• Title/Summary/Keyword: ACL Reconstruction

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Results of Conventional and Accelerated Rehabilitation Following ACL Reconstruction (전십자인대 재건술 후 고식적 재활과 적극적 재활의 결과)

  • Lee, Byung-Ill;Min, Kyung-Dae;Choi, Joong-Keun;You, Jae-Eung;Son, Chi-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.132-138
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    • 1997
  • The purpose of this study is to compare the results between conventional and accelerated rehabilitation program following ACL reconstruction using bone-patellar tendon-bone. Conventional rehabilitation focused on protecting the new ligament by blocking terminal extension and avoiding active quadriceps function in the terminal degrees of extension. But there is current trend toward early postoperative mobilization and intensive. so called 'accelerated', rehabilitation stressing hyperextension of the knee. The results of intraarticular ACL reconstruction with conventional and accelerated rehabilitation were prospectively compared for one year postoperatively in a series of 27 patients. Range of motion and thigh circumference were checked preoperatively, and weekly up to 8 weeks, 3 months. 6 months, and 1 year postoperatively. Stress radiologic test, KT-1000 arthrometer. Cybex II dynamometer were checked in preoperatively, and 3 months, 6 months, and 1 year postoperatively. There were no differences of objective stability and restoration of muscle power. But the accelerated group had a low incidence of extension loss. excellent range of motion, and less difference of thigh circumference. We concluded that accelerated rehabilitation program is recommendable due to superiority in terms of range of motion, especially less extension loss without increasing laxity of knee joint.

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Arthroscopic Evaluation for Endoscopic ACL Reconstruction Using a Multi-stranded Hamstring Tendon Graft and EndoButton (슬괵 건을 이용한 전방십자인대 재건술후 2차 관절경적 평가)

  • Lee, Kwang-Won;Lee, Byeong-Ki;Ryu, Chang-Soo;Keum, Teok-Seop;Choy, Won-Sik;Kim, Joon-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.124-128
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    • 1998
  • From Feb. 1996 to Feb. 1997. among sixty-four patients of anterior cruciate ligament(ACL) reconstruction using multi-stranded hamstring tendon and EndoButton fixation, twenty-five patients of volunteer, 15 men and 10 women, from 16 to 50 years of age(mean 27.6 years) underwent arthroscopic evaluation. Arthroscopic evaluation was routinely performed one year after surgery along with an examination of stability. The purpose of this study was to arthroscopically evaluate the morphological changes that occurred in hamstring tendon autograft one year after ACL reconstruction. Both of the tendon graft and the adjacent fibrous tissues were observed for gross appearance and physical properties with probing and response to passive anterior translation. Biopsy samples were taken from the surrounding fibrous tissue and the tendon graft. Grossly, we found a well-defined ligamentous structure with good tension tested with a probe. A common finding was that the reconstructed ligaments were embedded in a layer of the synovium, and blood vessels could be seen on the anterior surface of the ligament. The biopsy tissue was placed in formalin solution and subjected to histological preparation by hematoxylin and eosin staining method. The hamstring tendon graft appeared histologically normal under light microscopic finding. There were a few vessels located between existing collagen bundles, and the vessels had an orderly pattern. The surrounding fibrous tissue envelope was covered with synovium. We pleased with preliminary findings in our evaluation.

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One-stage Revision Anterior Cruciate Ligament Reconstruction Using Achilles Tendon Allograft (동종 아킬레스 건을 이용한 한 단계 전방 십자 인대 재 재건술)

  • Cho, Sung-Do;Ko, Sang-Hun;Park, Moon-Soo;Jung, Kwang-Hwan;Cha, Jae-Ryong;Gwak, Chang-Youl;Eo, Jin
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.159-164
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    • 2006
  • Purpose: To evaluate the clinical stability and function after one-stage revision anterior cruciate ligament (ACL) reconstruction using fresh-frozen Achilles tendon allograft Materials and Methods: Thirteen patients who underwent one-stage revision ACL reconstruction using Achilles tendon allograft could be evaluated. The average time from primary procedure to revision surgery was 61.8 months. The mean follow-up period was 38.4 months. The bone defects of pre-constructed femoral and tibial tunnels were filled with calcaneal bone attached to Achilles tendon and the new femoral and tibial tunnels were created. Evaluations included the causes of failure of primary ACL reconstruction, Lysholm knee score, Lachman test, pivot shift test and KT-1000 arthrometer measurement. Results: The most common causes of failure of ACL reconstruction were poor surgical techniques in 10 cases (76.9%). Ten patients (76.9%) were good or excellent on the Lysholm score. Twelve patients (92.3%) had negative or 1+firm end Lachman test. Eleven patients (84.6%) had negative pivot shift test. Nine patients (69.2%) had less than 3 mm difference of manual maximum by KT-1000 arthrometer. Conclusion: One-stage revision ACL reconstruction with fresh-frozen Achilles tendon allograft, creating new tunnels after filling bone defects, resulted in a reliable and predictable outcome in terms of stability.

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Comparative Study of Arthroscopic ACL Reconstruction Using Bone-Patellar Tendon-Bone Versus Four-Stranded Semitendinosus-Gracilis Tendon (관절경적 전방십자인대 재건술시에 골-슬개건-골과 네가닥 반건양건-박건을 이용한 방법의 비교연구)

  • Kim, Jin Goo;Lim, Young;Kim, Byung Jik;Ko, Han Suk;Moon, Hyung Tae
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.107-113
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    • 1998
  • This study is retrospective analysis of 31 patients treated by arthroscopically assisted ACL reconstruction, from September 1995 to September 1996. ACL reconstructions using autogenous bone patellar tendon bone (B-PT-B) were done in 18 patients, and using hamstring tendon were done in 13 patients. We used four-stranded hamstring tendon grafts and fixed the grafts using Endobutton and screw. The mean postoperative Lysholm knee score was 87.2 points in B-PT-B. group, and 89.0 points in hamstring tendon group. There were no clinically significant results between two groups in Telos test, quadriceps atrophy, Lachman test, anterior drawer test and pivot shift test, but the incidences of anterior knee pain were lower in hamstring group. Four-stranded hamstring tendon graft showed enough stability and good functional outcome similar to that of patellar tendon graft, and had an advantage of quicker return of quadriceps function and less donor site morbidity.

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Comparison between Conservative Treatment of partial ACL Rupture and Reconstructive Surgery with BPTB Autograft in ACL Rupture (전방 십자 인대 파열후 자가 슬개건을 이용한 재건술군과 부분 손상후 보존적 치료군의 비교)

  • Lee Dong Chul;Lee Su Ho;Kim Dong Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.131-137
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    • 2002
  • Purpose: To evaluate and compare the functional results, activity status, and anterior stability between conservative group with partial ACL injury and reconstruction group with bone-patellar ten-don-bone autograft in ACL total rupture. Materials and Methods: Thirty-eight patients with ACL injury were diagnosed and treated with arthroscopy and followed for more than two years. The number of patients with partial injury was 12(mean age; 38.3) and reconstruction group was 26 (mean age; 25.3). Objective stability was estimated under anterior loading of 15 lb and 20 lb by KT-2000 Arthrometer (MED metric, USA). Functional evaluation using Lysholm score and Tegner activity score were performed. Results: Average functional score of Lysholm was 88.5 in partial injury group and 89.3 in reconstruction group. Average score of Tegner was 5.3 in partial injury group and 5.1 in reconstruction group(P<0.05).Average anterior displacement compared with normal side. Under loading of 20lb, 1.7$\pm$4.3 mm in partial injury group, 2.3$\pm$1.9 mm in reconstruction group were anterior displaced (P<0.05). Under loading of 15lb, 1.2$\pm$1.0 mm in partial injury group, 1.4$\pm$1.5 mm in reconstruction group were dis-placed (P<0.05). There were giving way, effusion, instability and anterior knee pain in complication. Giving way was the frequent complication in the partial injury group. Conclusions: Clinical results of both group were similar. Functional evaluation of Lysholm was good and status of Tegner activity was maintained to physical fitness activites (jogging, regular bik-ing) in both groups on average. The results of conservative treatment for the partial ACL injury (less than 50$\%$) was satisfactory and equivalent to that of reconstructive treatment for the total ACL injury.

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Comparison of the Results between Anterior Cruciate Ligament Reconstruction alone and Combined with High Tibial Osteotomy for anterior Cruciate Ligament Ruptured Knees with Varus Alignment (전방 십자 인대 파열과 슬관절 내반 변형 동반시 근위 경골 절골술과 전방 십자 인대 재건술의 동반 치료와 전방 십자 인대 재건술의 단독 치료의 비교)

  • Kwak, Ji Hoon;Sim, Jae Ang;Lee, Yong Seuk;Hwang, Chul Ho;Lee, Beom Koo
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.44-49
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    • 2013
  • Purpose: To compare of the results between anterior cruciate ligament (ACL) reconstruction alone and combined with high tibial osteotomy for ACL ruptured knees with varus alignment. Materials and Methods: We retrospectively reviewed 8 cases of ACL reconstruction combined with high tibial osteotomy (Group I) and 13 cases of ACL reconstruction alone (Group II) for varus angulated ACL ruptured knees (from March 2005 to February 2007). Mean age were 34.1 years (range: 20-53) in Group I, 34.9 years (range: 21-50) in Group II. Average follow up period were 22.6 months (range: 12-35) in Group I, 20 months (range: 13-33) in Group II. We analyzed clinical and radiological results. Results: There were no significant differences in clinical and radiologic results between two groups for IKDC scores, Lysholm knee scores, Lachman test, pivot shift test, KT-2000 arthrometer, $30^{\circ}$ and $90^{\circ}$ anterior drawer stress radiographs. Tegner activity scales and Cincinnati knee ligament rating scales were 4.9, 57.9 in Group I, and 5.6, 72.9 in Group II. Group I was statistically lower than Group II for Tegner activity scales and Cincinnati knee ligament rating scales (p<0.05). Conclusion: There were no significant differences in daily living between ACL reconstruction alone and combined with high tibial ostetomy for varus angulated ACL ruptured knees. However, ACL reconstruction combined with high tibial osteotomy could limit sport activity ability.

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Comparison of ACL Reconstructions using Quadrupled Hamstring tendon Autograft and Tibialis tendon Allograft (자가 슬괵건과 동종 경골건을 이용한 전방십자인대 재건술의 비교)

  • Lee, Kwang-Won;Lee, Seung-Hun;Yang, Dong-Hyun;Kang, Sung-Il;Choy, Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.7-11
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    • 2008
  • Purpose: The purpose of this study was to compare the clinical outcomes of ACL reconstruction using autogenous hamstring tendon and allo-tibialis tendon. Materials and Methods: Between March 2002 and March 2005, We performed 30 ACL reconstuructions using hamstring autograft and 20 ACL reconstuructions using tibialis tendon allograft. The average follow up period was 22 months in auto-hamstring tendon and 18 months in allo-tibialis tendon. For the clinical evaluation, we measured the Lysholm score, International Knee Documentation Committee(IKDC) score and anterior laxity by KT-2000 arthrometer at final follow up and compare the results between two groups. Results: The Lysholm score improved from 69.5 preoperatively, to 95.3 at final follow-up in the hamstring autograft groups and from 69.0 to 90.4 in the tibialis allograft groups. According to the IKDC evaluation form, 80% of autogenous hamstring tendon group and 73% of allograft group were good results, higher than B(almost normal)(p>0.05). The average KT-2000 arthrometer side-to-side difference, decreased from 7.1mm preoperatively, to 1.8mm at final follow-up in the hamstring autograft groups and from 7.4 mm to 2.4mm in the tibialis allograft groups. Conclusion: The clinical results of ACL reconstruction using auto-hamstring tendon and allo-tibialis tendon showed no significant differences. The allo-tibialis tendon is an acceptable substitute for auto-hamstring tendon in ACL reconstruction.

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