• Journal of the Korean Orthopaedic Association
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• v.56 no.6
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• pp.540-545
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• 2021

A transverse fracture is the most common type of displaced patella fracture requiring surgery. These fractures are commonly fixed with parallel Kirschner wires or screws that cross the fracture line, often with an additional tension band. Nevertheless, conventional fixation methods of patella fractures have prevalent complications caused by the protrusion of wires or pins. These complications necessitate additional surgery for hardware removal, increase medical cost, and can limit the function of the knee joint. This paper reports cases treated with a minimally invasive load-sharing percutaneous suture of the patella tendon. The procedure provides reliable fixation for transverse patella fractures, minimizes soft tissue injuries, preserves blood flow, and reduces postoperative pain. In addition, the procedure also reduces the irritation and pain caused by the internal fixture, thereby reducing the risk of restricted knee joint movement.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.103-116
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• 2021

The use of 3-dimensional (3D) printing is becoming more common, and its use is increasing in the orthopedic surgery. Currently, there are four major methods of using 3D printing technology in orthopedic surgery. First, surgical planning simulation using 3D printing model; second, patient-specific surgical instruments; third, production of customized prosthesis using 3D printing technique; fourth, patient-specific prosthesis produced by 3D printing. The areas of orthopedic surgery where 3D printing technology can be used are shoulder joint, spine, hip and pelvis, knee joints, ankle joint, and tumors. Since the diseases and characteristics handled by each area are different, the method of using 3D printing technology is also slightly different in each area. However, using 3D printing technology in all areas can increase the efficiency of surgery, shorten the surgery time, and reduce radiation exposure intraoperatively. 3D printing technology can be of great help in treating patients with particularly complex and difficult orthopedic diseases or fractures. Therefore, the orthopedic surgeon should make the most of the benefits of the 3D printing technology so that patient can be treated effectively.

• Journal of the Korean Society for Precision Engineering
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• v.21 no.6
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• pp.188-196
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• 2004

The objective of this paper is to propose a new technology of the orthopaedic surgery using the combination of reverse engineering (RE) based on CT data and rapid prototyping (RP). The proposed technology utilizes symmetrical characteristics of the human body and capability of the combination of RE and RP, which rapidly manufactures three-dimensional parts from CT data. The original .stl data of injured extents are generated from the mirror transformation of .stl file fur uninjured extents. The physical shape before injuring is manufactured from RP using the original .stl data. Subsequently, pre-operative planning, such as a selection of proper implants, preforming of the implant, a decision of fixation locations and an insert position for the implant, an estimation of the invasive size, and pre-education of operators are performed using the physical shape. In order to examine the applicability and the efficiency of the proposed surgical technology, various case studies, such as a distal tibia commented fracture, a proximal tibia plateau fracture and an iliac wing fracture of pelvis, are carried out. From the results of case studies, it has been shown that the proposed technology is an effective surgical tool of the orthopaedic surgery reducing the operational time, the operational cost, the radiation exposure of the patient and operators, and morbidity. In addition, the proposed technology could improve the accuracy of operation and the speed of rehabilitation.

• 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.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.10a
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• pp.34-34
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• 2003

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.12-17
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• 2005

Several methods to resurface the lost cartilage of the knee have been used, multiple drilling, microfracture, abrasion arthroplasty Resurfaced cartilages resulting from above techniques are mostly fibrocartilage. Autologous osteochondral graft transfer and autologous chondrocyte transfer are known to resurface the lost cartilage with mostly hyaline cartilage. This article reviews basic researches, indications, operative technique, and clinical results of autologous osteochondral graft transfer.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.1-8
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• 2019

Globally, the elderly population is increasing rapidly, which means that the number of deformity correction operations for elderly spine deformity patient has increased. On the other hand, for aged patients with deformity correction operation, preoperative considerations to reduce the complications and predict a good clinical outcome are not completely understood. First, medical comorbidity needs to be evaluated preoperatively with the Cumulative Illness Rating Scale for Geriatrics or the Charlson Comorbidity Index scores. Medical comorbidities are associated with the postoperative complication rate. Managing these comorbidities preoperatively decreases the complications after a spine deformity correction operation. Second, bone densitometry need to be checked for osteoporosis. Many surgical techniques have been introduced to prevent the complications associated with posterior instrumentation for osteoporosis patients. The preoperative use of an osteogenesis inducing agent - teriparatide was also reported to reduce the complication rate. Third, total body sagittal alignment need to be considered. Many elderly spine deformity patients accompanied degenerative changes and deformities at their lower extremities. In addition, a compensation mechanism induces the deformed posture of the lower extremities. Recently, some authors introduced a parameter including total body sagittal alignment, which can predict the clinical outcome better than previous parameters limited to the spine or pelvis. As a result, total body sagittal alignment needs to be considered for elderly spine deformity patients after a deformity correction operation. In conclusion, for elderly spine deformity patients, medical comorbidities and osteoporosis need to be evaluated and managed preoperatively to reduce the complication rate. In addition, total body sagittal alignment needs to be considered, which is associated with better clinical outcomes than the previous parameters limited to the spine or pelvis.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.100-104
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• 2011

The purpose of this article is to examine correlation between femoral rotational angle and subjective satisfaction of high tibial osteotomy outcome of the range of motion of knee joint. The subjects were 15 patients (6 males, 9 females) with primary osteoarthritis undergoing high tibial osteotomy from June of 2004 to August of 2008. They were CT tested on the knee joint before and after high tibial osteotomy. TEA (Fig. 1) and Akagi's line (Fig. 2) are analyzed as percentages. The Kendall's and Spearman's nonparametric correlation coefficient were used for the statistical tests with 0.5 level of significance. The result reveals that femoral rotational angle correlates with not the range of motion of knee joint but subjective satisfaction of the patients. Therefore, this will enable patients and physicians to have better clinical outcome.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.281-293
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• 2020

An anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgical procedures in the knee joint, but despite the better understanding of anatomy and biomechanics, surgical reconstruction procedures still fail to restore rotational stability in 7%-16% of patients. Hence, many studies have attempted to identify the factors for rotational laxity, including the anterolateral ligament (ALL), but still showed controversies. Descriptions of the ALL anatomy are also confused by overlapping nomenclature, but it is usually known as a distinctive fiber running in an anteroinferior and oblique direction from the lateral epicondyle of the femur to the proximal anterolateral tibia, between the fibular head and Gerdy's tubercle. The importance of the ALL as a secondary restraint in the knee has been emphasized for successful ACL reconstructions that can restore rotational stability, but there is still some controversy. Some studies reported that the ALL could be a restraint to the tibial rotation, but not to anterior tibial translation. On the other hand, some studies reported that the role of ALL in rotational stability would be limited as a secondary structure because it bears loads only beyond normal biomechanical motion. The diagnosis of an ALL injury can be performed by a physical examination, radiology examination, and magnetic resonance imaging, but it should be assessed using a multimodal approach. Recently, ALL was considered one of the anterolateral complex structures, as well as the Kaplan fiber in the iliotibial band. Many studies have introduced many indications and treatment options, but there is still some debate. The treatment methods are introduced mainly as ALL reconstructions or lateral extra-articular tenodesis, which can achieve additional benefit to the knee stability. Further studies will be needed on the indications and proper surgical methods of ALL treatment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.109-112
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• 2011

Anatomical reduction and strong fixation in displaced patella fracture are needed for restoration of knee function and strength and early range of motion exercise. According to the type of fracture and various operational methods, their many complications have been reported. We report 2 cases of transverse patella fracture which were caused by transverse screw fixation in longitudinal patella fracture and fracture of bipartite patella in athletes.