• Journal of Korean Orthopaedic Sports Medicine
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• 제9권2호
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• pp.91-97
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• 2010

Purpose: The purpose of this study was to evaluate the results of treatment for longitudinal meniscal tear in ACL rupture patients by clinical evaluation and $2^{nd}$ look arthroscopy. Materials and Methods: Among the patients who underwent surgery due to ACL rupture and longitudinal meniscal tear between 2002~2009, 32 patients were selected for the study. The patients were devided into three groups; group 1 had repair, group 2 had partial menisectomy due to impossible to repair, group 3 had conservative treatment due to stable meniscus. Comparative retrospective analysis was applied with KT 1000 arthrometer, Lysolm' score, Tegner activity score, IKDC subjective score, and $2^{nd}$ look arthroscopy. Results: Lysolm' score, Tegner activity score, IKDC subjective score showed no statistical difference in all three groups. KT-1000 side to side difference improved from 6.2, 6.15, 6.38 before surgery to 2.56, 2.49, 2.58 after surgery in group 1, 2, and 3, respectively. In group 1, second-look arthroscopy revealed complete healing in 12 patients, incomplete healing without any clinical symptoms in 2, and healing failure in 1. In group 2, second-look arthroscopy showed partial regeneration on margin of meniscectomy. In group 3, second-look arthroscopy revealed complete healing in 2 patients, while 4 showed incomplete healing so that have repaired. Conclusion: In the study, the outcome was better when the stable longitudinal meniscal tear on posterior horn with ACL rupture had active treatment.

• Journal of the Korean Arthroscopy Society
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• 제8권1호
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• pp.1-8
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• 2004

Purpose: This study examined clinical cure and patients' satisfaction degrees by factors influencing surgical operation results, after arthroscopic inside to out repair as a nonabsorbable suture material, in case of meniscal rupture. Materials and Methods: Materials were 110 cases of 95 patients who could make paces for over 12 months from August 1999 to June 2002. Results were evaluated by clinical cure and subjective satisfaction degrees. This study, concerning those results, analyzed age, term from taking pictures to taking surgical operation, rupture section, rupture length, rupture types, lesion of articular-cartilage, and effects of anterior cruciate ligament operation accompanied. Results: 84 cases(76%) were clinically cured, 98 cases(89%) were subjectively satisfied. In case of accompanying anterior cruciate ligament rupture, and in case that rupture length was below 2 cm, rates of clinical cure and patients subjective satisfaction were significantly high. In case of complex or degenerative rupture, patients satisfaction rates were higher when comparing with clinical cure rates. Conclusion: Various sutures are possible as well as available in case of arthroscopic meniscal inside to out repair using nonabsorbable suture material. It can be concluded that patients age is not absolte consideration in determining the suture of meniscus. In cases of complex rupture, degenerative rupture, ruptures companied by joint-cartilage injuries, considerate consideratin need be paid to choose patients and operations.

• Journal of the Korean Arthroscopy Society
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• 제3권2호
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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 Korean Orthopaedic Sports Medicine
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• 제7권2호
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• pp.95-121
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• 2008

Purpose: The goal is to identify the effectiveness of the IKDC subjective score in the clinical outcome study after reconstruction of the anterior cruciate ligament. Materials and Methods: Twenty-four patients after ACL reconstructions using twelve hamstring autografts and twelve Achilles allografts were evaluated. Lysholm knee score, IKDC subjective score, Knee Outcome Survey score and Tegner activity score were evaluated for the subjective outcome value. Static instability tests, Biodex dynamometer and one-legged hop for distance tests were done for the objective outcome value. Three functional performance tests (FPTs) including Carioca test, Shuttle run test and Co-contraction test were performed for deciding the final results. Each scale was compared with FPTs results and Pearson's correlation test was used to test the correlation between the parameters. Results: IKDC subjective score, single hop test, and quadriceps power in low velocity of Biodex dynamometer tests had a positive correlation with the total FPTs results. Conclusion: IKDC subjective score can be an effective test to evaluate the functional status as well as the subjective outcome after ACL reconstruction.

• Journal of the Korean Arthroscopy Society
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• 제4권1호
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• pp.13-18
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• 2000

Purpose : The purpose of this study was to compare the efficacy of bone-patellar tendon-bone(B-PTB) allograft with autograft B-PTB reconstruction of anterior cruciate ligament(ACL) according to the subjective and objective criteria. Materials and Methods : 42 patients were treated for acute rupture or chronic insufficiency of the ACL between March 1993 and June 1996. There were 18 autografts and 24 allografts for ACL reconstruction. At 2 years of follow-up after operation, autograft and allograft groups were compared based on subjective, objective criteria and Telos stress arthrometer. Results : The modified Feagin Scoring System revealed 16 patients$(88.9\%)$ with a satisfactory result by autografts, but 21 patients$(87.5\%)$ with a satisfactory result by allografts after 2-years follow-lip. There was no statistically significant difference between the two groups. ACL reconstruction with B-PTB allograft did not produce a significant functional deficit. But patellofemoral pain and crepitus were more frequent in the autografts$(33.3\%)$ than allografts$(8.3\%)$ (p<0.05). Conclusion : The ACL deficient knees treated with allografts for ACL reconstruction tended to be better than those reconstructed with autografts fur the reduction of patellofemoral crepitus and pain. B-PTB allograft provides an acceptable alternative to autograft tissue for reconstruction of the ACL.

• Journal of the Korean Arthroscopy Society
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• 제3권1호
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• pp.24-29
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• 1999

Purpose : The purpose of this paper is to analyze the clinical results after meniscal repair using meniscal arrow. Materials and Methods : Between May 1997 and Aug 1998, we repaired 22 tom menisci in 22 patients using meniscal arrows. There were nineteen males and three females with an average age of 27 years. There were longitudinal tear in 14 cases, Bucket-handle tear were 7 cases and horizontal tear was in 1 case. In 22 meniscus tears, 16 cases were associated with anterior cruciate ligament tear. Average number of meniscal arrow that was used were 2.5(ranged 1 to 4). Average follow-up period was 14.7 months(ranged 6 to 22 months). We evaluated the clinical results by the Tapper and Hoover's grading system. Results : There were excellent in 16 cases, good in 4 cases and fair in 2 cases on the clinical results. At the last follow up, the range of the motion of the knee joint were average 135 degrees(ranged 125 to 140 degrees). Mean time elapsed for meniscal repair were 25 minutes(ranged 15 to 40 minutes). Conclusion : Meniscal arrow has many advantages such as short operative time, easy fixation technique, and less neurovascular injury. We think that arthroscopic meniscal repair using meniscal arrow is effective treatment method in selected patient who have longitudinal, bucket-handle tear at the posterior hom associated with anterior cruciate ligament tear.

• Journal of the Korean Arthroscopy Society
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• 제12권1호
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• pp.32-39
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• 2008

Purpose: To evaluate the effectiveness of MRI after ACL reconstruction with femoral tunnel at 10 o'clock position. Materials and Methods: MRI findings of 29 patients after ACL reconstruction using hamstring tendon autograft were evaluated. The mean period from operation to MRI was 18.9 months($7{\sim}40$ months). Signal intensity, morphology and continuity of graft, femoral insertion, graft angle, roof impingement, cross pin breakage and position were evaluated. Those findings were compared with KT-2000, Lysholm knee score and pivot shift test. Results: There was no significant correlation between signal intensity of graft and the duration to MRI. Most common pattern of the morphology was straight, and the continuity was well-preserved. 13 cases of femoral tunnel insertion were zone 4 and 16 were zone 3. There were no roof impingement. 10 cases showed cross pin breakages, of which 5 were found at the outside of distal femoral posterior cortex. 9 showed cross pin directed posteriorly in axial view. There was no significant correlation between clinical results and cross pin breakage. Conclusion: MRI examinations after ACL reconstructions are useful to evaluate the graft status, position of the graft and cross pins. Since the direction of the cross pin is important especially in 10 o'clock femoral position, care should be taken to avoid cross pin breakage.

• Journal of the Korean Arthroscopy Society
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• 제7권2호
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• pp.176-182
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• 2003

Purpose : The purpose of this study is to describe the surgical technique of ACL reconstruction with the flexible reamer and evaluate the clinical results of this method. Materials and Methods : Twenty four patients who followed for 12 months were included. The results were evaluated by Lachman test, KT-2000 arthrometer, Lysholm score, and postoperative roentgenogram of the knee. Results : The range of motion of the affected knee was acceptable except one case(10 to 90 degree) and at the last follow up, two cases were positive in Lachman test. Mean Lysholm knee scoring scale was 63.7 point preoperatively and 91.4 point at the last follow up. The results of KT-2000 arthrometer was 6.6mm preoperatively and 1.5mm at the last follow up. In operative time, there were decrease of mean 13.5 minute than ACL reconstruction without the flexible reamer, Conclusion : ACL reconstruction with the flexible reamer achieves the ideal isometric point of tibia and femur with no difficulty, proper notchplasty preventing from the impingement, and lessens the operative time.

• Journal of the Korean Arthroscopy Society
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• 제7권1호
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• pp.63-69
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• 2003

Purpose : Clinical outcome of meniscal repair fur meniscal injury was examined and the factors affecting the outcome were determined. Materials and Methods : We examined 55 patients with meniscal injury who underwent arthroscopic meniscal repair and could be followed-up for more than 1 year. Clinical outcome according to Tapper & Hoover classification was examined in relation with age, gender, injury site, the presence of bucket-handle tear, method of repair, the period between injury to repair, and the concomitant reconstruction of anterior cruciate ligament. Results : According to Tapper & Hoover classification, the outcome was excellent in 29 cases, good in 23 cases and fair in 3 cases. Age and method of repair have significant relationships with clinical results according to Tapper & Hoover classification, but gender, injury site, the presence of bucket-handle tear, the period between injury to suture, and the concomitant reconstruction of anterior cruciate ligament have no significant relationships. Conclusion : A satisfactory results was obtained in $95\%$ of the patients with meniscal injury with meniscal repair. Age at injury and method of repair have significant relationships with clinical result statistically.

• Journal of the Korean Arthroscopy Society
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• 제13권1호
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• pp.1-7
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• 2009

Purpose: To evaluate the 2 to 4-year follow-up results after arthroscopic anterior cruciate ligament (ACL) reconstruction using transtibial femoral tunnel at 10 or 2 O'clock position. Materials and Methods: Eighty-six ACL reconstructions could be evaluated. Evaluations included 2000 International Knee Documentation Committee (IKDC) subjective knee score, Lachman test, Pivot-shift test, KT-1000 arthrometer measurement, 2000 IKDC knee examination and second-look arthroscopy. Results: Seventy-five patients (87.2%) had over 80 in 2000 IKDC subjective knee score. Eighty-three patients (96.5%) had 1+firm end or negative Lachmann test. Seventy-eight patients (90.7%) had a negative Pivot-shift test. Eighty-three patients (96.5%) had less than 5 mm difference by KT-1000 arthrometer. Eighty patients (93.0%) were normal or nearly normal by 2000 IKDC knee examination. Second-look arthroscopy was done in fifteen cases. Nine cases showed good synovialization, four cases showed partial synovialization, two cases showed poor synovialization and graft failure was noted in one case. Conclusion: ACL reconstruction using transtibial femoral tunnel at 10 or 2 O'clock position resulted in a good outcome in terms of rotatory stability as well as antero-posterior stability.