• Title/Summary/Keyword: Anterior Cruciate Ligament Reconstruction

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Before and After Cruciate Ligament Reconstruction Comparison of Isokinetic Muscle Strength for Knee Extensor Muscles (십자인대재건술 전과 후의 무릎신전근육에 대한 등속성 근력 비교)

  • Moon, Dal-joo;Kim, Jong-woo;Hwang, Byeong-jun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.2
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    • pp.37-43
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    • 2021
  • Background: The purpose of this study is to compare and analysis the changes in strength and endurance of the knee extensor muscles after Anterior cruciate ligament reconstruction. Methods: Twelve male subjects with ligament injury were seated on Biodex and the hip joint was flexed at 110°, and torso, lower extremities, and legs were fixed using Velcro. The resistance device was placed at a point 3cm above the ankle, and measurements were taken before and a surgery at 60°/sec and 180°/sec when the knee was maximally extended. The postures ingeniously combine forward-bending poses countered with backward-bending ones. Results: There was no significant difference in the comparison of muscle strength of 60°/sec and 180°/sec before surgery. But there was a significant difference after surgery. There was significant difference in muscle endurance both before and after surgery. There was a significant difference in the pre- and post- operative comparison values of muscle strength and endurance in isokinetic movements at 60°/sec and 180°/sec during knee extension on the injured side. Conclusion: For cruciate ligament tears, Orthopedic reconstruction is recommended. Correct alignment of the knee ligament after surgery can enhance the strength and endurance of the quadriceps femoris during knee extension rejuvenated.

Factors Affecting the Extent of Graft Tendon Synovialization after Double-Bundle Anterior Cruciate Ligament Reconstruction: Based on Second-Look Arthroscopic Findings

  • Ahn, Gil Yeong;Nam, Il Hyun;Lee, Yeong Hyeon;Lee, Yong Sik;Choi, Young Duk;Lee, Hee Hyung;Hwang, Sung Hyun
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.413-419
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    • 2018
  • Background: We aimed to examine the factors that influence synovialization of the grafted tendon after double-bundle anterior cruciate ligament (ACL) reconstruction based on second-look arthroscopic findings. Methods: Out of 205 knees that were treated between August 2008 and May 2016 with double-bundle ACL reconstruction using bio-absorbable cross-pins and Endobuttons for femoral tunnel fixation, we enrolled 65 knees (64 patients) that underwent second-look arthroscopy with hardware removal at 1 year postoperatively. Measured clinical outcomes included the Lysholm score and Tegner activity score that were evaluated preoperatively and during the final follow-up. We analyzed the relationship between synovial coverage and patient age, length of the preserved remnant tissue on the tibial side, type of bundle (anteromedial or posterolateral), type of graft (autograft or allograft), and time from injury to surgery. Results: The area of synovial coverage showed a significant statistical correlation with patient age and the length of the preserved remnant tissue on the tibial side. The average synovial coverage was significantly better for the anteromedial bundle than for the posterolateral bundle, better for the autograft than for the allograft reconstruction, and better when treated in the acute stage than in the chronic stage. However, synovialization of grafted tendon did not correlate to clinical outcomes. Conclusions: While we were able to identify several factors influencing synovialization of the grafted tendon after double-bundle ACL reconstruction, including patient age, length of preserved remnant tissue of the torn ACL, type of bundle, type of graft, and time from injury to surgery, we found no evidence that increased synovialization improves clinical outcomes at 1 year postoperatively.

Anterior Cruciate Ligament Reconstruction with a Four-Strand Single Semitendinosus Tendon Autograft (반건양건 단일 4가닥을 이용한 전방십자인대 재건술)

  • Kyung, Hee-Soo;Kim, Tae-Gong;Oh, Chang-Wug;Yoon, Sang-Hyup
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.138-142
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    • 2009
  • Purpose: The purpose of this study was to evaluate the result of anterior cruciate ligament (ACL) reconstruction using a fourstrand single semitendinous tendon to decrease the donor site morbidity due to harvest both semitendinosus and gracilis tendon. Materials and Methods: Thirty seven consecutive patients who had underwent ACL reconstruction using four-strand single semitendinosus tendon were evaluated. Mean age was 28.6 years old. Male was 34, female 3 patients. Time from injury to surgery was 5.4 months. Combined injuries were 10 meniscus injuries, 3 medial collateral ligament injuries and 1 osteochondral injury. Mean follow-up period was 16 months(12~18 months). Clinical evaluation was done using range of motion, Lachman test, pivot-shift test, Lysholm score & KT-2000 arthrometer. Results: All patients showed the normal range of motion of mean 150..at follow-up. Lachman test and pivot-shift test was negative in 35 cases. Lysholm score was improve from 84 to 92. Two cases had residual laxity due to poor compliance. Mean anterior translation compared to contralateral side by KT-2000 arthrometer improved from 6.7 mm preoperatively to 2.1 mm at follow-up. Conclusion: Reconstruction of the anterior cruciate ligament with use of a four-strand single semitendinosus tendon autograft showed good clinical results.

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Endoscopic ACL Reconstruction Using A Quadrupled Semitendinosus Graft (4겹의 반건양근 건을 이용한 전방십자인대 재건술)

  • Lee, Kwang-Won
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.72-80
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    • 1997
  • Numerous techniques of anterior cruciate ligament (ACL) reconstruction have been described in literature. All have inherent advantages and disadvantages. The central one-third patellar tendon and hamstring tendons are the most commonly used autogenous tissues for replacement of a torn anterior cruciate ligament. Although the central one-third patellar tendon is considered to be 'the gold standard' for replacement of torn ACL. equivalent results have been reported using hamstring tendon grafts. Autogenous hamstring grafts provide adequate strength while avoiding donor site morbidity associated with bone-tendon-bone harvest. $EndoButton^{\circledR}$ femoral fixation allows precise femoral tunnel placement without a second incison. The purpose of this article is to describe surgical techniques using a quadrupled semitendinosus tendon and $EndoButton^{\circledR}$ fixation, and review the results of replacement of ACL.

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Exercise Treatment of Knee Joint After Anterior Cruciate Ligament Reconstruction Operation (전방십자인대 재건술 후 슬관절 운동치료 접근에 관한 고찰)

  • Kim, Yeun-Jung;Jung, Jae-Min;Han, Jin-Tae
    • 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.

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Intra-articular Giant Cell Tumor of Tendon Sheath Arising from Posterior Cruciate Ligament - Arthroscopic Excision Using Posterior Trans-septal Portal - (후방 십자 인대에서 발생한 건초성 거대 세포종 - 후격막 통과 도달법을 이용한 관절경적 절제 -)

  • Ahn, Jin Hwan;Seo, Jai Gon;Ha, Chul Won
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.97-100
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    • 1998
  • The giant cell tumor of tendon sheath is very rarely present inside the knee joint. The authors report a case of intraarticular giant cell tumor of tendon sheath arising from posterior cruciate ligament which was successfully excised arthroscopically using posterior trans-septal portal at the time of arthroscopic reconstruction of anterior cruciate ligament.

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Does Second-Generation Suspensory Implant Negate Tunnel Widening of First-Generation Implant Following Anterior Cruciate Ligament Reconstruction?

  • Sundararajan, Silvampatti Ramasamy;Sambandam, Balaji;Singh, Ajay;Rajagopalakrishnan, Ramakanth;Rajasekaran, Shanmuganathan
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.341-347
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    • 2018
  • Purpose: Tunnel widening following anterior cruciate ligament (ACL) reconstruction is commonly observed. Graft micromotion is an important contributing factor. Unlike fixed-loop devices that require a turning space, adjustable-loop devices fit the graft snugly in the tunnel. The purpose of this study is to compare tunnel widening between these devices. Our hypothesis is that the adjustable-loop device will create lesser tunnel widening. Materials and Methods: Ninety-eight patients underwent ACL reconstruction from January 2013 to December 2014. An adjustable-loop device was used in 54 patients (group 1) and a fixed-loop device was used in 44 patients (group 2). Maximum tunnel widening at 1 year was measured by the L'Insalata's method. Functional outcome was measured at 2-year follow-up. Results: The mean widening was 4.37 mm (standard deviation [SD], 2.01) in group 1 and 4.09 mm (SD, 1.98) in group 2 (p=0.511). The average International Knee Documentation Committee score was 78.40 (SD, 9.99) in group 1 and 77.11 (SD, 12.31) in group 2 (p=0.563). The average Tegner-Lysholm score was 87.25 (SD, 3.97) in group 1 and 87.29 in group 2 (SD, 4.36) (p=0.987). There was no significant difference in tunnel widening and functional outcome between the groups. Conclusions: The adjustable-loop device did not decrease the amount of tunnel widening when compared to the fixed-loop device. There was no significant difference in outcome between the two fixation devices. Level of Evidence: Level 3, Retrospective Cohort.

Posterior and Posterolateral Instability of Knee Joint (후방 및 후외측 불안정성 슬관절)

  • Lee, Dong-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.127-136
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    • 2003
  • Posterolateral instability of the knee occurs more commonly in association with an injury to anterior and posterior cruciate ligament and combined injuries are severe injuries that result in significant functional instability and articular cartilage degeneration. Reconstruction of the anterior and posterior cruciate ligament without an appropriate treatment of posterolateral corner injury result in failure of the reconstructed cruciate ligaments. Meticulous physical examinations, imaging studies, lower limb alignment and gait pattern should be evaluated. Acute grade III isolated or combined injury of the posterolateral corner is best treated within three weeks by direct repair, or augumentation, or reconstruction. The appropriate surgical method or combined methods are selected among the several methods of posterior and posterolateal reconstruction, and all injuried posterolateral and cruciate ligament structures are anatomically reconstructed simultaneously or by stages. If a varus alignment and varus thrust is disclosed in chronic posterolateral instability of knee, soft tissue reconstructions laterally are highly unlikely to be able to correct tile problem. It is appropriate that valgus osteotomy should be done before soft tissue reconstruction and reevaluate the posterolateral instability about 6 months later.

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