• Title/Summary/Keyword: 후방 십자 인대

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Rehabilitation after Posterior Cruciate Ligament, Posterolateral Rotatory Instability, and Multiple Ligament Reconstruction

  • Yu, Jae-Du
    • 대한관절경학회:학술대회논문집
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    • 2008.04a
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    • pp.84-85
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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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Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction Using Achilles Allograft - Preliminary Report - (이중고리 동종 아킬레스건을 이용한 후방십자인대 재건 - 예비 보고 -)

  • Lim, Hong-Chul;Yoo, Jae-Chul;Han, Sang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.7-13
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    • 2002
  • Purpose : Preliminary report of the technique and trial of double bundle PCL reconstruction using Achilles allograft. Materials and Methods : From May 1999 to July 2000, 8 cases of PCL insufficient patients were treated with Achilles allograft reconstruction using the double bundle and double femoral tunnel technique. The tibial tunnel was prepared anteromedially. All other combined injuries within the knees were treated accordingly. Minimal follow-up period was 1 year. The results was assessed from the point of function and stability using Lysholm knee score and KT-2000 arthrometer. Results : Up to present follow up. 8 patients showed good sign of recovery with no instability (translation less than 2 mm) except olio that has been grafted-ligament rupture. In addition, none showed any sign of infection nor ROM limitation. Two complications were seen, which one had grafted-bone fracture and the other grafted-ligament rupture. The former occurred during operation and the latter occurred due to improper protection. Conclusion : Presently the follow up period is too short to draw any conclusive opinion but it is essential to select healthy and well sterilized allografts fur successful outcome. Double femoral tunnel technique seems to be more physiologic in PCL reconstruction. With these prerequisites, it seems to be a good alternative to use Achilles allografts fur the reconstruction of PCL. However, a longer follow-up is needed.

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Symptomatic Mid-Substance Posterior Cruciate Ligament Calcification of the Knee Joint (증상을 동반한 슬관절의 후방십자인대 실질부에 발생한 석회화)

  • Ahn, Gil Yeong;Lee, Tae Hun;Hwang, Sung Hyun;Lee, Kyung Jin
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.93-97
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    • 2021
  • Calcification in the tendon is a common disease especially in the rotator cuff. The condition can be treated conservatively in the chronic stage, but surgically in the acute stage. On the other hand there are few reports of calcification in the cruciate ligament of the knee joint, especially calcification of the posterior cruciate ligament. A 51-year-old patient with symptomatic calcification in the mid-substance of the posterior cruciate ligament was treated conservatively. The symptoms did not improve after eight months of conservative treatment, so arthroscopic surgery was performed. During arthroscopic removal of the calcification, the ligament was damaged beyond preservation. Eventually a posterior cruciate ligament reconstruction was performed. At two years after surgery, radiography confirmed no recurrence of the calcification, and the patient was free. We report this case study with a review of the relevant literature.

Clinical Results of the Single-bundle, Transtibial Posterior Cruciate Ligament Reconstruction: A Systematic Review (경경골 단일다발 후방십자인대 재건술의 임상 결과: 체계적 고찰)

  • Kim, Yeong-Mo;Lee, Cassandra A.;Matava, Matthew J.
    • 대한관절경학회:학술대회논문집
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    • 2009.10a
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    • pp.57-57
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    • 2009
  • 관절경적 경경골 단일 다발 후방십자인대 재건술은 전통적으로 가장 흔하게 사용되는 사용되는 술기이다. 그러나, 후방십자 단독 파열시 이 술기의 결과에 대한 임상 평가 및 효용성에 대한 임상적 분석 자료가 거의 없는 실정이다. 이 술기를 시행받은 환자군들에서 객관적 슬관절 이완이 존재함에도 불구하고 주관적 슬관절 기능 장애는 우수한 결과를 나타낸다고 인정되어 왔다. 후방십자인대 단독 파열 후 경경골 단일 다발 재건술을 시행한 문헌 10개를 대상으로 잔존하는 후방 이완과 주관적, 객관적인 기능 평가, 활동성 정도, 환자 만족도, 골관절염의 발생 빈도, 술후 합병증을 체계적으로 고찰하였다. 술전 후방 슬관절 이완은 8.38~12.3 mm에서(4문헌) 술후 1.96~5.9 mm으로(9 문헌) 호전되었다. Lysholom 점수는 평균 81~100점이었다(9 문헌). IKDC는 75%에서 정상 또는 거의 정상의 결과를 보였다(6 문헌). 평균 Tegner 활동도는 4.7~6.3점이었다(8 문헌). 이번 고찰을 통한 결과에서 이 술기 후 퇴행성 변화가 관찰되었으며 보고된 합병증은 거의 없었다. 후방십자인대 단독 파열에서 경경골 단일 다발 재건술은 정상 슬관절의 안정성까지 회복하지는 못하나 한 등급 정도의 후방 슬관절 이완의 호전을 기대할 수 있다. 재활 및 운동으로의 회복에 대한 주관적 슬관절 점수는 80점이며 75%의 정상 또는 정상에 가까운 객관적 결과를 보여주었다. 이 술기가 퇴행성 관절염을 예방할 수는 없더라도 이러한 결과는 후방십자인대 재건 술기의 평가에 도움이 될 것으로 사료된다.

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Radiofrequency Shrinkage Method for Minor Degree of Cruciate Ligament Injury of knee joint (경도의 슬관절 십자 인대 손상환자에 대하여 시행한 열 위축술)

  • Moon Young Lae;Ha Sang Ho;You Jae Won;Joo Jeong Yong;Ju Pyong
    • 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.

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Arthroscopic Repair of Acute Posterior Cruciate Ligament Rupture with Autogenous Hamstring Tendon Graft Augmentation - Technical Note (급성 후방 십자 인대 파열의 관절경하 봉합술 및 자가 슬괵 이식건 보강술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Lee, Sang-Hak;Sung, Kee-Lyong
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.70-76
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    • 2005
  • Purpose: We describe a new technique of arthroscopic repair with using autogenous hamstring tendon graft augmentation for the acute posterior cruciate ligament rupture. Operative technique: A routine arthroscopic examination of the knee joint is initially performed, then the posterior trans-septal portal is prepared with the using the posteromedial and posterolateral portals. The torn tibial stump that is retracted to the posterior compartment is repaired by a suture hook that is introduced through the anteromedial portal; visualization during this procedure is done with the arthroscope via the posteromedial portal. Using the retrieved suture, both suture ends are brought out to the anteromedial portal. The torn tibial stump is pulled to the intercondylar notch and then repaired with stitches at the anterior compartment. After the tibial and femoral tunnels are prepared without damaging the remnant PCL bundle, the combined torn PCL fibers and the autogenous single-bundle semitendinosus and gracilis tendon grafts are passed through the femoral tunnel and fixed together Conclusion: Arthroscopic repair of the torn tibial stump and autogenous hamstring tendon graft augmentation after preparing the tibial and femoral tunnels by using the trans-septal portal, without damaging the remnant PCL bundle, seems to be a very effective method for the treatment for acute PCL injuries, and especially for tears at the femoral attachment.

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Arthroscopic Posterior Cruciate Ligament Reconstruction without Tourniquet (지혈대 없이 시행한 관절경하 후방십자인대 재건술)

  • Kim, Sang-Bum;Lee, Young-Goo;Son, Jung-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.94-97
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    • 2004
  • Purpose: To report the results of arthroscope assisted posterior cruciate ligament reconstruction without tourniquet, which has not yet been reported in documents within the country. Materials and Methods: Out of the 75 cases of arthroscope assisted posterior cruciate ligament reconstruction on patients with posterior cruciate ligament damage from January, 1998 to May,2003 in this hospital, study was done on 49 cases of patients with isolated posterior cruciate ligament damage, excluding 16 cases of patients who were applied tourniquet in extraarticular operation due to combined damage such as in lateral collateral ligament and posterolateral collateral ligament, and 10 cases where the postoperative observation period was less than 12 months. There were 13 cases where reconstruction was done using autogenous bone-patella tendon-bone, 19 cases using allogenous bone-patella tendon-bone, and 17 cases using allogenous achilles tendon. For assessment, the 49 cases were compared using Lysholm knee scoring scale. Results: The average duration of operation was 105 minutes. There were no severe complications such as swelling, bleeding, infection etc . Assessment results attained by Lysholm knee scoring scale was 74(fair) for cases where autogenous bone-patella ten-don-bone was used,75(fair) for cases where allogenous achilles tendon was used, and 76(fair) for cases where allogenous bone-patella tendon-bone was used. Conclusion: There are no difficulties to perform the arthroscopic assisted posterior cruciate ligament reconstruction. Reconstruction without tourniquet can be thought to prevent complications that could follow when using it.

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Treatment of Ruptured Posterior Cruciate Ligament using Augmentation of the Synthetic Polyester Prosthetic Ligament (Synthetic Polyester Prosthetic Ligament 보강술을 이용한 후방 십자 인대 손상의 치료)

  • Sohn, Sung-Won;Jeon, Si-Hyun;Park, Jin-Uck
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.121-125
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    • 2002
  • Purpose : The purpose of this study was to assess the clinical outcomes and radiological changes of arthroscopic augmentation with synthetic polyester ligament for posterior cruciate ligament injury Materials and Methods : The assessment was made among 60 patients who underwent arthroscopic augmentation with synthetic polyester ligament (ABC ligament, Surgicraft, U.K.) into the substance of ruptured PCL proper under the arthroscopic control from January, 1990 to January, 1996 and whose follow-up period was more than 5 years (average 7.8 years). The results were analyzed by using the posterior stress radiographs by Telos stress device, KT-2000 arthrometer and the clinical assessment by using Lysholm knee score. Results : The average difference of posterior displacement on stress radiographs were 13.2 mm preperatively and 3.6 mm at last follow up. Both knee showed minimal difference on KT-2000 arthrometer (0.7 mm on 20 lb) at the last follow-up. The mean Lysholm knee score was 49.2 preoperatively and improved to 84.3 post-operatively. Conclusion : Authors observed that long-term results of arthroscopic augmentation with synthetic polyester ligament for PCL injury were similar with those using human allograft. Taking these results into consideration, the synthetic polyester ligament is assumed to be a method of treatment of the PCL injury.

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The Results of Primary Repair in Acute Injuries of the Posterior Cruciate Ligament (후방 십자 인대 급성 손상에서 일차 복원술의 결과)

  • Lee, Dong-Chul;Baek, Seung-Hee
    • Journal of Yeungnam Medical Science
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    • v.18 no.1
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    • pp.101-111
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    • 2001
  • Background: We analyze the functional evaluation, posterior stability after surgery of acute injuries in the femoral detachment and tibial avulsion fracture of posterior cruciate ligament. Materials and Methods: Twenty two patients who underwent primary repair were followed more than one year after operation (mean follow-up 33.7 months). The patients were evaluated with KT 2000 arthrometer and posterior stress test for posterior stability. Lysholm knee score was used for knee function. Results: Lysholm score revealed 85.3 in femoral detachment group and 91.1 in tibial avulsion fracture group (P<0.05). Posterior displacement of the posterior stress test showed 17.2 mm at initial injury and 8.6 mm at last follow up in femoral detachment group, 16.8 mm at initial injury and 7.1 mm at last follow up in tibial avulsion fracture group. There revealed the tendency of the improved posterior stability of the tibial avulsion group compared with femoral detachment group, but there showed no statistical significance in KT 2000 arthrometer and posterior stress x-ray. Conclusion: Functional results of tibial avulsion fracture group revealed the better outcome compared with femoral detachment group, but the degree of posterior stability in tibial avulsion fracture group showed no statistical significance in posterior stability.

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The Evaluation of Usefulness New Assistant Device to Observe Posterior Cruciate Ligament Rupture and Patellofemoral Joint Injury in Emergency Patient (응급환자에서 후방십자인대 손상 및 슬대퇴 관절을 관찰하기 위한 보조기구 제작 및 유용성 평가)

  • Seo, Sun-Youl;Han, Man-Seok;Jeon, Min-Chul;Yu, Se-Jong;Kim, Yong-Kyun
    • Journal of radiological science and technology
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    • v.33 no.2
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    • pp.93-96
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    • 2010
  • This study evaluates usefulness of the developed assistant device by taking projection of patellofemoral joint in emergency patients who were doubt posterior cruciate ligament injury in knee joint. The subjects of experiment were patients who visited Eul-Ji University Hospital due to knee injury from January 2006 to December 2006. Seventeen patients, who took the Knee post stress view, Knee merchant view, Knee Seo's view to use assistant device and Knee MRI. To make assistant device of $170{\times}50{\times}70\;cm$, we evaluated its usefulness by measuring posterior dislocation of tibia. Seo's view is more accurate to make judgment of posterior cruciate ligament injury than original knee post stress view. Interval difference of posterior dislocation of original knee post stress view is $6.17{\pm}3.04$ and Seo's view is $8.74{\pm}4.47$. The results show injury of patellofemoral joint, vertical fracture of patella and posterior cruciate ligament injury by taking a projection using Seo's view. Therefore, it is useful to take projection earlier than talometer and MRI in emergency patients who were doubt posterior cruciate ligament injury in knee joint.