• Title/Summary/Keyword: ACL Reconstruction

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Revision of Failed ACL Reconstruction - Early Result - (전방 십자 인대 재 재건술 단기 추시 결과)

  • Ahn Jin-Hwan;Cho Yong-Jin;Lee Yong-Seuk;Shin Seong-Kee
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.169-175
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    • 2003
  • Purpose : The purpose was to evaluate the early result of revision of failed anterior cruciate ligament (ACL) reconstruction. Materials and Methods : From August 1997 to February 2002, this report presents the findings of 18 patients who had revision surgery for failed ACL reconstruction. There was an average of 39 $(7\~120)$months from index procedure to the time of revision. Allografts were used in 14 $(78\%)$cases and autografts were used in 4 $(22\%)$cases and the revision procedures were assisted by arthroscopic technique. The majority of chief complaints were instability in 16 $(89\%)$cases. Sixteen $(89\%)$ cases had 1 previous reconstruction, 2 $(11\%)$ cases had 2. Before and after revision, patients were evaluated by Lachman test, pivot shift test, KT 2000, radiographs, Lysholm score and HSS score and subjective satisfaction. Results : Average length of followup was 27 $(12\~60)$months. Preoperatively, all cases were positive in Lachman test and pivot shift test. After revision the majority of cases were negative. Objectively improving stability was confirmed by KT 2000 and all average KT 2000 was 7.75 $(3.5\~12.5)$mm preoperatively and 2.36 $(1.0\~6.0)$mm at final followup. Lysholm score and HSS score were also improved from 72.6 $(66\~77)$ and 72.5 $(68\~78)$ preoperatively to 89.2 $(80\~92)$ and 88.2 $(81\~92)$ at final followup. Most $(89\%)$ of patients were satisfied with their results. The most common causes of failed ACL reconstruction were malposition of femoral tunnel in 11 $(61\%)$cases. Conclusion : Arthroscopic revision ACL surgery with adequate graft for failed ACL reconstruction was successful in objectively and subjectively improving stability. However, considering the most common causes of failure after ACL reconstruction were errors in surgical technique, it is important that the primary ACL reconstruction should be performed with correct surgical technique.

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A Prospective Randomized Study of Anterior Cruciate Ligament Reconstruction Comparing Single-Bundle and Double-Bundle Techniques (단일다발 및 이중다발 전방십자인대 재건술의 전향적 무작위적 비교 연구)

  • Park, Sang-Eun;Lim, Moo-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.13-19
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    • 2010
  • Purpose: To evaluate and compare the postoperative knee stability and functional scores between single- and double- bundle anterior cruciate ligament (ACL) reconstruction at a minimum 2 years follow-up. Materials and Methods: 56 patients (group T) with ACL injury in one knee were recruited with 27 allocated to the double bundle ACL reconstruction group (group D) and 29 to the single bundle ACL reconstruction group (group S). Clinical outcomes including Lysholm knee scores, Tegner activity scores, Lachman and pivot shift test results, and radiographic stabilities were also compared between two groups. Results: Clinical outcomes including Lysholm knee and Tegner activity scores were similar in the two groups at 2 years follow-up. Furthermore, stability results of Lachman test, pivot shift test, and radiological findings failed to reveal any significant inter-group differences. Conclusion: Double bundle ACL reconstruction does not produce better in clinical outcomes and postoperative stabilities.

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Overview of the PCL Reconstruction (후방 십자 인대 손상 치료의 개관(over view))

  • Jung, Young Bok
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.1-3
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    • 1998
  • The PCL reconstruction in chronic isolate PCL reconstruction was still controversy. 1) In isolate PCL deficient knee, functionally not so bad as like ACL deficient knee. 2) The result of the PCL reconstruction was not as good as ACL reconstruction. Therefore, isolate PCL injuries has been treated as nonoperatively. Hey Grovere, who was the first to attempt an intra-articular reconstruction of the PCL, utilized the semi-tendinous tendon other static procedures have been described in only a few cases with very limited follow-up. Dynamic procedures utilizing the medial head of the gastrocnemius has been reported by Hugston and Degenhardt, Kennedy and Grainger, and Insall and Hood. These procedures did not improve static stability. Dr Clancy, who was introduce the use of BPTB for the PCL reconstruction transtibial and femoral tunnel. From 1995, untill early 1990 PCL reconstruction was done as tend as placement of the isometric point. Physiometic placement of Anatomical placement of the femoral tunnel in PCL reconstruction were introduced in 1995. Tibial Inlay Technique was reported by Dr Berg in 1995. The main advantage of the tibial Inlay Technique was to avoid fraying of the graft at the posterior tibial tunnel orifice. In complete PCL ruptured and severely posterior unstable knee, dual femoral tunnel technique will be to get better result than one bundle technique. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the posterolateral structures. Futher research is necessary to evaluate new surgical approches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.

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Meniscal Repair with Resorbable Meniscal Arrows with Concurrent ACL Reconstruction (전방 십자 인대 재건술과 병행한 흡수성 Meniscal Arrow를 이용한 반월상 연골 봉합술)

  • In Yong;Kim Seung-Key;Bahk Won-Jong;Park Jong-Beom;Shin Jae-Hyuk;Chang Han
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.134-137
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    • 2000
  • Purpose : To evaluate tile clinical results of resorbable meniscal arrow fixation for repairable meniscal tear with concurrent anterior cruciate ligament(ACL) reconstruction. Materials and Methods : Between April, 1997 and June, 1999, we performed resorbable meniscal arrow fixation and ACL reconstruction simultaneously for 18 cases of repairable meniscal tears with ACL injuries. Nine cases were acute injuries, 5 cases, subacute and 4 cases, chronic. The average follow-up was 21.5 months($12\~38$ months). Results : The healing rate was $89\%$ for acute injuries, $80\%$ for subacute injuries and $50\%$ for chronic injuries. Conclusion : Resorbable meniscal arrow fixation with concurrent ACL reconstruction is a good treatment modality for acute and subacute injuries.

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Arthroscopic Double-Bundle Reconstruction of Anterior Cruciate Ligament (관절경을 이용한 전방 십자 인대의 이중 다발 재건술)

  • Jung, Young-Bok;Park, Se-Jin;Jung, Ho-Joong;Yoo, Jae-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.92-98
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    • 2007
  • Purposes: The purpose of this study was to report surgical technique of double bundle anterior cruciate ligament(ACL) reconstruction and to compare the short-term clinical results between arthroscopic single-bundle and double-bundle ACL reconstruction. Materials and Methods: From May 2005 to May 2006, ninety-eight patients were underwent ACL reconstruction. We designed prospective study with sixty-one patients who were revealed isolated ACL injury. We serially checked clinical and radiologic data preoperatively and postoperatively. We compared single-bundle with double-bundle ACL reconstruction patients with preoperative datas and postoperatively 1-year data. There were 30 single bundle reconstruction and 31 double bundle reconstruction. Stability was assessed objectively by anterior stress radiographs with the $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer. The clinical results were assessed by IKDC(International Knee Documentation Committee) and OAK(Orthopadische Arbeitsgruppe Knie) scores. Also, we evaluated postoperative thigh circumference and range of motion. All of operations were done by only one surgeon. Results: At single-bundle reconstruction group, preoperative AP instability which was checked by $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer was $7.9{\pm}3.3$ and $7.4{\pm}2.0$, respectively. At double-bundle reconstruction group, it was $8.3{\pm}3.5$ and $7.9{\pm}3.2$, respectively. Residual AP laxity checked at 1 year after operation was $1.9{\pm}1.2$ and $2.2{\pm}1.6$ in single-bundle reconstruction group, and $1.1{\pm}0.9$ and $1.0{\pm}1.0$ in double-bundle reconstruction group. So, double-bundle reconstruction had better results in both anterior stress radiographs with the $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer, and there were significant differences in statistics. But, clinical results such as IKDC(International Knee Documentation Committee) scores, OAK(Orthopadische Arbeitsgruppe Knie) scores, thigh circumference and range of motion had no significant difference between two groups. Conclusions: On the basis of stability, the side-to-side anterior laxity of double-bundle ACL reconstruction was significantly better than that of single-bundle reconstruction, although there were no significant differences in the other clinical measures among them.

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Anterior Cruciate Ligament Reconstruction using Hamstring Tendons (슬괵건을 이용한 전방 십자 인대 재건술)

  • Kim, Hyoung-Soo;Kim, Joo-Hak;Ji, Jeong-Min
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.123-131
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    • 2005
  • The central third of the patellar tendon and hamstring tendons(semitendinosus and gracilis) are the most frequently used tissues for intra-articular replacement of the anterior cruciate ligament(ACL). At present, many surgeons consider the central third patellar ten don graft to be the gold standard for replacement of the ACL. Recent prospective studies by Marder et at and Aglietti et al, however, have failed to show any statistically significant differences in knee stability and functional outcome between central third patellar tendon grafts and hamstring tendon grafts. The review of this article is to (1) review the historical use of hamstring tendon grafts for ACL reconstruction; (2) discuss indications for use of hamstring tendon grafts for ACL reconstruction; (3) describe our present operative technique using a combined double-looped semitendinosus and gracilis graft with $RIGIDFIX^{circledR}$ and $INTRAFIX^{circledR}$ and (4) review the results of hamstring ACL reconstructions.

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Pretibial cyst after Arthroscopic Anterior Cruciate Ligament Reconstruction using Hamstring Autograft - A Case Report - (자가 슬괵근을 이용한 전방 십자 인대 재건술 후 발생한 전경골 낭종 - 증례 보고 -)

  • Seo, Seung-Suk;Kim, Chang-Wan;Ha, Dong-Jun;Jung, Hun-Jae
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.53-57
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    • 2009
  • The pretibial cyst is a very rare complication after anterior cruciate ligament (ACL) reconstruction. It occurs whatever kind of graft choice or kind of graft fixation method at tibial side. It have been known such as graft necrosis at tibial side, extra-articular leakage of joint fluid through tibial tunnel, foreign body reaction due to breakdown of the bioabsorbable screw and incomplete incorporation of graft to bony tunnel as the cause of pretibial cyst. We experienced one case of pretibial cyst which had undergone ACL reconstruction with autogenous hamstring graft fixed with biodegradable interference screw. We report a rare case of pretibial cyst with literature review.

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The Usefulness of Quadriceps Exercise for Improvement of Knee Extensor Muscular Function after Cruciate Ligament Reconstruction (십자인대 재건술 후 슬관절 신전근의 근기능 향상을 위한 대퇴사두근 운동의 유용성)

  • Jang, Kyung-Mo;Seo, Dong-Ick;Seo, Kyung-Mook;Kim, Don-Kyu
    • Journal of Korean Physical Therapy Science
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    • v.16 no.3
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    • pp.29-34
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    • 2009
  • Background: The purpose of this study was to investigate the usefulness of quadriceps exercise for improvement of knee extensor muscular function after cruciate ligament reconstruction. Methods: Participate in 18 of patients with cruciate ligament reconstruction, ACL & PCL reconstruction was 9 of patients, respectively. All subjects instructed that quadriceps exercise repeated daily, composed to QSE(quadriceps femoris setting exercise) and SLR(straight leg raises). Knee extensor muscular function was measured before and after quadriceps exercise. Initial test was measured before cruciate ligament reconstruction, and retest was measured 6month after cruciate ligament reconstruction. Results: Knee extensor muscular function significantly increased in both ACL and PCL reconstruction(P<0.05). Conclusion: The results of this study indicated that quadriceps exercise useful for improve knee extensor muscular function in patients with cruciate ligament reconstruction.

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