• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.198-204
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• 2008

Purpose: The purpose of this study is to analyze the merits and demerits of double bundle reconstruction and achieve improvements hereafter, by comparing the results of double bundle and single bundle reconstruction using tibialis anterior allograft. Materials and Methods: Twenty seven patients were divided to undergo either double bundle(n=14) or single bundle(n=13) reconstruction with tibialis anterior allograft tendon. The evaluation methods were AP laxity with KT-2000 arthrometer, isokinetic knee strength measurements, pivot-shift test, IKDC subjective score, Lysholm knee score, Tegner activity score, radiographic evaluations with postoperative MRI, and second look arthroscopy. Results: Lysholm knee score and Tegner activity score were significantly better in double bundle reconstruction. In pivot-shift test, single bundle reconstruction was evaluated as grade 0 in 10 of the knees, grade 1 in 1, and grade 2 in 2. Double bundle reconstruction was evaluated as grade 0 in 13, and grade 2 in 1. In second look arthroscopy, single bundle was evaluated as excellent in 6 of the knees, fair in 7, anteromedial bundle of double bundle reconstruction was excellent in 13 and fair in 1, and posterolateral bundle was excellent in 4, fair in 9, and poor in 1. There were no significant differences in other evaluations. Conclusion: Favorable outcome may be expected with double bundle reconstruction of ACL. However there are still need for improvement in terms of reconstruction technique and rehabilitation protocol to reduce PL bundle injury.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.153-159
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• 2003

Purpose : The purpose of this study was to compare the pattern of displaced bucket-handle tear of lateral and medial menisci and the treatment modality and results from accompanying injury. Materials and Methods : Patients who were diagnosed for displaced bucket-handle tear of medial meniscus (group I: 52patients, 52cases) and lateral meniscus (group II: 31patients, 32cases) from September 1998 to December 2002. The mean ages were 25years $(16\~66)$ for Group I and 29years $(18\~63)$ for Group II, and the average follow-up period were 18months $(12\~44)$ and 13months $(6\~46)$, respectively. The zone of meniscus tear and the existence of accompanying injury were verified through intraoperative arthroscopy and discoid type meniscus was additionally examined for group II. The assessment was made according to the physical examination and clinical pattern at the postoperative last follow-up, and the 2nd look arthroscopy was performed in 19cases $(23\%)$ for the cases accompanying anterior cruciate ligament (ACL) injury in both groups. Results : There were 38cases $(73\%)$ in group I, 5cases $(16\%)$ in group II for associating ACL injury. We observed discoid type meniscus (19cases, $59\%$) in group II. At last follow-up clinical success in repair cases of group I and II are 22cases $(85\%)$, 2cases $(67\%)$, in resection cases are 26cases $(100\%)$, 26cases $(93\%)$ respectively. Reoperation is performed 2cases in repair cases of group I. One case is re-rupture, the other case is newly developed tear in white-white zone. Reoperation is performed 2cases due to remnant meniscal tear in resection cases of group II. All of 2cases are discoid type menisci. Conclusion : Displaced bucket-handle tear of medial & lateral menisci would be substantially different an aspect, considering on difference would help to select proper treatment modality.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.160-166
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• 2012

Purpose: The aim of this study was to determine the patterns of the stress distribution within the reconstructed anterior cruciate ligament (ACL) double bundles in response to an anterior tibial load and rotatory load at $45^{\circ}$ flexed knee model by use of a 3-dimensional finite element analysis (FEM). Materials and Methods: The $0^{\circ}$ and $45^{\circ}$ flexed 3-D knee model were reconstructed based on the high resolution computed tomography (CT) images from the right knee of a healthy male subject. To simulate double bundle ACL reconstruction, in $0^{\circ}$ analytic model, four 7 mm diameter tunnels were created at the center of each anteromedial (AM) and posterolateral (PL) footprints on the femur and tibia. The grafts were inserted into the corresponding bone tunnels and then reconstructed knee model was flexed to $45^{\circ}$. As a next step, the 5 mm anterior tibial load and internal rotational load of $10^{\circ}$ were applied on the final Computer aided design (CAD) model. And then stress patterns of each bundle were assessed using a finite element analysis. Results: In response to the 5 mm of anterior tibial load, the AM bundle showed increased stresses around the tibial and femoral attachment sites; especially in the anterior aspect of the bundle. In the PL bundle, the highest stress concentration was also noticed on the anterior aspect of the bundle. Under $10^{\circ}$ internal rotational load, the stress concentration was predominant around the anterior aspect of the tibial attachment site within the AM bundle. The PL bundle also showed highest stress concentration on the anterior aspect of the bundle. Conclusion: Although the stress patterns were not identical among the AM and PL bundle, there were common trends in the stress distribution. The stress concentration was predominant on the anterior aspect of both bundles in response to the anterior tibial load and rotatory load.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.18-26
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• 2011

Purpose: This study is to compare the clinical results of ACL reconstruction between three groups using hamstring tendon autograft, mixed and tibialis tendon allograft. Materials and Methods: Between August 2003 and August 2008, we analyzed 169 cases of ACL reconstruction, 66 cases used hamstring tendon autograft, 42 cases used mixed graft and 61 cases used tibialis tendon allograft, with a minimum follow-up of 12 months. For the clinical evaluation, we evaluated the Lysholm score, Telos stress test device and IKDC score. Results: The average side to side difference in Telos stress test decreased from $7.5{\pm}1.0$ mm to $1.6{\pm}1.0$ mm in autograft group, from $7.6{\pm}1.1$ mm to $1.4{\pm}1.1$ mm in mixed graft group and from $7.4{\pm}1.3$ mm to $2.5{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from 58.6 to 92.3 in autograft group, from 60.6 to 92.6 in mixed graft group and from 55.3 to 91.5 in allograft group. There was no significant difference between three groups in clinical results. At second look arthroscopy, tension of ligament and synovial coverage were good result in autograft and mixed graft than allograft group. Conclusion: All hamstring tendon autograft, mixed graft and tibialis tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. Both hamstring tendon autograft and mixed graft showed good synovial coverage in second look arthroscopy. So mixed graft will be considered as good alternative in case of shorter or thin harvested hamstring tendon.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.89-96
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• 2002

Purpose : The purpose is to analyze the relationship between bone bruise in MRI and associated injuries after the knee joint trauma. Materials and Methods : Total 50 cases were reviewed, divided into two groups according to initial trauma energy. High-energy group (group I), such as traffic accident was 13 cases, low-energy group (group II), such as sports trauma was 37 cases. The type of the lesion was used the classification by Costa-Paz. The site of lesion was analyzed according to femoral/tibial, medial/lateral and anterior/middle/posterior site respectively. Associated injuries were confirmed by physical examination, radiograph, MRI and arthroscopy. Results : In group I there was a various distribution of the bone bruise in the knee joint according to mechanism of injury. The bone bruise with ACL injury was 38$\%$ only and the most frequent type was Costa-Paz type I (52.6 $\%$). In group II more frequent locations were the middle portion of the lateral femoral condyle and the posterior portion of the lateral tibial condyle. Bone bruise associated with ACL injury, was upto 56.8 $\%$ and the frequent type were Costa-Paz type II (48 $\%$), in order type I (42 $\%$). As a result, in the high-energy injury the bone bruise had a various location in both condyle and less frequently associated injury, but in the low-energy injury there was particularly frequent location of bone bruise, associated injury and type. Conclusions : We could assess the associated injury by analysis of the location and type of bone bruise, especially in the low-energy injury, e.g. sports injury. But further study will be necessary with more case analysis.

• 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.

• Asian-Australasian Journal of Animal Sciences
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• v.22 no.12
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• pp.1654-1660
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• 2009

This study was conducted to investigate the effects of different fattening periods i.e. 25, 27 and 29 months of age (25 mo, 27 mo and 29 mo), on feed consumption, body weight gain, carcass parameters, and lipogenic gene expression in 45 Korean native steers (Hanwoo). Daily DM intake was higher in steers on 29 mo compared with those on 25 mo or 27 mo. Daily body weight gain was higher in steers on 25 mo compared with those on 27 mo or 29 mo during fattening and overall experimental periods. Therefore, feed conversion ratio was lower in 25 mo compared with 27 mo or 29 mo during the fattening and whole experimental periods. As expected, slaughter and carcass weights were higher in the order of 29 mo>27 mo>25 mo. Carcass yield grade was relatively lower in 29 mo reflecting higher back fat thickness compared with other treatments, while carcass quality grade was not largely influenced by the treatments. By investigation with an ultra-sound scanning technique, the marbling score was significantly and numerically higher in 25 mo compared with 27 mo or 29 mo. The mRNA levels of stearoyl-CoA desaturase (SCD) gene were gradually increased in the late fattening stages (p<0.01) and mRNA of acetyl-CoA carboxylase (ACC), ATP citrate lyase (ACL) and glucose transporter 4 (GLUT4) gene were highly expressed in 29 mo compared with 25 mo and 27 mo (p<0.05). However, gene expressions of adipocyte fatty acid binding protein 4 (FABP4) and lipoprotein lipase (LPL) were not significantly different among the treatments. Thus the present results indicated that different fattening period has no major effect on carcass characteristics, although 25 mo had a lower carcass weight compared with 27 mo or 29 mo.

• Journal of the Korea Concrete Institute
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• v.17 no.1 s.85
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• pp.85-94
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• 2005

Post-tensioned Precast concrete System(PPS) consists of U-shaped precast wide beams and concrete column. The continuity of beam-column joint is provided with floor concrete cast on the PC shell beam and post-tensioning. The purpose of this paper is to evaluate the response of PPS interior beam-column joint subjected to cyclic lateral loading. To this end, an experimental investigation was performed with three half-scale specimens of interior connection. The design parameters are the amount of beam reinforcement placed inside the joint core. The test results showed that cracks were distributed well without my significant degradation of strength and ductility. Also, it was found that the prestressing may affect to alter the torsional crack angle. And the specimens sufficiently resist up to limiting drift ratio of 0.035 in accordance with the provisional by ACl of acceptance criteria for concrete special moment frames.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.97-101
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• 1999

Purpose : The purpose of this study is to prevent thc graft-tunnel mismatch by measuring the patellar tendon length, intertunnel distance, tibial tunnel length and by obtaining appropriate bone block length. Materials and Methods : Authors analyzed 15 patients who had taken the anterior cruciate ligament reconstruction from March 1997 to June 1999. Tibial guide was always set on the "endo" $40^{\circ}$ position(Acufex, MA, USA). We measured the following indices, intertunnel distance(X), tibial tunnel length(T), patellar tendon length(N), tibia bone plug length(Y). Both of the femoral tunnel length(F) and the patellar bone plug length(P) were made in 25mm. The appropriate tibial bone plug length was simply calculated by subtracting the patellar tendon length from the sum of the intertunnel distance and thc tibial tunnel length(Y=X+T-N). Results : The average indices were as follows ; the intertunnel distance(X) was $23.4{\pm}1.4mm$, the tibial tunnel length(T) was $43.6{\pm}1.7mm$, the patellar tendon length was $40{\pm}2.4mm$, and the tibia bone plug length was $27{\pm}2.4mm$. Conclusion : In authors' endoscopic technique, establishment of individually determined optimal tibial bone plug length, based on total tunnel length and patellar tendon length could prevent the problem of graft-tunnel mismatch.

• 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.