7 mm. In tibial external rotation evaluation, 7 patients were functional, 2 patients were partially functional and one failure. The average Lysholm knee score improved from 54 preoperatively to 86 postoperatively. At the final IKDC evaluation, 8 patients were graded as nearly normal, 2 were graded as abnormal. In contralateral harvest site morbidity evaluation, 2 patients complained of numbness around the wound but negligible. Conclusion: PCL and PLS reconstruction using bilateral hamstring autografts was considered as a good treatment method with minimal contralateral harvest site morbidity.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.99-107
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• 2011

Purpose: The purpose of this study was to investigate the clinical results after a anatomical double bundle ACL reconstruction using a longitudinally split tibialis anterior allograft. Materials and Methods: We evaluated 24 patients with a minimum follow-up of 12 months who had undergone anatomical double bundle ACL reconstructions. The grafts utilized in all cases were tibialis anterior allografts which were longitudinally split into two strands. A standard rehabilitation protocol was applied in all patients. The pre- and post-operative data including Lysholm scores, International Knee Documentation Committee (IKDC) scores, Lachman test, pivot shift test and the side-to-side differences of anterior laxity measured by KT-2000 arthrometer were analyzed by use of a statistical method Results: The mean side-to-side instrumented laxity measured by the KT-2000 arthrometer significantly improved to a mean of $1.04{\pm}0.80\;mm$ (P < 0.001). The Lysholm knee scores also improved from $58.34{\pm}15.32$ to $86.25{\pm}6.48$ after surgery (P < 0.001). The patients exhibited improved IKDC scores (A: 15 cases, B; 9 cases) at the final follow-up, compared to preoperative scores (B: 5, C: 10, D: 9). Conclusion: Our data demonstrated that clinical results of anatomical double bundle ACL reconstruction with a split tibialis anterior allograft are encouraging with excellent side-to side laxity, significantly improved Lysholm knee score, IKDC score, Lachman and pivot shift data.

• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.107-113
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• 2010

Purpose: To evaluate the outcome of the two-bundle anterior cruciate ligament reconstruction with single femoral tunnel and tibialis anterior tendon allograft and to determine any functional advantages. Materials and Methods: From June 2006 to March 2008, we performed single femoral tunnel and two-bundle ACL reconstruction with tibialis anterior tendon allograft in 26 cases. Mean age was 35.5 years. 20 cases were male and 6 cases were female. Average follow-up period was 2 years and 5 months, range from 1 year to 3 years and 5 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test and IKDC score. Results: Postoperative mean Lysholm knee score, IKDC Evaluation Form, Tegner activity scale, Pivot shift test, and anterior displacement by the Telos stress test demonstrated statistically significant differences compared to the preoperative. Conclusion: Two-bundle anterior cruciate ligament reconstruction with single femoral tunnel showed good clinical results and was good operative technique.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.85-91
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• 2007

Purpose: To analyze the clinical results and second look arthroscopic findings of anterior cruciate ligament(ACL) reconstruction with a tibialis anterior tendon allograft and a hamstring tendon autograft. Materials and Methods: We reviewed the cases of athroscopic ACL reconstructions using allogenous tibialis anterior(TA) tendon and autogenous hamstring tendon done from March, 2002 to August, 2005 and followed-up more than 1 year. The 250 cases were included in this study and allogenous TA tendon was used in 150 cases and autogenous hamstring tendon in 100 cases. The mean follow-up period was 15 months and 14 months, respectively. The clinical evaluation was done by Lachman test, Pivot shift test, KT-1000 arthrometer and International Knee Documentation Committee(IKDC) knee score. Graft tension, synovial coverage were observed in cases of second look arthroscopy. Results: At final follow-up, there was no significance between the two groups in clinical examination. On second look arthroscopy, synovial coverage was better in autogenous hamstring tendon group than allogenous TA tendon group(p=0.005). But no difference was found in graft tension(p>0.05). Conclusion: There were no significant differences between the two groups in the clinical results. But autogenous hamstring tendon group had better synovial coverage than allogenous TA tendon group in second look arthroscopy.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.107-113
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• 2012

Purpose: The purpose of this study was to evaluate the posterior cruciate ligament (PCL) reconstruction with single bundle, single-incision technique using Achilles tendon and tibialis anterior allograft with ligament remnant preservation. Materials and Methods: Twenty six patients underwent PCL reconstruction was included. There were 21 males and 5 females. Mean age was 32 years. Used graft was a fresh frozen Achilles tendon allograft (group I, 14 cases) and tibialis anterior allograft (group II, 12 cases). Arthroscopic PCL reconstruction was performed using transtibial, single-incision and single bundle technique with remnant preserving as possible. For clinical evaluation, range of motion, posterior drawer test, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) grade and posterior stress radiograph were used. The mean follow-up period was 21.6 months (12-40 months). Associated injuries were 5 medial collateral ligament injuries, which were treated by conservative method. Results: Range of motion (ROM) was returned to normal range in 24 cases, but ROM deficit under $10^{\circ}$ flexion was 2 cases at final follow-up period. Preoperative posterior drawer test was 17 cases in grade II and 9 cases in grade III. At final follow-up 13 cases returned within normal grade, 7 cases grade I and 6 cases grade II posterior instability. Lysholm mean score was improved from preoperatively 62 to 90 at final follow-up period. Tegner activity mean scale improved from preoperatively 3.5 to 5.6 at final follow-up period. IDKC grade was grade A was 3 cases, grade B 17 cases, grade C 6 cases. In posterior stress radiograph, posterior displacement was improved from mean 12 mm preoperative to 4.5 mm at final follow-up. There were no statistical differences between two groups in clinical evaluations. There were two cases of re-rupture of graft at the bone-tendon junction in group I. Conclusion: We had successful results of PCL reconstruction with single-incision, single bundle technique using Achilles and tibialis anterior allograft without difference between two groups in patients with PCL injury. There were more re-rupture of graft in Achilles tendon group.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.196-200
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• 2003

Purpose : To evaluate clinical outcomes after anterior cruciate ligament (ACL) reconstruction in middle-aged patients and determine the factors affecting the outcome. Subjects and Methods : Clinical results obtained from 60 cases (60 patients) older than 40 years of age at the time of surgery and 58 cases (58 patients) younger than 40 years of age who underwent ACL reconstruction between August 1988 to January 2002, return to sports activity, and stress radiographs using Telos instrument were compared. Results : The Lysholm knee score was improved from the preoperative score of 54.0 points to the postoperative score of 92.9 in patients older than 40 years of age and was improved from 56.2 points to 92.2 points in patients younger than 40 years of age. Clinical outcome was excellent in 51 cases $(85\%)$ and good in 9 cases $(15\%)$ in patients olde. than 40 years of age and was excellent in 47 cases $(81.0\%)$ and good in 11 cases $(19.0\%)$ in patients younger than 40 years of age. There was a significant difference in the rate of returning to preoperative sports activity between patients older than 40 years of age ($60\%$, 36 cases) and younger than 40 years ($82.8\%$, 48 cases). According to Telos stress radiography, the preoperative difference of 11.2 mm was decreased to the postoperative difference of 3.1 mm in patients older than 40 years of age and the preoperative difference of 10.7 mm was decreased to the postoperative difference of 2.9 mm in patients younger than 40 years of age. Clinical outcome did not show significant correlation with age, gender, surgery method, the presence of additional injury, and the rate of return to sports activity before receiving injury (p>0.05). Conclusion : Age didn't have a significant influence on the final outcome of ACL reconstruction and good results could be obtained with ACL reconstruction even in middle-aged patients.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.1-6
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• 2008

Purpose: The purpose of this study is to compare the results of the arthroscopic reconstruction of ACL using autologous hamstring tendon and autologous bone-patellar tendon-bone. Materials and Methods: From January, 2000 to December, 2004, 120 patients underwent arthroscopic ACL reconstruction using autologous hamstring tendon(60 cases) and autologous bone-patellar tendon-bone(BPTB)(60 cases). The mean followed up period of hamstring tendon group was 42 months(range $24{\sim}69$ months) and patellar tendon group was 52 months(range $24{\sim}84$ months). At the time of the final follow up, sixty patients in each group were evaluated the results of physical examination, activity level, patients' satisfaction, functional status, and objective anteriror stability using KT-2000 arthrometer. Results: At the time of the final follow up we compared the two groups who had ACL reconstruction using either autologous hamstring tendon or BPTB, and the final results of the Lachman test showed negative, or mildly positive in 85%(51 cases) of the hamstring tendon group and 90%(54 cases) of the BPTB group. Pivot shift test indicated positive in both groups, 8%(5 cases) and 5%(3 cases) respectively and showed no statistically significant difference. The evaluation of the anterior laxity using the KT-2000 arthrometer revealed no significant difference in the hamstring and BPTB groups: differences less than 3 mm compared to the healthy side were 85%(51 cases) and 90%(54 cases)(p>0.05). The Lysholm score improved from a preoperative score of 51 to a postoperative score of 79.1 in the hamstring groups and from 52 to 82.2 in the BPTB groups. According to the IKDC rating system, 87%(52 cases) were normal or near normal in the hamstring group. In the BPTB group, 83%(50 cases) were normal or near normal. The Tegner score for the hamstring groups was 4.8 preoperatively and 7.1 at the final follow up, and the Tegner score for the BPTB groups was 4.5 preoperatively and 7.3 after the last follow-up. The anterior knee pain was found in 7%(4 cases) in the hamstring tendon group and 10%(6 cases) in the patellar tendon group. Conclusion: Arthroscopic ACL reconstruction using both the autologous hamstring tendon and the patellar tendon during their mid term follow up period demonstrated excellent results. However, the final results during their last follow up showed no statistically significant difference between the two groups.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.74-79
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• 2001

Purpose : The purpose of this study is to evaluate the clinical results after arthroscopic PCL reconstruction and to compare the clinical results after arthroscopic PCL reconstruction using BPTB(bone patellar tendon bone) autograft(Group I : 11 cases), Achilles tendon allograft(Group II : 7 cases) and BPTB allograft(Group 111.6 cases). Materials and Methods : We reviewed the result of 24 patients who had been managed with arthroscopic reconstruction using different graft materials such as BPTB autograft, Achilles tendon allograft and BPTB allograft. Twenty-four patients(average age, 37 years) with PCL rupture were retrospectively evaluated more than one year(average, 31 months) after having arthroscopic posterior cruciate ligament reconstruction. The clinical results were evaluated by IKDC ligament standard evaluation form, using $KT-2000^{TM}$ knee ligament arthrometer and also evaluated Lysholm knee scoring scale. Results : The final evaluation was nearly normal in 11 patients($45\%$ in Group I, $43\%$ in Group II, $50\%$ in Group III). The corrected posterior sagging was abnormal(side to side difference more than 6mm) in 8 patients($36\%$ in Group I, $29\%$ in Group II, $33\%$ in Group III). We could not find significant difference among three groups by IKDC scale. Conclusion : Comparing with other reports, our overall results were not satisfactory. And also, we could not find any remarkable difference among the three groups. Further research is necessary to evaluate new surgical approaches as well as improved techniques for capsular and collateral ligament injuries.