• Journal of the Korean Society of Physical Medicine
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• v.3 no.1
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• pp.27-37
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• 2008

Purpose : Today, it enjoys a sports and a leisure where the anterior cruciate ligament(ACL) injury patient increase. The knee joint is important means of human body movement and to do an important duty when it encounters ACL injuries of the knee joint and the many restriction follows in the life which is ordinary. When it is damaged ACL, it comes to determinate that ACL reconstruction and preservation treatment that the according to condition of ligament and knee joint. After ACL reconstruction, that is the fact which already becomes known the exercise treatment advances a recovery and to reduce a sequela. Methods : we researched the method of exercise treatment after anterior cruciate ligament reconstruction operation by journal of science direct and KISS in daecu university. Results : The representative exercise treatment is isometric exercise, isokinetic exercise isotonic exercise and complex exercise but what kind of exercise treatment most is effective, it revealed and support it was not. The method of exercise treatment is very various, so It causes a confusion made to the therapist and patients. So it executes once again it sought the kinetic therapeutic method which is efficient from this research and it tried to observe preceding research after ACL reconstruction. To operation a various the exercise treatments, operation only the treatment which is general compared to it was effective in muscular power and muscle functional improvement. But this like improve despite with the exercise treatment consequence which is continuous from research of most the pain leg compares to the health leg, it appeared the discrepancy which is a muscular power, a muscular endurance and a hypertrophy muscle etc, to the health leg or before operating 100% of muscular power to having gets the many therapy time was the recovery rate. Conclusion : Therefore after ACL reconstruction, it will become the many research continuously which is improve the muscle functional and ROM of the exercise treatment method and From therapeutic site of the patients it does to memorizes knowledge in advance about ACL injuries and the application the isokinetic treatment or exercise program are the set of necessary, frequency and amusement that considers complex what kind of therapeutic exercise becomes accomplished with the patient take care of attention.

• 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.

• Biomaterials and Biomechanics in Bioengineering
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• v.3 no.1
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• pp.27-35
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• 2016

Anterior knee pain is a major problem among adolescents and young adults especially those who participates in sports. The most common pathogenesis of anterior knee pain can arise from compression and shear forces in the patellofemoral joint. It is also caused by impingement of infrapatellar fat pad. Fat pad impingement can occur when the fat pad becomes swollen and inflamed due to a direct blow or chronic irritation. As a result, the bottom tip (or inferior pole) of the patella can pinch the fat pad. One of the many causes of swollen fat pad can be secondary to anterior cruciate ligament (ACL) injury. The aim of this study was to compare the infrapatellar fat pad volume in patients with acute ACL injury and a group of age-, gender-, and activity- matched controls with intact ligament. Axial magnetic resonance (MR) images have been performed on 32 patients with torn ACL and 40 control patients. The volume of the fat pad was measured digitally from MR image by using a 3d Reconstruction software, ellipsoidal approximation, and a MATLAB code. The results were compared between patients with torn ACL and control group. Patients with a torn ACL had a significantly larger fat pad than the controls (P=0.01). There was no significant difference between the methods used to measure the infrapatellar fat pad volume (P=0.83-0.87). Thus, lesions of the infrapatellar fat pad is often associated with ACL injury.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.15-19
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• 2003

Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

• The Journal of Korean Physical Therapy
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• v.14 no.1
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• pp.27-37
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• 2002

This is the study of the knee joint injured patients at the orthopaedic surgery clinic where is located in Daejon, who has MCL combine injured ACL reconstruction caused by sport activity and accident during the period from Jan. 2001 to Oct. 2001. By comparing with groups between 7th case of I-group for MCL combined stitch and II-group for ACL reconstruction since 6weeks cast. We have been concluded with that following results. 1. Range of motion for the knee was not limited at 5th case(37%) of I-group, 6th case(42%) of II-group and the cases of Flexion deficit less then 10 -degree were 2nd case(13%) of I-group and II-group 1st case(8%) with no extension deficit more then 5 -degree. 2. The level of activity that tells you whether you are capable of exercise for six month after operation. It han been divided by 3 levels. The case of capable of doing low risk exercise(swimming, cycling, etc.) was 5th case of I-group, the case of capable of doing medium risk exercise(jogging, etc.) was 3rd case of I-group and 4th case of II-group and the case of capable of doing high risk exercise(football, etc.) were 3rd case of I-group and 3rd case of II-group. 3. The timing of the return to their job were average 6.4 weeks for I-group and average 22.9 weeks for II-group(P<.05, statistical difference). 4. There was no statistical difference between I-group and II-group for the timing of the return to their job(P>.05). 5. By using VAS to compare them there was no statistical difference between I-group and II-group of clinical results according to Lysholm scale.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.1
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• pp.11-20
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• 2008

Purpose : This study was to comparison of EMG of an stable exercise group and unstable exercise group on patients who have had anterior cruciate ligament reconstruction(ACL reconstruction). Methods : The subjects of the study were patients who had no less than 4 weeks after ACL reconstruction and could stand on one leg, and they divided into a control group with 9 patients doing closed kinetic chain exercises on the stable floor and an experimental group with 10 patients doing closed kinetic chain exercises on the unstable floor and in order to compare degrees of the muscle activity of the thigh extensor and flexor was tested each before the exercise, in 3 weeks and 6 weeks after doing exercises by using surface electromyography (Surface EMG). The patients made 3 sets of exercises (10 times per set), each of which consisted of exercises using elastic bands and the squat. Results : There was statistic significance about the vastus medialis muscle. Conclusion : It is thought that the closed-chain exercise could be an exercise program through which patients could enhance the muscle activity of the vastus medialis muscle optionally among the quadriceps muscle and the hamstring muscles which should weaken after ACL reconstruction.

• The Journal of Korean Physical Therapy
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• v.31 no.6
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• pp.339-345
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• 2019

Purpose: The purpose of this study was to identify changes in knee muscle strength after reconstruction of the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). Methods: Thirteen subjects (males) with anterior ligament injury and ten subjects (males) with posterior ligament injury voluntarily participated in this study. Both groups were evaluated at the pre-and post-reconstruction stages using an isokinetic dynamometer. Peak torque, total work, and the hamstrings to quadriceps (H/Q) peak torque ratio were calculated at angular velocities of 60°/sec and 180°/sec. Statistical analysis was conducted on SPSS 18.0 for Windows using t-tests to compare mean differences. Results: At an angular velocity of 60°/sec, both the ACL and PCL groups showed a significant increase in muscle strength in the flexors and extensors. Muscle strength in the extensors was significantly increased in the PCL group compared to the ACL group. At an angular velocity of 180°/sec, the ACL group showed a significant increase in muscle endurance in the flexors and extensors, and the PCL group showed a significant increase in muscle endurance in the flexors. At angular velocities of 60°/sec and 180°/sec, the H/Q peak torque ratio increased in the ACL group but decreased in the PCL group. Consequently, the H/Q peak torque ratio was significantly different for the two groups. Conclusion: The results suggest that the patients with ACL injury should focus on strengthening the knee extensors and that the patients with PCL injury need to strengthen the knee flexors.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.14-25
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• 2021

Several factors need to be considered for a successful anterior cruciate ligament (ACL) reconstruction, such as preoperative planning, operation technique, and postoperative rehabilitation. Graft choice, fixation, preparation method, maturation, incorporation to host bone, and graft tension should also be considered to achieve a good outcome after an ACL reconstruction. Factors to consider when selecting a graft are the graft strength, graft fixation, fixation site healing, and donor site morbidity, as well as the effects of initial strength, size, surface area, and origin of the graft on its potential for weakening during healing. There are two types of graft for an ACL reconstruction, autograft or allograft. Several autografts have been introduced, including the bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon-bone. On the other hand, each has its advantages and disadvantages. The recent increased use of allografts for an ACL reconstruction is the lack of donor site morbidity, decreased surgical time, diminished postoperative pain, and good availability of source. Despite this, there are no reports suggesting that an allograft may have a better long-term outcome than an autograft. Allografts have inherent disadvantages, including a longer and less complete course of incorporation, remodeling, biomechanically inferiority to autograft, the potential risk of an immunogenic reaction and disease transmission. Higher long-term failure rates and poorer graft maturation scores were reported for allografts compared to autografts. An autograft in an ACL reconstruction should remain the gold standard, although the allograft is a reasonable alternative. If adequate length and diameter of autograft can be obtained for an ACL reconstruction, an autograft with adequate graft fixation and postoperative rehabilitation should be chosen instead of an allograft to achieve better results.

• PNF and Movement
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• v.21 no.3
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• pp.291-298
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• 2023

Purpose: This study aimed to suggest an effective exercise for treating anterior cruciate ligament (ACL) and hamstring injuries based on the dynamic control ratio (DCR) for the hamstring and quadriceps during eccentric hamstring exercises. Methods: Twenty-four healthy participants participated in this study. The participants performed three eccentric hamstring exercises, including the Nordic exercise, the supine leg curl, and single-leg deadlifts. During the eccentric hamstring exercises, the vastus medialis oblique (VMO), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) were measured using surface electromyography. Results: The DCR was significantly lower during the supine leg curl and single-leg deadlift than during the Nordic exercise (p < 0.05). The activity of the VMO and VL was significantly greater during the supine leg curl than during the Nordic exercise and the single-leg deadlift (p < 0.05). VL activity was significantly higher during the single-leg deadlift than during the Nordic exercise (p < 0.05). ST activity was significantly higher during the supine leg curl and Nordic exercise than during the single-leg deadlift (p < 0.05). BF activity was significantly higher during the supine leg curl than during the Nordic exercise and single-leg deadlift (p < 0.05). Finally, the BF showed significantly higher activity during the Nordic exercise compared to during the single-leg deadlift (p < 0.05). Conclusion: Based on the DCR ratio and quadriceps activity, the supine leg curl should be introduced early in rehabilitation for ACL injuries.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.92-98
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• 2007

Purpose: We evaluated the clinical results of arthroscopic ACL reconstruction using quadrupled hamstring tendon with tibial remnant-preserving technique. Materials and Methods: Thirty-five cases were evaluated from Feb, 2003 to May, 2006. The average interval from injury to surgery was $2.6{\pm}1.6$ months. The cause of injury was mostly sports-related trauma. The average follow-up period was 17 months. Tibial remnant was preserved as much as possible and caution was taken not to damage the remnant during ACL reconstruction. Postoperative rehabilitation was the same as the usual rehabilitation method after ACL reconstruction, except for delaying motion for 2 weeks with an extension locking brace. Clinical evaluation was performed using ROM; Lachman test; pivot-shift test; anterior displacement measurement using KT-2000 arthrometer; Lysholm score and proprioception measured by single limb standing test. Results: There was no limitation of knee motion without contracture. The Lachman test and pivot-shift test were both negative. The side-to-side difference of anterior displacement measured using KT-2000 arthrometer was improved from 6.7 mm to 2.2 mm. The average Lysholm score improved from 81 to 96. The single limb standing test for proprioceptive evaluation showed no significant difference from a normal leg. Conclusion: ACL reconstruction with tibial remnant-preserving technique can preserve mechanoreceptors with prorioception and expect good functional recovery.